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

References:

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

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