title: [Lyme disease--a reason for sudden sensorineural hearing loss and vestibular neuronitis?].
abstract: 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.
  
  
  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.
authors.affiliation: Universitäts-HNO-Klinik, Friedrich-Schiller-Universität Jena. Leif.Walther@med.uni-jena.de
authors.forename: L E
authors.initials: LE
authors.lastname: Walther
authors.forename: H
authors.initials: H
authors.lastname: Hentschel
authors.forename: A
authors.initials: A
authors.lastname: Oehme
authors.forename: H
authors.initials: H
authors.lastname: Gudziol
authors.forename: E
authors.initials: E
authors.lastname: Beleites
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood; D025065:Borrelia burgdorferi / Q000276:immunology; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D003639:Hearing Loss, Sudden / Q000209:etiology* / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D020852:Lyme Neuroborreliosis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D020338:Vestibular Neuronitis / Q000209:etiology* / Q000276:immunology
chemical_list: D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D007075:Immunoglobulin M
vernacular_title: Die Lyme-Borreliose--eine Ursache für "Hörsturz" und "Vestibularisausfall"?