A patient with neuroborreliosis presenting gadolinium-enhanced MRI lesions in bilateral facial nerves

Hideaki Tokunaga, Yasumasa Ohyagi, Hirokazu Furuya, Takehisa Araki, Takeshi Yamada, Emiko Isogai, Jun Ichi Kira

    Research output: Contribution to journalArticlepeer-review

    4 Citations (Scopus)

    Abstract

    We report a 33-year-old man with bilateral facial paralysis due to neuroborreliosis. About three weeks after rhinorrhea and fever lasting four days, he noticed fatigue in the legs and paresthesia in all four extremities. Another week later, he developed paresthesia in his tongue and bilateral facial muscle weakness, and was admitted to our hospital. On admission, neurological examination revealed moderate bilateral facial muscle weakness, mild paresthesia in the tongue and four extremities, and decreased Achilles tendon reflex bilaterally. Mild pleocytosis and increased protein were found in the cerebrospinal fluid (CSF). IgM antibodies that reacted with the antigens of Borrelia garinii and Borrelia afzelii were found in his serum. Clinically and serologically, he was thus diagnosed as having neuroborreliosis. Brain MRI revealed gadolinium-enhanced lesions of the bilateral facial nerves in the facial nerve canal portion. After three weeks of treatment with 100 mg/day doxycycline and 2 g/day ceftriaxone sodium, his symptoms and CSF abnormalities were rapidly improved. Although facial nerve paralysis is a major symptom of neuroborreliosis, the present report is the first to detect the inflammatory lesions of the facial nerves in the facial nerve canal portion by MRI.

    Original languageEnglish
    Pages (from-to)632-634
    Number of pages3
    JournalClinical Neurology
    Volume41
    Issue number9
    Publication statusPublished - 2001 Dec 1

    Keywords

    • Borrelia garinii
    • Enhanced lesion
    • Facial paralysis
    • MRI
    • Neuroborreliosis

    ASJC Scopus subject areas

    • Clinical Neurology

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