Lyme neuroborreliosis presenting as spinal myoclonus. Issue 12 (29th December 2019)

• Record Type: Journal Article
• Authors: Li, Xena; Kirschner, Aaron; Metrie, Mary; Loeb, Mark
• Is Part Of: BMJ case reports. Volume 12:Issue 12(2019)
• Publication Date: 2019-12-29
• Subjects: infections -- neurology (drugs and medicines) -- infection (neurology); Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2019-233162
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Early neurological Lyme disease (neuroborreliosis) typically presents with well-recognised neurological syndromes. Spinal myoclonus is however a rare manifestation of neuroborreliosis. We present the case of a man who developed spinal myoclonus 3 weeks after returning from the Czech Republic where he developed erythema migrans on his arm following multiple tick exposures. Spinal fluid analysis showed a pleocytosis and MRI showed enhancement at C5-C6. His serology was positive for IgM antibodies to Borrelia afzelli . He was successfully treated with ceftriaxone and doxycycline with improvement of his spinal myoclonus and radiculitis. We conclude that early Lyme neuroborreliosis may present with uncommon neurological manifestations and so a high degree of suspicion is needed.