Opsoclonus and multiple cranial neuropathy as a manifestation of neuroborreliosis

Abstract

Neuroborreliosis can manifest with virtually any combination of central and peripheral neurologic symptoms, including the rare opsoclonus-myoclonus syndrome (OMS).1,–,3 In this report, we present a patient with opsoclonus without myoclonus, due to active neuroborreliosis, accompanied by a video registration. ### Case report. A previously healthy 50-year-old man consulted his general practitioner for a painful red right eye, present since 3 days, and diffuse unilateral headache since approximately 6 weeks. On physical examination, a right-sided conjunctivitis and irregularly jerking, gaze-evoked nystagmus-like conjugated movements of both eyes were noticed. One week later, the patient woke up with a right-sided drooping mouth and eyelid. He was referred to our clinic. The patient had not experienced involuntary jerky movements of his limbs, nor oscillopsia or diplopia. His headache was not accompanied by any other symptoms. The patient lived in the north of the Netherlands and had recently been on holiday in the south of Germany, both areas endemic for Lyme disease. However, he could …