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Rigshospitalet - a part of Copenhagen University Hospital
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Lyme Neuroborreliosis in a Patient with Breast Cancer: MRI and PET/CT Findings

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  1. Postembolization Syndrome after Prostatic Artery Embolization: A Systematic Review

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  2. AZGP1 Protein Expression in Hormone-Naïve Advanced Prostate Cancer Treated with Primary Androgen Deprivation Therapy

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  3. Can Computed Tomography Perfusion Predict Treatment Response After Prostate Artery Embolization: A Feasibility Study

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  4. Acute Tentorial Subdural Hematoma Caused by Rupture of the Posterior Cerebral Artery after Minor Trauma-A Case Report

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  1. Cerebellar mutism syndrome in children with brain tumours of the posterior fossa

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  2. Effect of bevacizumab on intracranial meningiomas in patients with neurofibromatosis type 2 - a retrospective case series

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We present a case demonstrating the performance of different radiographical and nuclear medicine imaging modalities in the diagnostic work-up of a patient with Lyme neuroborreliosis. The patient presented in late summer 2019 with radicular pains followed by a foot drop and peripheral facial palsy, both right-sided. Due to a history of breast cancer, disseminated malignant disease was initially suspected. Bone metastasis was ruled out by skeletal scintigraphy. Magnetic resonance imaging (MRI) of the neuroaxis and a whole body 18F-FDG PET-CT was performed within 48 hours. The MRI revealed a strong contrast enhancement of the conus medullaris and fibers of the cauda equina, while the 18F-FDG PET/CT was without pathological findings. Examination of cerebrospinal fluid led to the definitive diagnosis of Lyme neuroborreliosis with monocytic pleocytosis and a positive intrathecal test for Borrelia burgdorferi. The patient became pain-free after 10 days of ceftriaxone, and the paralysis slowly regressed the following month. This case highlights the difficulty of the diagnosis of Lyme neuroborreliosis and discusses the relevant imaging findings.

Original languageEnglish
JournalDiagnostics
Volume10
Issue number1
ISSN2075-4418
DOIs
Publication statusPublished - 9 Jan 2020

ID: 59422283