title: Audiologic manifestations of patients with post-treatment Lyme disease syndrome.
abstract: OBJECTIVE
  The purpose of this study was to characterize auditory function in patients diagnosed with post-treatment Lyme disease syndrome (PTLDS).
  
  
  METHODS
  Eighteen patients with PTLDS were evaluated and compared to a normal population. Evaluations consisted of pure tone and speech thresholds, word recognition (WRS), acoustic immittance battery, auditory brain stem response (ABR), and loudness discomfort level (LDL). Both seropositive and seronegative patients were evaluated. Audiologists were blinded to patient status.
  
  
  RESULTS
  Forty four percent of the patients had one or more abnormal pure tone thresholds compared to gender- and age-adjusted norms. Thirty-one percent showed abnormally reduced LDLs, and 17% had abnormal acoustic reflexes at one or more frequencies.
  
  
  CONCLUSIONS
  This paper catalogs previously unstudied long-term auditory system sequelae resulting from PTLDS. Our most significant finding was the dramatically reduced loudness tolerance in the presence of either normal or minimally impaired hearing. The clinician is encouraged to consider PTLDS when confronted with these or similar findings in patients having history of Borrelia burgdorferi infection and continued complaints.
authors.affiliation: Hearing Section, Neuro-Otology Branch, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Maryland, USA. Larry.Shotland@med.va.gov
authors.forename: Lawrence I
authors.initials: LI
authors.lastname: Shotland
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Mastrioanni
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Choo
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Szymko-Bennett
authors.forename: Leonard G
authors.initials: LG
authors.lastname: Dally
authors.forename: Anita T
authors.initials: AT
authors.lastname: Pikus
authors.forename: Kathryn
authors.initials: K
authors.lastname: Sledjeski
authors.forename: Adriana
authors.initials: A
authors.lastname: Marques
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone; D001302:Audiometry, Speech; D001308:Auditory Perceptual Disorders / Q000209:etiology*; D001309:Auditory Threshold; D002908:Chronic Disease; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D006801:Humans; D008144:Loudness Perception; D008193:Lyme Disease / Q000150:complications* / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged