Acute polyradiculoneuropathy and Lyme disease [Polirradiculoneurite aguda e doença de Lyme-símile]

Abstract

Introduction: In Brazil, the usual pattern of neurological involvement is cranial nerves palsy, meningitis and radiculoneuritis, manifested during the initial phase and an infrequent occurrence of Guillain-Barré syndrome following infection. Objective: Reporting one case and publicizing Lyme disease in our country. Method: Case report of a 30 years old man, hiking in mountain of Mantiqueira, with bilateral facial palsy developing an acute painful polyradiculoneuropathy. He had frequents tick bites. Results: It was protein-citology dissociation in cerebrospinal fluid. Imunological reactions in blood and CSF are positives (IgM) to borrelia. The patient received antibiotic for 30 days and presented a gradual improvement of weakness; after 2 months the imunological tests were negatives. Discussion: Manifestation of bilateral facial palsy, epidemiological history and the unusual presentation of polyradiculoneuropathy raised the diagnosis hypothesis. Conclusion: The clinical suspicion in Brazil is obligatory, even when it doesn't have skin manifestations. © Copyright Moreira Jr. Editora. Todos os direitos reservados.