I n Europe, Borrelia burgdo@ infection causes a severe, Predominantly axonal polyradiculoneuropathy that is typically accompanied by cranial neuropathy and lymphocytic meningitis (Bannwarth's or Garin-Bujadoux-Bannwarth syndrome) .','' Although a similar clinical syndrome occurs in the U.S.,6,7 this presentation is less common than a chronic, predominantly sensory polyradicul~neuropathy.~,~ Lyme disease presenting with acute onset of quadriparesis, clinically resembling the Guillain-BarrC syndrome (GBS), is rare."'" We report 2 patients with an acute, predominantly motor polyradiculopathy due to Lyme disease; 1 patient's illness clinically mimicked GBS, while the other had the uncommon accompaniment of myelopathic signs.
CASE REPORTS
Patient 1. A 64year-old man presented in August with 1 week of left arm pain and weakness. Eight months earlier, he developed left elbow pain and swelling which improved over 1 month. This recurred 1 month prior to presentation in association with upper respiratory symptoms for 3-4 days.
One week prior to presentation he developed pain in his left neck, upper scapular border, shoulder, and entire arm associated with severe proximal greater than distal left arm weakness. Within 3 days, the right arm was similarly affected, along with bilat-From the