title: Lyme disease of the brainstem.
abstract: Lyme disease is a multisystem infectious disease caused by the tick-borne spirochete, Borrelia burgdorferi. Central nervous system (CNS) involvement typically causes local inflammation, most commonly meningitis, but rarely parenchymal brain involvement. We describe a patient who presented with clinical findings suggesting a brainstem process. Magnetic resonance imaging (MRI) and positron emission tomography (PET) suggested a brainstem neoplasm. Prior to biopsy, laboratory evaluation led to the diagnosis of Lyme disease. Clinical and imaging abnormalities improved markedly following antimicrobial therapy. We describe Lyme disease involvement of the cerebellar peduncles with hypermetabolism on PET. Although MRI is the primary imaging modality for most suspected CNS pathology, the practical applications of PET continue to expand.
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA. kalina.peter@mayo.edu
authors.forename: Peter
authors.initials: P
authors.lastname: Kalina
authors.forename: Andrew
authors.initials: A
authors.lastname: Decker
authors.forename: Ezriel
authors.initials: E
authors.lastname: Kornel
authors.forename: John J
authors.initials: JJ
authors.lastname: Halperin
mesh_terms: D000328:Adult; D002528:Cerebellar Neoplasms / Q000175:diagnosis; D002531:Cerebellum / Q000382:microbiology* / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008193:Lyme Disease / Q000150:complications*; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18