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Lymphocytic meningoradiculitis, known as Garin-Bujadoux-Bannwarth syndrome, [1] is a well-recognized complication of Lyme disease, but the precise pathogenesis is unknown. Lymphocytic meningoradiculitis is a common form of neuroborreliosis in Europe but is infrequent in the United States. The differences in the frequency of this may reflect antigenic variation in the Borrelia species present in North America as opposed to Europe. Treatment of this condition has relied primarily upon antibiotics. The role of immune modulation has not clearly been established, but a recent randomized study [2] shows steroids as efficacious as penicillin in relieving pain in lymphocytic meningoradiculitis. We report a case of Lyme meningoradiculitis presenting as an acute inflammatory demyelinating polyneuropathy (AIDP) that improved following intravenous immunoglobulin (IVIg) without clearance of the organism from the CSF.
Case report.
A 68-year-old retired railway employee residing in a non-endemic area for Lyme disease was referred for abdominal pain and weakness. In early June 1994 he spent 2 weeks camping near Boston. He did not suffer any tick bite or rash. On July 13, 1994, he developed apparent flu-like symptoms and was given antibiotics by his doctor. From July 13 to 20 he was in Philadelphia for a family reunion camping. During this time he took antibiotics. On July 21 he developed upper-quadrant abdominal pain and intense constipation. He was admitted to hospital and considered to have pseudo-obstruction. During the hospital admission he developed …
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