Acute Transverse Myelitis and Lyme Disease: A Case Study

Dr. Cameron believes one of the best ways to understand Lyme disease is by reviewing real clinical cases. In this Inside Lyme Podcast episode, he discusses a 25-year-old man diagnosed with acute transverse myelitis associated with Lyme disease.

This case was first reported by Dumic and colleagues in the journal IDCases in 2019.

The authors described “a previously healthy 25-year-old man who presented with inability to urinate and frequent falls associated with bilateral lower-extremity weakness and numbness.”

His condition worsened as weakness in both legs progressed and his gait became increasingly unstable.

MRI imaging revealed inflammation of the spinal cord consistent with myelitis. A spinal tap demonstrated pleocytosis, an increased number of white blood cells in the cerebrospinal fluid.

The patient’s symptoms included motor weakness, sensory abnormalities, and autonomic dysfunction—findings typical of acute transverse myelitis.

Based on the clinical presentation, MRI findings, and spinal fluid analysis, the physicians diagnosed the patient with acute transverse myelitis associated with Lyme disease.

Understanding Lyme Disease and Transverse Myelitis

Transverse myelitis is a neurologic disorder caused by inflammation of the spinal cord. When the spinal cord becomes inflamed, nerve signals between the brain and the body can be disrupted.

Symptoms of transverse myelitis may include:

Weakness of the legs or arms
Numbness or sensory changes
Difficulty walking
Bladder or bowel dysfunction
Autonomic nervous system abnormalities

Although uncommon, Lyme disease can affect the spinal cord and lead to neurologic complications such as transverse myelitis.

Learn more about neurologic complications of Lyme disease in my overview of neurologic Lyme disease.

Clinical Takeaway

This case highlights an important neurologic complication of Lyme disease. Patients presenting with unexplained weakness, gait instability, or bladder dysfunction should be evaluated for neurologic causes, including tick-borne infections.

Recognizing Lyme disease as a possible cause of acute transverse myelitis can allow clinicians to initiate appropriate testing and treatment earlier.

Inside Lyme Podcast Series

You can hear more clinical case discussions through Dr. Cameron’s blog, social media channels, and YouTube videos.

How to Connect with Dr. Daniel Cameron

Website: DanielCameronMD.com
Contact page: Request an appointment
Instagram: Instagram
Facebook: Facebook
YouTube: YouTube Channel
Leave a review on Apple Podcasts or wherever you listen to podcasts.

Disclaimer: The information provided in this podcast is for educational purposes only and is not intended as medical advice for any individual patient. Patients should consult a qualified healthcare professional for diagnosis and treatment.

Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention