Abstract

Camptocormia is the abnormal posture of the trunk with thoraco-lumbar spine flexion, which increases during walking and improves when supine. A man, aged 57, noticed a rash behind his left knee. Next, he developed pain in his left knee and hip, then progressive leg weakness over 4–6 weeks. His posture started to stoop, to the point that he became shorter than his wife. Examination showed camptocormia. Muscle tone was normal, with mild weakness of the neck flexors, truncal and abdominal muscles, as well as in the left arm and leg. He was areflexic. He had a suspended sensory level from T8 to T10. Routine blood screen was normal, as was spinal MRI. LP showed: clear CSF, WBC 100 (66% neutrophils, 32% lymphocytes), protein 1884 mg/l, glucose 5.9 (serum 10.9), oligoclonal bands seen in CSF but not blood. Serological tests for Borrelia burgdorferi were positive in blood and CSF. Neurophysiology was not performed. The diagnosis of paraspinal muscle weakness secondary to polyradiculopathy caused by Lyme disease was made. Treatment with IV ceftriaxone resulted in rapid resolution of his pain. The strength in his muscles returned over the next few months. Videos before and after treatment will be shown. We believe this is the first reported case of camptocormia secondary to polyradiculopathy caused by Lyme neuroborreliosis.