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Case Reports in Neurological Medicine
Volume 2015, Article ID 389081, 4 pages
http://dx.doi.org/10.1155/2015/389081
Case Report

Stroke as an Unusual First Presentation of Lyme Disease

Department of Neurology, St. Josef Hospital, The Academic Hospital of Duisburg-Essen University, Mülheimer Strasse 83, 46045 Oberhausen, Germany

Received 11 October 2015; Accepted 7 December 2015

Academic Editor: Jorge C. Kattah

Copyright © 2015 Mohamad Almoussa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Lyme neuroborreliosis is a nervous system infection caused by spirochete Borrelia burgdorferi with diverse neurological complications. Stroke due to cerebral vasculitis is a rare consequence of neuroborreliosis and has been described in just a few case reports. Case Presentation. Here, we report the case of a 43-year-old patient who presented with discrete left-sided hemiparesis and amnestic cognitive impairment. Brain magnetic resonance imaging showed a thalamic infarct, and serological and cerebrospinal fluid (CSF) tests confirmed the diagnosis of active neuroborreliosis. The antibiotic treatment with intravenous ceftriaxone for three weeks led to an improvement of the symptoms and remarkable regression of radiological findings, but not to full recovery of the amnestic cognitive disorder. Conclusion. Lyme neuroborreliosis should be suspected in patients with cerebrovascular events without obvious risk factors, especially those living in endemic areas such as northern Europe or those who have been exposed to ticks and those with clinical or radiological findings suggesting Lyme neuroborreliosis, in order to establish the diagnosis and start a proper antibiotic therapy.