Facial palsy, enhancement of cranial nerves and Lyme disease

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.