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Lyme disease presenting with multiple cranial neuropathies on MRI
Pierre-Philippe Piché-Renaud1, Helen Branson2, E Ann Yeh3
1Pediatrics Resident, Sainte-Justine Hospital, University of Montreal, Canada.
Idcases
|June 27, 2018
Summary
A pediatric case of neuroborreliosis presented with severe facial palsy. Diagnosis was confirmed via MRI and cerebrospinal fluid analysis, with full recovery after IV ceftriaxone treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Neuroborreliosis, a Lyme disease manifestation, can affect the nervous system.
- Facial palsy is a recognized neurological symptom of Lyme disease.
Purpose of the Study:
- To report a pediatric case of neuroborreliosis presenting with severe bilateral facial palsy.
- To highlight diagnostic findings and treatment outcomes.
Main Methods:
- Case presentation of a 10-year-old patient.
- Magnetic Resonance Imaging (MRI) of the brain and spine.
- Cerebrospinal fluid (CSF) analysis via lumbar puncture.
- Serological testing for Borrelia burgdorferi.
Main Results:
- Severe bilateral facial palsy was the primary symptom.
- MRI revealed enhancement of cranial and cervical nerve roots.
- CSF analysis showed pleocytosis and elevated protein levels.
- Serology confirmed neuroborreliosis.
Conclusions:
- Neuroborreliosis should be considered in pediatric cases of facial palsy, especially in endemic areas.
- Multimodal diagnostic approach including MRI and CSF analysis is crucial.
- Prompt treatment with intravenous antibiotics leads to favorable outcomes.
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