Two Cases of Unusual Lyme Infection presenting as Central Nervous System Lyme Disease

Background

Lyme disease is a tick-borne illness caused by a species of the spirochete Borrelia (B. burgdorferi, B. afzelii, B. garinii). The most common manifestation of nervous system Lyme disease is cranial –mostly facial – nerve palsy (Brunner J et al., Klin Padiatr 2010; 222; 302–307). Central nervous system involvement is seen in a minority of the patients as lymphocytic meningitis, whereas encepha­litis is even more rare and usually accompanied by myelitis (Steere et al., N Engl J Med 2001; 345: 115–125). We present 2 cases with an unusual Lyme infection in the central nervous system.