A 13-year-old male patient came to the clinic for cervicalgia of 20 days of evolution, non-irradiated and without sensory or motor alterations in the upper limbs, predominantly nocturnal and with poor diazepam response to treatment with ibuprofen.
Intermittent diplopia, fever lasting two days at the beginning of the process, without accompanying general symptoms.
Ten days after the onset of symptoms a complete blood count, erythrocyte sedimentation rate and cervical radiography were performed, which were normal.
The physical examination revealed a deviation of the oral commissure with the smile; the rest of the neurological examination was normal.
There were no rashes, although the mother reported, when asked, a sting on her shoulder two months earlier, with progressive circular erythema lasting about two weeks.
Twenty-one days after suspected Lyme disease, serological studies with EIA (IgG, IgM) and immunotransfixed Western oral (IgG, IgM) were performed.
The patient is asymptomatic after one month of treatment.
