Lyme Disease and Hearing Loss

Lyme disease is caused by the bacteria Borrelia burgdorferi and is transmitted by the deer tick Ixodes ricinus. The incidence of Lyme disease in the United States has been increasing since first reported in 1977. The disease exhibits three stages with various associated symptoms. The hallmark of the first stage is a spreading rash called erythema migrans. During the second stage, cranial neuropathies have been observed. In the third stage, neurologic symptoms related to encephalopathy and demyelinating disease can be observed.

Among the otolaryngologic manifestations, facial weakness is the best appreciated and can sometimes be bilateral. Dizziness can occur in approximately 12% of patients. A sudden onset or rapidly progressive sensorineural hearing loss (typically bilateral) and/or tinnitus occur in a small percentage of patients (T 5%). Among patients who have experienced a sudden sensorineural hearing loss, seropositivity to Borrelia is several times higher than within the general population. The hearing loss can frequently be low-frequency. Lyme disease is treated with antibiotic therapy, and highly variable response rates of hearing loss and tinnitus to treatment have been reported.