Lymphocytic meningoradiculitis (Bannwarth's syndrome). Neurologic involvement of Lyme disease

We describe a patient with Lyme's disease who showed neurologic symptoms of meningoradiculitis (Bannwarth's syndrome) and had no previous history of exposure to tick bite or chronic erythema migrans. He had longterm fever and bilateral facial paralysis. Antibody titres for Borrelia Burgdorferi in serum and cerebrospinal fluid (CSF) were increased. The CSF changes showed an intrathecal production of immunoglobulins (presence of plasmatic cells and immunoblasts; IgG-CSF: IgG-serum ratio much higher than albumin-CSF: Albumin serum ratio, according to Reiber's diagram; presence of oligoclonal bands). Therapeutic response to high doses of penicillin was resolutive. The second day of treatment the patient developed uveitis, that was treated with corticoids.