Bibrachial plegia due to Lyme radiculopoliomyelitis-myelitis

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RitaA
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Bibrachial plegia due to Lyme radiculopoliomyelitis-myelitis

Post by RitaA » Wed 28 Jun 2017 6:33

https://www.ncbi.nlm.nih.gov/pubmed/28566141
J Neurol Sci. 2017 Jul 15;378:1-2. doi: 10.1016/j.jns.2017.04.028. Epub 2017 Apr 17.

Bibrachial plegia due to Lyme radiculopoliomyelitis-myelitis.

Akbik F1, Matiello M1, Piquet A2, Cho T1, Cohen A1, Venna N3.

Author information

1 Massachusetts General Hospital, United States; Harvard Medical School, United States.
2 University of Utah, United States.
3 Massachusetts General Hospital, United States; Harvard Medical School, United States.

Abstract

Nervous system involvement occurs in up to 15% of patients with Lyme disease, most commonly manifested as cranial neuropathy, lymphocytic meningitis, and or radiculoneuritis. We describe a patient with subacute radiculopoliomyelitis-myelitis matching the selective involvement of the anterior horns and roots of the cervical spinal cord seen on MRI and on electrodiagnostic studies. We demonstrate positive CSF Lyme antibodies and document a near-complete recovery with antibiotics. This case highlights the importance of recognizing an atypical presentation of Lyme disease in the setting of initial radiculitis and or myelitis, particularly given the potential for favorable outcomes with appropriate treatment.

Copyright © 2017. Published by Elsevier B.V.

KEYWORDS:
Lyme; Myelitis; Neuroborreliosis; Poliomyelitis; Radiculopoliomyelitis-myelitis

PMID:
28566141
DOI: 10.1016/j.jns.2017.04.028
From the full text link:

http://www.jns-journal.com/article/S002 ... 7/fulltext
Highlights

• Although nervous system involvement frequently complicates Lyme disease, transverse myelitis is rare
• Our case report had features of an acute, asymmetric cervical radiculitis followed by a lower-motor-neuron pattern bibrachial paresis with minimal sensory changes
• The presentation was due to a multi-segmental, contiguous, cervical radiculopoliomyelitis-myelitis in the ventral gray matter and nearby long-tracts
Given the propensity for radiculitis, B. burgdorferi may access the central nervous system by tracking along peripheral nerves into the meninges

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