[Tick bite meningoradiculitis and other neurological aspects of Lyme disease]

In the majority of cases, meningoradiculitis consecutive to tick bite most probably belongs to Lyme disease caused by Borrelia burgdorferi. The disease may be limited to the primary, though inconstant, stage of cutaneous migratory erythema, or it may develop into cardiac and, mostly, neurological disorders. The nervous system involvement, which we observed in 7 patients, mainly consists of peripheral motor neuropathy of moderate severity and sometimes limited to the cranial nerves, associated with very severe radicular pain regularly heralding radicular deficit. Lyme disease predominates in a rural environment, and most patients live near wooded areas where ticks parasitize numerous mammals. The diagnosis, suggested by the socio-environmental context, the clinical features and the results of CSF examination, is confirmed by serology at a 1/256 dilution. Tetracyclines are effective in the initial stage, but intravenous penicillin is necessary in the secondary stage and to reduce the risk of arthritis and also perhaps neuropsychiatric disorders at a late stage.