Chorea as a symptom of neuroborreliosis: a case study

Borrelia burgdorferi (Bb) can cause a large number of neurological symptoms . Although extrapyramidal disturbances are rare (representing less than 2% of all neurological complications), diffuse choreic dyskinesias have been d escribed during the course of mild encephalitis. The data published in the literature suggest that there are clinical and neurological analogies betwe en neuroborreliosis and multiple sclerosis (MS). The presence of specific a nti-Bb antibodies in cerebrospinal fluid is a discriminating factor that al lows a diagnosis of neuroborreliosis to be made. We describe the case of a patient with Lyme disease, characterised by widespread chorea and behaviour al disturbances. Emphasis is placed on the atypical onset and evolution, th e difficulties encountered in formulating a diagnosis, and the uncertaintie s concerning the pathophysiology and clinical/neuroradiological correlation s of the disease.