{
  "abstract": "Introduction Lyme disease is endemic in the UK, with the highest incidence in Scotland (6.8/100,000). Approximately 5% of cases develop neurological involvement.Methods Data was collected from the Scottish Lyme Disease and Tick-borne Infections Reference Laboratory (2018–2024). Cases from Greater Glasgow and Clyde with CSF-positive Lyme Neuroborreliosis (LNB) were identified, and clinical notes were reviewed.Results Ten cases were identified, aged 27–75. Six patients reported tick bites, but only three recalled an associated rash. Clinical Presentation: 3/10 had 6th Nerve palsy, 3/10 had 7th Nerve palsy (one bilateral), and 3/10 presented with meningoencephalitis. One atypical case involved a pure motor “Man-in-Barrel” syndrome. Bannwarth Syndrome was seen in three patients. All cases had CSF positive for LNB with raised CSF/serum antibody index. Imaging findings varied: 7/10 showed normal/non-specific findings, 2/10 showed nerve enhancement, and one exhibited diffuse pachymeningitis. All patients received IV Ceftriaxone. After a mean follow-up of 22 months, 8/10 reported ongoing symptoms. Most commonly fatigue, poor concentration, and sensory symptoms. One patient required a cross-facial nerve graft for residual facial weakness.Conclusion LNB presentations are highly variable.A high index of suspicion is necessary for any patient with potential tick exposure and neurological symptoms.michaelclark@doctors.org.uk",
  "authors": [
    {
      "affiliations": [
        "Institute of Neurological Sciences, Glasgow"
      ],
      "name": "Clark Michael"
    },
    {
      "affiliations": [
        "Institute of Neurological Sciences, Glasgow"
      ],
      "name": "Nekkare Ramesh"
    }
  ],
  "title": "14 The clinical spectrum of neuroborreliosis: a case series of 10 patients from a single centre",
  "uid": "76bf2ed0-416a-50c9-81e4-6e7d68e2a354"
}