» Articles » PMID: 39867056

Unveiling Lyme Neuroborreliosis in the Absence of Dermatological Symptoms

Overview
Journal Cureus
Date 2025 Jan 27
PMID 39867056
Authors
Affiliations
Soon will be listed here.
Abstract

Lyme neuroborreliosis can present with isolated neurological manifestations, posing diagnostic challenges, especially in the absence of hallmark dermatological symptoms like erythema migrans. This case highlights a patient with isolated cervical radiculopathy due to Lyme neuroborreliosis, presenting without systemic features such as fever, arthralgia, or rash. The diagnosis was confirmed through serological testing, with positive findings on the Western blot. Comparisons with reported cases, including isolated urinary retention, bilateral neurosensory hearing loss, and Bannwarth syndrome, reveal the clinical heterogeneity of Lyme neuroborreliosis. Elevated inflammatory markers, tick exposure, and serological findings remain crucial for diagnosis. This case emphasizes the importance of clinical vigilance in endemic areas, as timely recognition and treatment are essential to prevent long-term complications.

References
1.
Marques A, Okpali G, Liepshutz K, Ortega-Villa A . Characteristics and outcome of facial nerve palsy from Lyme neuroborreliosis in the United States. Ann Clin Transl Neurol. 2022; 9(1):41-49. PMC: 8791801. DOI: 10.1002/acn3.51488. View

2.
Marques A, Strle F, Wormser G . Comparison of Lyme Disease in the United States and Europe. Emerg Infect Dis. 2021; 27(8):2017-2024. PMC: 8314816. DOI: 10.3201/eid2708.204763. View

3.
Junttila J, Peltomaa M, Soini H, Marjamaki M, Viljanen M . Prevalence of Borrelia burgdorferi in Ixodes ricinus ticks in urban recreational areas of Helsinki. J Clin Microbiol. 1999; 37(5):1361-5. PMC: 84776. DOI: 10.1128/JCM.37.5.1361-1365.1999. View

4.
Miklossy J . Chronic or late lyme neuroborreliosis: analysis of evidence compared to chronic or late neurosyphilis. Open Neurol J. 2013; 6:146-57. PMC: 3551238. DOI: 10.2174/1874205X01206010146. View

5.
Diaz M, Wesley S . Meningoradiculitis and transaminitis from neuroborreliosis: A case of variant Bannwarth syndrome. Clin Neurol Neurosurg. 2019; 186:105532. PMC: 8057864. DOI: 10.1016/j.clineuro.2019.105532. View