Neurológia pre prax 5/2013

Transverse myelitis as the only manifestation of neuroborreliosis

The etiology of acute transverse myelitis (ATM) is in most cases parainfectious, less frequently is ATM caused by demyelinating disorders such as multiple sclerosis. The origin can be also infectious, ischemic or idiopathic, but as the only manifestation of neuroborreliosis it represents less than 5% of all cases. The authors present a case report of 62-year old woman, in whom a red exanthema appeared. After 3 weeks she developed radicular pain in lower thoracic and lumbal region radiating along ribs. Subsequently sensory impairment below the Th7 level, sphincter dysfunction and mild spastic paraparesis appeared. In cerebrospinal fluid changes typical for aseptic meningitis were detected and the lyme disease antibodies IgG and IgM in the blood and cerebrospinal fluid were proved. Spinal MRI showed T2 weighted hyperintense lesion at the Th6 level. After 3 weeks of intravenous treatment with ceftriaxon and corticosteroids the clinical state significantly improved and within 4 months the patient fully recovered.

Keywords: neuroborreliosis, transverse myelitis, aseptic meningitis, MRI.