Cranial nerve involvement with Lyme borreliosis demonstrated by magnetic resonance imaging

Abstract

We report a patient with cranial nerve and meningeal symptoms secondary to Lyme borreliosis. MRI using gadolinium contrast material demonstrated this inflammatory process. The patient did not have the parenchymal lesions described in previous reports of patients with CNS Lyme borreliosis.

Chronic Inflammatory Demyelinating Polyneuropathy with Multiple Hypertrophic Nerves in Intracranial, and Intra- and Extra-Spinal Segments.

“…In our case, cranial nerves V, VI, VII and VIII were thickened, with Gd-DTPAenhancement of the cranial nerves III, V, VI and VIII. The mechanism for enhancement seen with inflammatory processes is considered to be due to breakdown of the blood-nerve barrier (15,16). In 66% of patients with CIDP, a slow monophasic progressive course was observed (17), as seen in our case.…”

Lyme Neuroborreliosis: Manifestations of a Rapidly Emerging Zoonosis

“…18,40,41 Third, fifth, and seventh cranial nerve enhancements have all been reported (Fig 5). 42,43 We have observed enhancement predominantly of the seventh cranial nerve with combined involvement of the fundal tuft and labyrinthine and tympanic segments more than generalized fundal tuft-to-mastoid involvement. The higher incidence of meningoradiculoneuritis (Bannwarth syndrome) in Europe is characterized by specific MR imaging findings of cervical, thoracic, and lumbar nerve root contrast enhancement.…”

Acute infectious disorders of the spinal cord and its roots with gadolinium-DTPA enhancement in magnetic resonance imaging

“…So far only a few cases of neuroborreliosis with cranial nerve involvement, showing enhancement, have been described [25,27], but none with B. burgdorferi-associated polyradiculitis and enhancement of spinal nerve roots. Under physiological conditions the spinal roots do not enhance within the dural sac [38].…”