Thickening of the dura mater T3-T9– incidental finding or manifestation of neuroborreliosis?

The diagnosis of Lyme borreliosis is often based on the peripheral facial paralysis – a common clinical manifestation of Lyme borreliosis in childhood. Ataxia is a rare symptom and mostly manifestation of a later stage of neuroborreliosis. We report on an unusual diagnosis of neuroborreliosis in a previously healthy three-year old girl with acute ataxia. The images of the spinal MRI show a pathological finding a thickening of the dura mater. The diagnosis of a neuroborreliosis in our patient is based on the examination of the cerebrospinal fluid. We treated the young patient with intravenous antibiotics (cefotaxim) and the initial symptom of ataxia disappeared. The reversibility of the dural thickening must be shown in further spinal MRIs. To our knowledge, a spinal tumor with meningeal enhancement caused by neuroborreliosis has rarely been reported. It has to be discussed if both events – dural thickening and neuroborreliosis – are causal or coincidental.