American neuroborreliosis presenting as cranial polyneuritis and radiculoneuritis

Lyme disease is a tickborne illness caused primarily by Borrelia burgdorferi in the United States. CNS involvement typically manifests as 1 or a combination of 3 classic syndromes: meningitis, radiculoneuritis, and cranial neuritis. While facial nerve involvement represents about 80% of cranial neuritis in Lyme neuroborreliosis (LNB), other cranial nerves may also be individually involved; however, multiple cranial nerve involvement is unusual. We report a case of LNB with simultaneous involvement of the third, fifth, sixth, and seventh cranial nerves in addition to cervical and thoracic radiculoneuritis.