Case report highlights subtle MRI sign of neuroborreliosis

This Clinical Rounds case report describes a 59-year-old man with headache, tremor, and hiccups whose diagnosis of neuroborreliosis was delayed, partly because subtle MRI findings were initially overlooked. The authors state there is emerging recognition that radial and patchy hyperintensities in the cerebral peduncles, mesencephalon, and pons represent a distinct MRI feature of neuroborreliosis, and suggest wider awareness of this pattern could aid more timely diagnosis in future patients.

Most relevant for: Relevant to evaluation of patients presenting with atypical neurological symptoms such as tremor or hiccups where neuroborreliosis or brainstem encephalitis is being considered on MRI.

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