Lyme and Head, Neck and Hearing Disorders

Audiologic Manifestations of Patients with Post-Treatment Lyme Disease Syndrome

Lawrence I. Shotland; Mary Ann Mastrioanni; Daniel L. Choo; Yvonne M. Szymko-Bennett; Leonard G. Dally; Anita T. Pikus; Kathryn Sledjeski; Adriana Marques

Abstract
As part of a comprehensive effort to study post-treatment Lyme disease syndrome (PTLDS), this article describes the auditory responses on a cohort of PTLDS patients. Eighteen patients underwent comprehensive audiologic evaluations, brain magnetic resonance imaging (MRI) with gadolinium, and cerebrospinal fluid analysis. They were compared with 33 age- and sex-matched healthy controls and with a published database. Of the 18 patients, 41% showed non-specific white matter lesions on MRI; 44% had subtle pure-tone abnormalities exceeding the 95% percentile; and 31% had reduced loudness tolerance levels. The reduced loudness tolerance in the presence of either normal or minimally impaired hearing appears to be part of PTLDS. Whereas other articles have reported hearing loss in Lyme disease patients, definitions of hearing loss are inconsistent among studies. In contrast to the more traditional approach of identification according to clinical hearing loss, the approach used in the present study appears to be more

Manifestations of systemic diseases in the head and neck.

Collin S. Karmody MD, Donald J. Annino, MD, DMD

Unquestionably, the structures of the head and neck have their intrinsic disorders but more often than not, they participate in and are frequently the presenting point of systemic diseases. In this paper, we summarize some of the more recent relevant literature on a limited number of systemic disorders as they relate to the head and neck. The main focus is on

• the human immunodeficiency syndrome and
• a few of the more frequently encountered autoimmune disorders, such as Wegener's granulomatosis and relapsing polychondritis. We have also included
• Lyme disease, which is being recognized as a ubiquitous problem.

[Review article]

Laryngoscope 1991 Jun;101(6 Pt 1):592-5

Otolaryngologic aspects of Lyme disease.

Moscatello AL, Worden DL, Nadelman RB, Wormser G, Lucente F

Abstract:
Lyme disease is a systemic illness caused by the spirochete Borrelia burgdorferi and transmitted by the bite of a tick in the Ixodes ricinus complex. While the illness is often associated with a characteristic rash, erythema migrans, patients may also present with a variety of complaints in  the absence of the rash.

The otolaryngologist may be called upon to see both groups of patients, with any number of signs and symptoms referable to the head and neck, including

• headache,
• neck pain,
• odynophagia,
• cranial nerve palsy,
• head and neck dysesthesia,
• otalgia,
• tinnitus,
• hearing loss,
• vertigo,
• temporomandibular pain,
• lymphadenopathy, and
• dysgeusia.

• 75% of whom experienced head and neck symptoms.

Keywords:
Adolescence, Adult, Aged, Aged, 80 and over, Facial Paralysis, ETIOLOGY,
Female, Hearing Loss, Bilateral, ETIOLOGY, Human, Lyme Disease, COMPLICATIONS,
DIAGNOSIS, Male, Middle Age, Otorhinolaryngologic Diseases, COMPLICATIONS,
DIAGNOSIS

Unique ID: 91251692

Pol Merkuriusz Lek. 1998 Feb;4(20):98-9. Polish.

[Lasting hearing loss in the course of neuro-borreliosis]

Zajkowska JM, Snarska-Furla I, Rogowski M.

Of related interest:

• J. Gruber, Basic Multifrequency Tympanometry