Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of Lyme neuroborreliosis without erythema migrans

Katsuki Eguchi, M.D.1), Kazuhumi Tsuzaka, M.D., Ph.D.1), Ichiro Yabe, M.D., Ph.D.2) and Hidenao Sasaki, M.D., Ph.D.2)

1)Department of Neurology, Kushiro Rosai Hospital
2)Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University

A 56-year-old man was sustained ticks at the left axilla and flank. He did not have a rash. About 3 months after the tick bites, he developed back pain, right leg weakness, right abducens nerve palsy, and left facial palsy. Western blot analysis for serum IgM and IgG antibodies against Borrelia were positive. We diagnosed Lyme borreliosis. The patient was treated with antibiotics and steroids, and the symptoms improved. Our findings demonstrate that, even if erythema migrans is not obvious, neuroborreliosis should be considered when neurological signs, such as multiple cranial nerve palsies, are present.
Full Text of this Article in Japanese PDF (485K)

(CLINICA NEUROL, 58: 124|126, 2018)
key words: neuroborreliosis, erythema migrans, cranial nerve palsy, radiculoneuritis

(Received: 20-Nov-17)