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Lyme disease presenting as a stroke in the vertebrobasilar territory: MRI
1Département de Neurosciences, CHU Henri Mondor, Créteil, France.
Abstract:
A 28-year-old female farmer, without vascular risk factors, developed a limited infarct of the pons, associated with a lymphocytic cerebrospinal fluid (CSF) pleocytosis. Titres of specific antibodies against Borrelia burgdorferi were high in serum and CSF. MRI confirmed an infarct in the territory of the medial pontine arteries, but angiography showed no evidence of cerebral angiopathy. Antibiotic therapy rapidly led to a return to normal of CSF cytology and serology. We suggest that Lyme disease is a possible cause of cerebral ischaemia.
Insights
Lyme disease may cause brain ischemia. A farmer with high Borrelia burgdorferi antibodies experienced a pontine infarct, which resolved with antibiotics, suggesting a link between Lyme disease and stroke.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Cerebral ischemia typically presents without vascular risk factors in younger individuals.
- Lyme disease, caused by Borrelia burgdorferi, is known for diverse neurological manifestations.
Observation:
- A 28-year-old female farmer presented with pontine infarct and lymphocytic cerebrospinal fluid (CSF) pleocytosis.
- Elevated serum and CSF antibodies against Borrelia burgdorferi were detected.
- Cerebral angiography revealed no signs of vasculopathy.
Findings:
- Magnetic Resonance Imaging (MRI) confirmed an infarct in the medial pontine artery territory.
- Antibiotic treatment led to rapid normalization of CSF cytology and serology.
- The patient had no pre-existing vascular risk factors.
Implications:
- This case suggests Lyme disease as a potential cause of cerebral ischemia, particularly in the pons.
- Further research is warranted to explore the mechanisms linking Borrelia burgdorferi infection to ischemic stroke.
- Early diagnosis and treatment of Lyme neuroborreliosis may prevent severe neurological complications.