A case of Borrelia brainstem encephalitis presenting with severe dysphagia

Yuji Kawano, Hiroshi Shigeto, Yoshimasa Shiraishi, Yasumasa Ohyagi, Jun Ichi Kira

研究成果: Contribution to journalArticle査読

1 被引用数 (Scopus)

抄録

We report the case of a 30-year-old man who developed severe dysphagia owing to neuroborreliosis. He showed dysphagia, diplopia, hiccups, and walking difficulty Neurological examination revealed mild disturbance of consciousness, diplopia on left lateral gaze, left-side-dominant blephaloptosis, gaze-evoked horizontal nystagmus on left lateral gaze, mild bilateral muscle weakness, palatoplegia, dysphagia, dysarthria, and truncal ataxia. An increased pharyngeal reflex caused dysphagia in this patient. An EEG revealed intermittent high amplitude slow wave activity. However, head MRI, blood count, serum chemistry, and cerebrospinal fluid examination showed no abnormality. Initially, brainstem encephalitis with unknown etiology was diagnosed. The hiccups, diplopia, and ptosis were improved by corticosteroid therapy, but other symptoms were refractory to corticosteroid therapy and IVIg. After these immunotherapies, anti-Borrelia IgG and IgM antibodies were found to be positive, and symptoms, including dysphagia, were improved by doxycycline and cefotaxime. Because the clinical symptoms of Borrelia infection are widely variable, neuroborreliosis should be considered in patients with brainstem encephalitis refractory to conventional immunotherapies.

本文言語英語
ページ(範囲)265-267
ページ数3
ジャーナルClinical Neurology
50
4
DOI
出版ステータス出版済み - 4 2010

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

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