[Left sided sudden hemiparesis linked to a central form of Lyme disease]. / Hémiparésie gauche soudaine rattachée à une forme centrale de maladie de Lyme.

Lyme disease is known for its numerous neurological manifestations. Cerebral ischemic lesions are more rarely reported. We describe the case of a 27 - year old man - presenting with a left-sided hemiparesis when waking up. We first thought of a stroke, due to the presence of a light right capsulo-thalamic hypodensity on C.T. scan and the spontaneous regression of the hemiparesis within a few days. However, the lumbar puncture performed on the patient due to a fever running 38 degrees C and some drowziness showed a lymphocytic pleocytosis with a very inflammatory face of the spinal fluid. The M. R.I. revealed a right capsular and thalamic image with edema of the front part of the thalamus showing either a vascular or an inflammatory origin. The Lyme serodiagnosis in the blood and in the spinal fluid was positive, and we demonstrated an intrathecal Borrelia burgdorferi specific antibody synthesis. This case is interesting because it shows a central form of neuroborreliosis through cerebral infarct and its regressive evolution under treatment. The possible pathophysiology mechanisms have been discussed.

[Extradural arachnoid cyst of the dorsal region with relapsing and recurrent development]. / Kyste arachnoïdien extradural de la région dorsale d'évolution régressive et à rechute.

An extradural arachnoid cyst of the thoracic spine was diagnosed and operated in a 39 year-old woman with a history of two regressive attacks of spastic paraplegia during a 19 year-period. The diagnosis was established by magnetic resonance imaging and myeloscan, which demonstrated the cyst and its consequences on the spinal cord and the spine. Theories of etiology and development of extradural arachnoid spinal cysts are reviewed.