Lyme Neuroborreliosis in a Patient with Breast Cancer: MRI and PET/CT Findings

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Diagnostics 2020, 10(1), 36;
Received: 6 November 2019 / Revised: 5 January 2020 / Accepted: 6 January 2020 / Published: 9 January 2020
(This article belongs to the Section Medical Imaging)
We present a case demonstrating the performance of different radiographical and nuclear medicine imaging modalities in the diagnostic work-up of a patient with Lyme neuroborreliosis. The patient presented in late summer 2019 with radicular pains followed by a foot drop and peripheral facial palsy, both right-sided. Due to a history of breast cancer, disseminated malignant disease was initially suspected. Bone metastasis was ruled out by skeletal scintigraphy. Magnetic resonance imaging (MRI) of the neuroaxis and a whole body 18F-FDG PET-CT was performed within 48 hours. The MRI revealed a strong contrast enhancement of the conus medullaris and fibers of the cauda equina, while the 18F-FDG PET/CT was without pathological findings. Examination of cerebrospinal fluid led to the definitive diagnosis of Lyme neuroborreliosis with monocytic pleocytosis and a positive intrathecal test for Borrelia burgdorferi. The patient became pain-free after 10 days of ceftriaxone, and the paralysis slowly regressed the following month.
This case highlights the difficulty of the diagnosis of Lyme neuroborreliosis and discusses the relevant imaging findings. View Full-Text



There are numerous important findings within this article but two that glare out like a torch is the fact this patient became PAIN FREE after 10 days of cedtriazone and PARALYSIS regressed within a month due to treatment.

This, my friends, is why TREATMENT IS CRUCIAL for Lyme patients.  It can take a patient who has given up all hope due to excruciating pain and unbelievable symptoms and give them hope again.  This, right here, is why we need to keep pressing in until the medical community understands and values treatment for patients beyond 21 days of doxycycline.  

The question for this patient of course is whether or not the pain and paralysis remain gone or if they suffer a relapse of symptoms, which is very common in patients.  To suffer a relapse logically points to the need for further treatment, something the CDC and mainstream medicine is in denial over.  These studies are not long enough to uncover the relapse issue but relapses are happening all over the world in thousands of patients – most of which suffer due to the inability to get further treatment due to the polarization over the persistent/chronic nature of this illness.

Spread the word!