Neuroborreliosis: the Guillain-Barré mimicker

Tyagi N, Maheswaran T, Wimalaratna S.

BMJ Case Reports, Online first, 2015 Jun 25. 

http://doi.org/10.1136/bcr-2014-209080

Summary

A 34-year-old woman presented to the medical admissions unit with progressive ascending weakness of her limbs and areflexia. Diagnosis of Guillain-Barré syndrome was suspected and she was started on intravenous immunoglobulins. 

Owing to a poor initial response, further exploratory history revealed travel to the New Forest and a possible tick bite; subsequent investigations confirmed positive serology for antibodies against Borrelia. The patient's weakness improved with intravenous ceftriaxone for neuroborreliosis, a manifestation of Lyme disease. 

With inpatient neurorehabilitation, she made good recovery and was able to mobilise with a stick from being completely bed bound 6 weeks after completion of her antibiotics. 

http://doi.org/10.1136/bcr-2014-209080