Lyme Neuroborreliosis Presenting as Multiple Cranial Neuropathies

Aishwarya Sriram, Samantha Lessen, Kevin Hsu, Cheng Zhang

Research output: Contribution to journalArticlepeer-review


Neuroborreliosis can manifest with cranial nerve (CN) palsies, commonly CN VII. Rarely have isolated or multiple palsies been reported. We describe a case of a young female from a Lyme endemic region who presented with bilateral CN VI palsies and a dilated right pupil, possibly a partial CN III palsy. She later developed CN VII palsy and bilateral enhancement of multiple cranial nerves on neuroimaging. She was diagnosed with Lyme disease by serological testing, with gradual improvement on antibiotics. Our case illustrates that neuroborreliosis can present as any or multiple CN palsies, and should be considered particularly in endemic areas.

Original languageEnglish (US)
Pages (from-to)131-135
Number of pages5
Issue number2
StatePublished - 2022


  • Lyme disease
  • cranial nerve palsy
  • cranial neuropathy
  • neuroborreliosis

ASJC Scopus subject areas

  • Ophthalmology
  • Clinical Neurology


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