Lyme disease presenting with multiple cranial neuropathies on MRI

Pierre-Philippe Piché-Renaud; Helen Branson; E Ann Yeh; Shaun K Morris

doi:10.1016/j.idcr.2018.04.004

Lyme disease presenting with multiple cranial neuropathies on MRI

IDCases. 2018 Apr 11:12:117-118. doi: 10.1016/j.idcr.2018.04.004. eCollection 2018.

Authors

Pierre-Philippe Piché-Renaud¹, Helen Branson², E Ann Yeh³, Shaun K Morris⁴

Affiliations

¹ Pediatrics Resident, Sainte-Justine Hospital, University of Montreal, Canada.
² Division of Radiology, Hospital for Sick Children, University of Toronto, Canada.
³ Division of Neurology, Hospital for Sick Children, University of Toronto, Canada.
⁴ Division of Infectious Disease, Hospital for Sick Children, University of Toronto, Canada.

Abstract

We present the case of a 10-year old patient from southeastern Ontario with severe bilateral facial palsy. MRI was performed that showed extensive symmetric enhancement of cervical cranial nerve roots and multiple cranial nerves (III, V, VI, VII, VIII, X and XII). Lumbar puncture was performed that revealed pleocytosis and elevated proteins in the cerebrospinal fluid. Serology confirmed the diagnosis of neuroborreliosis. The patient was treated with a 4-week course of IV ceftriaxone, following which he returned to baseline.

Keywords: Cranial neuropathies; Facial nerve palsy; Lyme disease; Neuroborreliosis.