PMC3362302_01
Extensive high-signal alterations are visible in the cervical and thoracic spinal cord, comprising large portions of the medullar cross section (sagittal STIR, short-tau inversion recovery sequence, a; axial T2-weighted turbo spin echo sequence, b). c Cerebral involvement is also seen as bilateral hyperintense signal alterations in the dorsal portions of the pons (axial T2-weighted turbo spin echo sequence). d Western blots for IgG and IgM of serum and CSF at day 1 (d1) and serum at day 7 (d7) and day 17 (d17). Bands before the blue alignment marker are positive controls for serum, IgG, IgM and a cutoff control (in this order). The Borrelia-specific antigens p41, OspC, and Osp17 are indicated. The VlsE antigen showed no band in any of the samples.
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F1
Some of these lesions comprised 2 or more segments and involved large parts of the cord's cross section (fig. 1a, b), in combination with moderate swelling at the cervical level and a faint enhancement after intravenous gadolinium administration (not shown). A cerebral MRI scan showed bilateral pontine T2 signal hyperintensities (fig. 1c). Western blotting was positive in CSF and serum for p41- and OspC-specific IgM and IgG at day 1, and revealed an additional positive Osp17-IgM band in serum at days 7 and 17 (fig. 1d).