Startle Myoclonus Induced by Lyme Neuroborreliosis

Julia Schoof; Christian Kluge; Hans-Jochen Heinze; Imke Galazky


J Med Case Reports. 2013;7(124) 

In This Article


Although there are many reports about symptomatic pathologic startle reactions, we have found scant data about an exaggerated startle reflex induced by Lyme neuroborreliosis.[5] In the case we describe here, our patient presented with some typical signs of Lyme neuroborreliosis, including Bannwarth's syndrome, a meningoradiculitis that presented with lymphocytic pleocytosis in his CSF; cranial nerve palsies (VI and VII on his right side); and radicular thoracic pain. Nevertheless, such a considerable startle response to tactile and visual stimuli is uncommon in this disease. The lack of startle reaction to acoustic stimuli could be explained by the severe bilateral hypacusis. The brain stem is thought to generate the startle reflex,[1] thus brain stem involvement can be assumed in our patient's case of neuroborreliosis, even though MRI showed no relevant pathology in that area.