Lyme neuroborreliosis mimics stroke: A case report

Lyme neuroborreliosis is diagnostically challenging because of its diverse manifestations. The well-documented neurologic spectrum includes lymphocyti c meningitis, cranial neuropathy, and radiculoneuritis in the early dissemi nated stage; and peripheral neuropathy, chronic encephalomyelitis, and mild encephalopathy in the late persistent stage. This case report describes a 74-year-old man who developed progressive left hemiparesis and facial palsy . The patient was hospitalized to rule out a cerebral vascular accident. Th e diagnosis of Lyme borreliosis was established with serologic studies. The patient was treated with intravenous ceftriaxone and responded with rapid clinical and functional recovery. Lyme neuroborreliosis presenting as hemip aresis has rarely been reported. Prompt diagnosis and treatment appear to f acilitate symptomatic relief and prevent persistent neurologic deficits.