Laryngorhinootologie. 2003 Apr;82(4):249-57.     Related Articles, Links
    Click here to read
    [Lyme disease--a reason for sudden sensorineural hearing loss and
vestibular neuronitis?]

    [Article in German]

    Walther LE, Hentschel H, Oehme A, Gudziol H, Beleites E.

    Universitats-HNO-Klinik, Friedrich-Schiller-Universitat Jena.
Leif.Walther@med.uni-jena.de

    BACKGROUND: Lyme disease has been described as one possible cause
of sudden sensorineural hearing loss and vestibular neuronitis. The
necessity of serological diagnosis and its therapeutic consequences have
been discussed controversially. PATIENTS AND METHODS: 344 patients with
acute sensorineural hearing loss and 66 patients with vestibular
neuronitis were examined in retrospect. By means of ELISA (Enzygnost
Borreliosis, Dade Behring Marburg) the specific prevalences of IgG- and
IgM-antibodies against borrelia in serum were evaluated. The frequency
of seroprevalences for both diseases were compared to those given in the
literature. Neurootological findings of the seropositive patients were
compared with those of seronegative and analysed statistically. RESULTS:
15.7 % of the patients with sudden sensorineural hearing loss had
positive levels of IgG-antibodies. IgM-titers were elevated in 4.7 % of
the patients. The seroprevalences for IgM and IgG were above those
described by other investigators for the healthy population. Patients
with positive IgM-antibodies showed more often low frequency hearing
loss than IgG-positive patients. 18.2 % of the patients with neuronitis
vestibularis had IgG- and 1.5 % IgM-antibodies against Borrelia. Whereas
IgG occurred more often than known for the healthy population, IgM was
within the limit for the healthy population. The seropositive group did
not show any remarkable neurootological signs compared with the
seronegative group. CONCLUSIONS: Because of the elevated seroprevalences
Borrelia infections may be one possible but very rare cause of sudden
sensorineural hearing loss and vestibular neuronitis. Low frequency
hearing loss may be a sign for an infection with Borrelia as an
etiological factor especially in combination with seropositive titers.
In case of the presence of IgM-antibodies, patients may be treated with
oral antibiotics (Doxycyclin, Cefuroxim). In patients with neuronitis
vestibularis a neuroborreliosis should be excluded by means of lumbar
puncture.

    PMID: 12717599 [PubMed - indexed for MEDLINE]