Borrelia burgdorferi: A Rare Cause of Stroke

Lyme disease is the most common tick-borne zoonosis in Europe. It is a multisystemic infectious disease that can produce cerebrovascular events on rare occasions. Here, the authors describe a case of a 58-year-old female patient living in a rural area who presented to the hospital with dysarthria, right central facial paralysis, right hypoesthesia, and severe right hemiparesis. Imaging revealed an infarct in the left corona radiata, posterior limb of the internal capsule, posterior parietal region, and multiple microhemorrhages scattered throughout the cerebral hemispheres. She was hospitalized with the diagnosis of ischemic stroke. Given the absence of known risk factors, the diagnostic workup included a lumbar punction, which showed cerebrospinal fluid serology positive for immunoglobulin M against Borrelia burgdorferi. The patient was treated with doxycycline for 21 days, leading to clinical improvement.