Audiologic manifestations of patients with post-treatment Lyme disease syndrome.
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.
Shotland
Lawrence I
LI
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
Mastrioanni
Mary Ann
MA
Choo
Daniel L
DL
Szymko-Bennett
Yvonne M
YM
Dally
Leonard G
LG
Pikus
Anita T
AT
Sledjeski
Kathryn
K
Marques
Adriana
A
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