Clinical Short Communication| Volume 378, P1-2, July 15, 2017

Bibrachial plegia due to Lyme radiculopoliomyelitis-myelitis

Published:April 17, 2017DOI:


      • Although nervous system involvement frequently complicates Lyme disease, transverse myelitis is rare
      • Our case report had features of an acute, asymmetric cervical radiculitis followed by a lower-motor-neuron pattern bibrachial paresis with minimal sensory changes
      • - The presentation was due to a multi-segmental, contiguous, cervical radiculopoliomyelitis-myelitis in the ventral gray matter and nearby long-tracts
      • Given the propensity for radiculitis, B. burgdorferi may access the central nervous system by tracking along peripheral nerves into the meninges


      Nervous system involvement occurs in up to 15% of patients with Lyme disease, most commonly manifested as cranial neuropathy, lymphocytic meningitis, and or radiculoneuritis. We describe a patient with subacute radiculopoliomyelitis-myelitis matching the selective involvement of the anterior horns and roots of the cervical spinal cord seen on MRI and on electrodiagnostic studies. We demonstrate positive CSF Lyme antibodies and document a near-complete recovery with antibiotics. This case highlights the importance of recognizing an atypical presentation of Lyme disease in the setting of initial radiculitis and or myelitis, particularly given the potential for favorable outcomes with appropriate treatment.


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