ro13-9904 and Blepharoptosis

Topics: Amiodarone; Autoimmunity; Blepharoptosis; Ceftriaxone; Cerebrospinal Fluid; Delayed Diagnosis; Dexamethasone; Emergencies; Female; Fever; Heart Valve Prosthesis Implantation; Humans; Hypoxia; Immunocompetence; Magnetic Resonance Imaging; Meningitis, Pneumococcal; Myelitis; Oxygen Inhalation Therapy; Postoperative Complications; Quadriplegia; Spinal Cord; Streptococcus pneumoniae; Tachycardia; Young Adult

Lyme neuroborreliosis is a frequent cause of facial nerve palsy in children, isolated oculomotor nerve palsy due to Borrelia-associated nervous system infection however is rarely seen. Here we report a case of isolated oculomotor nerve palsy due to a nervous system infection with Borrelia burgdorferi in childhood and restitutio in integrum after intravenous antibiotic therapy.

Topics: Anti-Bacterial Agents; Blepharoptosis; Borrelia burgdorferi; Ceftriaxone; Child, Preschool; Female; Humans; Lyme Neuroborreliosis; Neurologic Examination; Oculomotor Nerve Diseases; Treatment Outcome

Topics: Anti-Bacterial Agents; Blepharoptosis; Ceftriaxone; Diagnosis, Differential; Female; Fibrinolytic Agents; Headache; Heparin; Humans; Jugular Veins; Lemierre Syndrome; Magnetic Resonance Imaging; Middle Aged; Tomography, X-Ray Computed; Treatment Outcome

A 90-year-old woman presented with subacute painless left ptosis. Examination of the left eye revealed ptosis with loss of the superior eyelid sulcus, 2 mm of proptosis, mild tenderness with retropulsion, and optic disc edema. Levator function and extraocular movements were normal, and there was no relative afferent pupillary defect. MRI demonstrated thickening of the extraocular muscles in the left orbit with lacrimal gland enlargement and mild enhancement of the optic nerve sheath. Serology revealed a positive enzyme-linked immunosorbent assay for Lyme antibodies and a positive Western blot of Lyme IgG titer. The patient recalled a tick bite 6 months earlier, at which time Lyme serologies were negative. After 3 weeks of intravenous ceftriaxone, she had a significant improvement and a full recovery by 3 months. Lyme disease should be included in the differential diagnosis of orbital inflammation, especially in Lyme-endemic areas.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Blepharoptosis; Ceftriaxone; Female; Functional Laterality; Humans; Inflammation; Lyme Disease; Magnetic Resonance Imaging; Orbit