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Case Reports
. 2021 Sep 28;13(4):487-496.
doi: 10.3390/neurolint13040048.

Lyme Disease and Associated NMDAR Encephalitis: A Case Report and Literature Review

Natalja Predkele  1   2   3 , Jānis Mednieks  1   2
Affiliations
Case Reports

Lyme Disease and Associated NMDAR Encephalitis: A Case Report and Literature Review

Natalja Predkele et al. Neurol Int. .

Abstract

We present a case of a patient with positive N-methyl-D-aspartate receptor (NMDAR) IgG antibodies in their serum and cerebrospinal fluid (CSF) associated with neuroborreliosis. Clinically, the patient presented with symptoms of confusion, as well as behavioral and speech impairments. Regardless of antibacterial treatment, no significant improvement was achieved. Methylprednisolone provided a marked improvement in the patient's clinical signs and CSF findings. The screening did not reveal any underlying neoplasm. Taking into account the marked clinical improvement after treatment with glucocorticosteroids, we suggest that NMDAR encephalitis is a possible autoimmune complication in neuroborreliosis patients requiring additional immunotherapy.

Keywords: Lyme disease; NMDAR antibodies; NMDAR encephalitis; autoimmune encephalitis; neuroborreliosis.

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Conflict of interest statement

The authors declare no conflict of interest.

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