Yuka Shirai, Yumiko Uchiyama, Masaki Kobayashi, Eiichi Ito, Shinichiro Uchiyama, Yuko Shimizu, Kazuo Kitagawa Department of Neurology, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan
2018
http://mathewsopenaccess.com/PDF/Neurol ... _1_009.pdf
ABSTRACT
A 53-year-old man presented with bilateral foot drop. His lower-extremity weakness predominantly affected the distal right limb. He presented hypercreatine kinasemia and high antibody titer for Borrelia species (spp). The nerve conduction study and needle electromyography suggested active neurogenic findings, indicating motor neuropathy. The gastrocnemius muscle biopsy showed scattered fiber necrosis and inflammatory cell infiltration, representing myositis. After administration of minocycline, Borrelia spp antibodies became negative. Symptoms gradually improved with repeated intravenous immunoglobulin administration. This is a very rare case of post-Lyme disease syndrome involving motor neuropathy and myositis, which represents an immune-mediated reaction to Borrelia spp infection
INTRODUCTION
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However, the pathogenesis of PLDS remains unknown. Some reports have described cases of PLDS associated with myositis and neuropathy [2]. Thus,, patients with other conditions may be included [3]. However, we provide the first report of chronic motor axonal neuropathy and myositis without acute symptoms of Lyme disease in a patient with PLDS.
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This suggests that an immune-mediated response to Lyme disease caused motor axonal polyneuropathy […..]