Brainstem encephalitis in neuroborreliosis: typical clinical course and distinct MRI findings

Objective In this retrospective observational study and referring to a historical case presented in 2009, we searched for typical clinical and imaging features of brainstem encephalitis in neuroborreliosis. Methods In addition to the historical case we describe five affected patients. Results All patients had a very similar prolonged clinical course with unspecific symptoms such as wasting, fatigue and headache. Brainstem signs were irregularly observed. MRI showed symmetrical brainstem alterations in all patients. In coronary FLAIR imaging these changes formed a figure resembling a Philippine tarsier. Conclusions A subset of patients with neuroborreliosis develops a brainstem encephalitis with a typical clinical course and distinct MRI findings.

Automated summary

In this study, typical clinical and imaging features of brainstem encephalitis in neuroborreliosis were identified through a retrospective observational analysis with reference to a historical case from 2009. The patients exhibited prolonged clinical course with unspecific symptoms like wasting, fatigue, and headache, along with irregularly observed brainstem signs and symmetrical brainstem alterations on MRI, forming an image resembling a Philippine tarsier in FLAIR imaging. A subset of neuroborreliosis patients were found to develop brainstem encephalitis with distinct clinical course and MRI findings.