Isolated fascicular abducens nerve palsy and Lyme disease.
A patient with Lyme disease developed an isolated sixth nerve palsy at the end of a 1 month course of oral antibiotics. Magnetic resonance imaging disclosed high-signal abnormality at the left pontomedullary junction, implicating involvement of the distal sixth nerve fascicle. Although facial numbness ensued during a subsequent course of intravenous antibiotics, corticosteroid therapy was associated with prompt improvement of neurologic signs, suggesting an immunologic mechanism for the central nervous system dysfunction.
Mastrianni
J A
JA
Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Galetta
S L
SL
Raps
E C
EC
Liu
G T
GT
Volpe
N J
NJ
D000010:Abducens Nerve; D000328:Adult; D005207:Fasciculation / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008193:Lyme Disease / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000209:etiology*