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Bannwarth Syndrome

Bannwarth syndrome, an early form of Lyme neuroborreliosis, presents with lymphocytic meningoradiculoneuritis (thoracic or lumbar) with or without cranial neuritis (cranial nerve VII).1 Early Lyme neuroborreliosis develops weeks to months after inoculation.2 Diagnosis is confirmed by presence of Borrelia-specific antibodies found in the serum and CSF.2 MRI shows spinal nerve root enhancement corresponding to the radicular symptoms.3 Demyelinating polyradiculoneuropathy is seen on nerve conduction studies.3 Intravenous ceftriaxone for 2-4 weeks is highly effective.2 Untreated or inadequately treated cases can progress to chronic neurologic Lyme disease and chronic neuropsychiatric Lyme disease.4


  1. Ogrinc K, Hernández SA, Korva M, et al. Unique clinical, immune, and genetic signature in patients with Borrelial meningoradiculoneuritis. Emerg Infect Dis. 2022;28(4):766–76; doi:10.3201/eid2804.211831
  2. Kaminsky AL, Maisonobe T, Lenglet T, Psimaras D, Debs R, Viala K. Confirmed cases of neuroborreliosis with involvement of peripheral nervous system: Description of a cohort. Medicine (Baltimore). 2020;99(40):e21986; doi:10.1097/MD.0000000000021986
  3. Valand HA, Goyal A, Melendez DA, Matharu SS, Mangat HS, Tu RK. Lyme disease: What the neuroradiologist needs to know. American Journal of Neuroradiology. 2019;40(12):1998-2000; doi:10.3174/ajnr.A6301
  4. Miklossy J. Chronic or late Lyme neuroborreliosis: Analysis of evidence compared to chronic or late neurosyphilis. Open Neurol J. 2012;6:146-57; doi:10.2174/1874205X01206010146

Goel R, Khan F.; e-pearl American Academy of Neurology