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Locked-in state in Borrelia burgdorferi meningitis

A Merlo1, B Weder, E Ketz

  • 1Department of Neurology, Kantonsspital, St. Gallen, Switzerland.

Insights

This case study details a young woman with persistent tetraplegia after Lyme disease meningitis. Vasculitis affecting the basilar artery likely caused pontine infarction, leading to severe neurological deficits.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Vascular Medicine

Background:

  • Lyme disease, caused by Borrelia burgdorferi, can present with neurological complications.
  • Meningitis is an inflammation of the membranes surrounding the brain and spinal cord.

Observation:

  • A 28-year-old woman developed persistent tetraplegia after acute meningitis.
  • She initially presented with erythema chronicum migrans, followed by radicular pain.
  • The patient's condition worsened, indicating a severe neurological event.

Findings:

  • The clinical outcome suggested pontine infarction.
  • This infarction was attributed to vasculitis affecting branches of the basilar artery.
  • The vasculitis was a complication of Borrelia burgdorferi meningitis.

Implications:

  • This case highlights a rare but severe neurological complication of Lyme disease.
  • It underscores the importance of recognizing vasculitis as a potential cause of infarction in neuroborreliosis.
  • Early diagnosis and treatment of Borrelia burgdorferi infection are crucial to prevent devastating outcomes.

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