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.
Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia 19104.
J A
JA
Mastrianni
S L
SL
Galetta
E C
EC
Raps
G T
GT
Liu
N J
NJ
Volpe
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*