06 April 2026
: Case report 
Lyme Neuroborreliosis With Acute Encephalopathy Despite Early Antibiotic Therapy: A Case Report
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment
Jon M. Johannesson ABDEF 1*, Kristen V. Dicks ABDEF 1, Michelle E. Perkons
ABDEF 2, Diego F. Cepeda Mora ABDEF 2, Matthew W. Luedke ABDEF 3, Matthew E. Ehrlich ABDEF 3, Jessica L. Houk ABDEF 4, Mehri S. McKellar ABDEF 1
DOI: 10.12659/AJCR.951927
Am J Case Rep 2026; 27:e951927
Figure 3 Findings of magnetic resonance imaging of the brain with and without contrast. (A) Axial images at the level of the sphenoid sinuses demonstrate pathologic contrast enhancement of the cisternal segment of the right trigeminal nerve (white arrow). (B) Axial post contrast images at a slightly caudal level demonstrate pathologic enhancement of the cisternal segment of the right facial nerve (white arrow) which extends to involve the geniculate ganglion and distally within along the tympanic segment.