RT Journal Article
SR Electronic
T1 Lyme neuroborreliosis presenting as spinal myoclonus
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e233162
DO 10.1136/bcr-2019-233162
VO 12
IS 12
A1 Xena Li
A1 Aaron Kirschner
A1 Mary Metrie
A1 Mark Loeb
YR 2019
UL http://casereports.bmj.com/content/12/12/e233162.abstract
AB 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.