Acute Transverse Myelitis as a Main Manifestation of Early Stage II Neuroborreliosis in Two Patients

Acute neuroborreliosis with involvement of the central nervous system

“…Acute NB presenting with dramatic and fulminating involvement of the central nervous system has rarely been reported [10,[27][28][29]. Acute CNS parenchymal involvement in the cerebrum, brain stem or spinal cord combined with acute or subacute polyradiculopathy simultaneously in the disease course such as encephalomyelitis, myelitis, radiculomyelitis or meningoradiculomyelitis, as the primary manifestations of NB were the most interesting and characteristic features in our reported patients.…”

“…Diversity of molecular and immunological characteristics among isolates of B. burgdorferi sensu lato from different endemic regions has been previously demonstrated [5][6][7][8][9] and the clinical presentation of NB has been found to differ in Europe and the United States [2][3][4]10]. In Europe, meningopolyradiculoneuritis with facial palsy, caused by Borrelia garinii or Borrelia afzelii, is the most common manifestation of acute NB [4,10,11].…”

“…In Europe, meningopolyradiculoneuritis with facial palsy, caused by Borrelia garinii or Borrelia afzelii, is the most common manifestation of acute NB [4,10,11]. Subacute aseptic meningitis, caused by B. burgdorferi sensu stricto, is the most common presentation in the US [4,11].…”

Poliomyelitis-like syndrome with matching magnetic resonance features in a case of Lyme neuroborreliosis

“…Three sequential clinical stages have been described: (i) early localised; (ii) early disseminated; and (iii) late persistent disease. Lyme neuroborreliosis may occur during the early dissemination phase, most often as a painful meningo-radiculitis and very rarely as a radiculo-myelitis, whereas encephalomyelitis is observed in the late phase 2. We report the case of a patient with an early subacute poliomyelitis-like syndrome closely matching the selective involvement of the anterior horns and roots of the cervical spinal cord seen on magnetic resonance (MR) imaging.…”

“…Recently, eight documented cases of early subacute Bb myelitis have been reported 2. In six of these cases, painful radicular symptoms appeared before spinal cord signs.…”