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Brainstem encephalitis in neuroborreliosis: typical clinical course and distinct MRI findings

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Abstract

Objective

In this retrospective observational study and referring to a historical case presented in 2009, we searched for typical clinical and imaging features of brainstem encephalitis in neuroborreliosis.

Methods

In addition to the historical case we describe five affected patients.

Results

All patients had a very similar prolonged clinical course with unspecific symptoms such as wasting, fatigue and headache. Brainstem signs were irregularly observed. MRI showed symmetrical brainstem alterations in all patients. In coronary FLAIR imaging these changes formed a figure resembling a Philippine tarsier.

Conclusions

A subset of patients with neuroborreliosis develops a brainstem encephalitis with a typical clinical course and distinct MRI findings.

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Acknowledgements

We would like to thank Professor Dr. Rafe M. Brown, Department of Ecology and Evolution of the University of Kansas, Lawrence for permission to use his picture of the Philippine tarsier.

Author information

Authors and Affiliations

  1. Department of Neurology, Klinikum Ingolstadt, Krumenauerstrasse 25, 85049, Ingolstadt, Germany

    Thomas Pfefferkorn

  2. Department of Neurology, Asklepios Klinik Altona, Hamburg, Germany

    Joachim Röther

  3. Institute of Radiology and Neuroradiology, Asklepios Klinik Altona, Hamburg, Germany

    Bernd Eckert

  4. Institute of Radiology and Neuroradiology, Klinikum Ingolstadt, Ingolstadt, Germany

    Hendrik Janssen

Authors
  1. Thomas Pfefferkorn
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  2. Joachim Röther
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  3. Bernd Eckert
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  4. Hendrik Janssen
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Contributions

TP analyzed the data; drafted the manuscript for intellectual content. JR major role in the acquisition of data; revised the manuscript for intellectual content. BE major role in the acquisition of data; revised the manuscript for intellectual content. HJ major role in the acquisition of data; created the figures; revised the manuscript for intellectual content.

Corresponding author

Correspondence to Thomas Pfefferkorn.

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Conflicts of interest

None.

Ethics approval

Our regional review board (state medical association of Bavaria, Germany) informed us that formal ethical approval and patient consent are not necessary for this retrospective and anonymous analysis of cases with completed treatment.

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Pfefferkorn, T., Röther, J., Eckert, B. et al. Brainstem encephalitis in neuroborreliosis: typical clinical course and distinct MRI findings. J Neurol 268, 502–505 (2021). https://doi.org/10.1007/s00415-020-10188-9

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  • DOI: https://doi.org/10.1007/s00415-020-10188-9

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