LYME NEUROBORRELIOSIS MASQUERADING AS A BRAIN-STEM TUMOR IN A 15-YEAR-OLD

A 15-year-old boy had onset of unilateral facial weakness. A few days later, he experienced mild vertigo, double vision, and headache. Exami nation confirmed a peripheral right seventh nerve weakness in addition to an internuclear ophthalmoplegia, The neurologic features suggested a pontine glioma. A T-2-weighted MRI scan revealed demyelinating lesi ons in the pens and in several areas of the cerebrum, including the pe riventricular region. Subsequent history revealed that he had been dia gnosed with Lyme arthritis 7 years earlier while living in Connecticut . The radiographic studies favored a diagnosis of multiple sclerosis. However, studies of blood and cerebrospinal fluid established a diagno sis of Lyme neuroborreliosis. (C) 1996 by Elsevier Science Inc. All ri ghts reserved.