MRI in Lyme disease of the spinal cord

Neuroradiology. 2001 Jun;43(6):485-8. doi: 10.1007/s002340100583.


We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Borrelia burgdorferi / isolation & purification*
  • Borrelia burgdorferi / pathogenicity
  • Diagnosis, Differential
  • Humans
  • Immunoglobulin M / analysis
  • Lyme Disease / diagnosis
  • Lyme Disease / pathology*
  • Magnetic Resonance Imaging
  • Male
  • Myelitis / etiology*
  • Myelitis / pathology*
  • Serologic Tests


  • Immunoglobulin M