PT - JOURNAL ARTICLE AU - Tim Soane AU - Fahad Shaikh AU - Grant Mair AU - Amy Baggott AU - Suvankar Pal TI - 067 Bannwarth syndrome presentation of neuroborreliosis, with radiological evidence of CNS demyelination AID - 10.1136/jnnp-2019-ABN-2.85 DP - 2019 Dec 01 TA - Journal of Neurology, Neurosurgery & Psychiatry PG - A26--A26 VI - 90 IP - 12 4099 - http://jnnp.bmj.com/content/90/12/A26.1.short 4100 - http://jnnp.bmj.com/content/90/12/A26.1.full SO - J Neurol Neurosurg Psychiatry2019 Dec 01; 90 AB - A 59 year old right handed IT professional presented with left shoulder pain, which evolved to whole arm weakness, numbness and pain, before affecting his right arm and then legs to a lesser degree. Over subsequent weeks he developed right facial weakness and circumferential numbness around his torso. Examination revealed a mixed picture of lower motor neurone signs and long tract signs. CSF analysis showed a pleocytosis of 415 white cells, predominantly lymphocytes and elevated protein at 3.49 g/dL. MRI head showed a number of periventricular and brainstem lesions with appearances and locations typical for demyelination. Nerve conduction studies were compatible with a demyelinating polyradiculoneuropathy.Lyme serology showed elevated IgG positive and borderline elevated IgM. His CSF antibody levels were compatible with neuroborreliosis. He was treated with ceftriaxone 4 g daily for 21 days.The Bannwarth syndrome is a triad of painful polyradiculopathy and facial nerve palsy and lymphocytic pleocytosis, and is a presentation of neuroborreliosis typically associated with European neuroborreliosis caused by infection with Borrelia afzelii and garinii genospecies.