Lyme disease presenting as acute ischemic strokes with an embolic pattern

Abstract

Ischemic stroke due to Lyme disease is considered a rare entity. We report a 76-year-old woman who presented with acute ischemic strokes with an embolic pattern. Her clinical course was challenged by pseudo-elevation of autoimmune antibodies and atypical radiological findings, which were unique to this case. Lymphocytic pleocytosis in cerebrospinal fluid and positive Lyme antibodies were compatible with the Lyme neuroborreliosis (LNB). LNB-associated vasculopathy should be considered in patients presenting with acute ischemic strokes with an embolic pattern of undetermined etiology, especially in those who live in or have come from areas with high prevalence of tick-borne diseases.

Keywords

• Lyme disease
• Ischemic stroke
• Lyme neuroborreliosis-associated vasculopathy