Purpose: To describe the neuroimaging manifestations of Lyme disease at magnetic resonance (MR) imaging of the brain.
Materials and methods: Institutional review board approval was obtained and HIPAA compliance was followed. This study retrospectively reviewed the MR imaging findings of all patients seen from 1993 to 2007 in whom neuro-Lyme disease was suspected and who were referred for MR imaging of the brain for the evaluation of neurologic symptoms.
Results: Of 392 patients suspected of having neuro-Lyme disease, 66 patients proved to have the disease on the basis of clinical criteria, serologic results, and response to treatment. Seven of these 66 patients showed foci of T2 prolongation in the cerebral white matter, one had an enhancing lesion with edema, and three demonstrated nerve-root or meningeal enhancement. Of the seven patients with foci of T2 prolongation in the white matter, three were an age at which white matter findings due to small-vessel disease are common.
Conclusion: In cases of nerve-root or meningeal enhancement, Lyme disease should be considered in the differential diagnosis in the proper clinical setting.