{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:40:01Z","timestamp":1756320001899,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,6]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:p>Early neurological Lyme disease (neuroborreliosis) typically presents with well-recognised neurological syndromes. Spinal myoclonus is however a rare manifestation of neuroborreliosis. We present the case of a man who developed spinal myoclonus 3 weeks after returning from the Czech Republic where he developed erythema migrans on his arm following multiple tick exposures. Spinal fluid analysis showed a pleocytosis and MRI showed enhancement at C5-C6. His serology was positive for IgM antibodies to <jats:italic>Borrelia afzelli<\/jats:italic>. He was successfully treated with ceftriaxone and doxycycline with improvement of his spinal myoclonus and radiculitis. We conclude that early Lyme neuroborreliosis may present with uncommon neurological manifestations and so a high degree of suspicion is needed.<\/jats:p>","DOI":"10.1136\/bcr-2019-233162","type":"journal-article","created":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T04:15:54Z","timestamp":1577679354000},"page":"e233162","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Lyme neuroborreliosis presenting as spinal myoclonus"],"prefix":"10.1136","volume":"12","author":[{"given":"Xena","family":"Li","sequence":"first","affiliation":[{"name":"Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Kirschner","sequence":"additional","affiliation":[{"name":"Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Metrie","sequence":"additional","affiliation":[{"name":"Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2315-5390","authenticated-orcid":false,"given":"Mark","family":"Loeb","sequence":"additional","affiliation":[{"name":"Medicine, McMaster University, Hamilton, Ontario, Canada"},{"name":"Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,29]]},"reference":[{"key":"2025082711064261000_12.12.e233162.1","doi-asserted-by":"publisher","DOI":"10.1086\/508667"},{"key":"2025082711064261000_12.12.e233162.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2015.121"},{"key":"2025082711064261000_12.12.e233162.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2009.11.016"},{"key":"2025082711064261000_12.12.e233162.4","doi-asserted-by":"crossref","DOI":"10.1136\/jnnp.61.4.420","article-title":"Lyme neuroborreliosis presenting with propriospinal myoclonus","volume":"61","author":"de la Sayette","year":"1996","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2025082711064261000_12.12.e233162.5","unstructured":"Turkoglu SA , Sirmatel F , Orallar H , et al . 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