MRI in Lyme disease of the spinal cord

We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebr...

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Bibliographic Details
Published in:Neuroradiology 2001-06, Vol.43 (6), p.485-488
Main Authors: MANTIENNE, C, ALBUCHER, J. F, CATALAA, I, SEVELY, A, COGNARD, C, MANELFE, C
Format: Article
Language:English
Subjects:
Adult
Bacterial diseases
Biological and medical sciences
Borrelia burgdorferi - isolation & purification
Borrelia burgdorferi - pathogenicity
Borrelia infections
Diagnosis, Differential
Human bacterial diseases
Humans
Immunoglobulin M - analysis
Infectious diseases
Lyme Disease - diagnosis
Lyme Disease - pathology
Magnetic Resonance Imaging
Male
Medical sciences
Myelitis - etiology
Myelitis - pathology
Serologic Tests
Tropical bacterial diseases
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Summary:We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case.
ISSN:0028-3940
1432-1920
DOI:10.1007/s002340100583