A case of Lyme disease with the triad of neurologic manifestations (meningitis, radiculoneuritis, facial nerve palsy) and dermatitis of the nail roots

Ikuko Murakami, Hideo Hara, Hiroshi Shigeto, Takeshi Yamada, Emiko Isogai, Jun-Ichi Kira

Research output: Contribution to journalArticle

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Abstract

A 23-year-old man experienced dysesthesia of the distal parts of four limbs and spilling of drinking water from the right corner of his mouth. He also experienced low grade fever, headache, and nausea. Neurological examination showed weakness of the right frontal, orbicularis oculi and orbicularis oris muscles, atrophy and weakness of the interosseous muscles in both upper limbs and dysesthesia in the distal parts of four limbs. Lasegue's sign was also positive on the left side. Examination of CSF showed lymphocytic pleocytosis and an increase of total protein. Serum antibody against Borrelia garinii was positive as determined by ELISA. The patient was diag: nosed as a case of Lyme disease. His symptoms were not alleviated by administration of ceftriaxone (2 g/day) for 15 days, and dermatitis of nail roots appeared. Following administration of penicillin G at a high dose (12 million units/day) for 20 days, both neurologic symptoms and dermatitis were alleviated. Since B. garinii was reported to move preferentially toward the sites of low temperature, dermatitis of nail roots may be one of the characteristic features of Lyme disease caused by B. garinii.

Original languageEnglish
Pages (from-to)570-572
Number of pages3
JournalClinical Neurology
Volume39
Issue number5
Publication statusPublished - May 1 1999

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Borrelia burgdorferi Group
Lyme Disease
Facial Paralysis
Facial Nerve
Dermatitis
Nails
Neurologic Manifestations
Meningitis
Paresthesia
Extremities
Penicillin G
Muscular Atrophy
Ceftriaxone
Leukocytosis
Muscle Weakness
Neurologic Examination
Upper Extremity
Drinking Water
Nausea
Headache

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

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A case of Lyme disease with the triad of neurologic manifestations (meningitis, radiculoneuritis, facial nerve palsy) and dermatitis of the nail roots. / Murakami, Ikuko; Hara, Hideo; Shigeto, Hiroshi; Yamada, Takeshi; Isogai, Emiko; Kira, Jun-Ichi.

In: Clinical Neurology, Vol. 39, No. 5, 01.05.1999, p. 570-572.

Research output: Contribution to journalArticle

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