Lyme disease involves multiple organ systems including in 10-15 % of cases,
the nervous system. Cranial neuropathies are observed in the second stage
of the disease. The facial nerve is the most frequently affected nerve (20-
30%). Facial nerve enhancement may be associated with cochleovestibular ner
ve abnormalities and can mimick an intracanalicular pseudomass. We present
post-gadolinium enhancement of multiple cranial nerves associated to an int
racanicular enhancement illustrated in a patient referred for a facial nerv
e palsy and presenting a Lyme disease. We discuss the differential diagnosi
s.