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In this Clinical Rounds, we present a case of neuroborreliosis in a man aged 59 years who initially complained of headache, tremor, and hiccups. Diagnosis was delayed, partly due to an atypical presentation but mainly because subtle MRI findings were overlooked. There is emerging recognition that radial and patchy hyperintensities in cerebral peduncles, mesencephalon, and pons is a distinct MRI feature of neuroborreliosis. Dissemination of this knowledge could contribute to more timely and efficient diagnoses in future patients.
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Lindland et al. (2026) studied this question.
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