Audio-Vestibular Function in Patients Diagnosed with Lyme Neuroborreliosis

BACKGROUND: This study assessed the audio-vestibular function and symptoms in patients diagnosed with Lyme neuroborreliosis (LNB). METHODS: Patients with LNB were included prospectively. Diagnosis was based on a cerebrospinal fluid leukocyte count ≧ 10 × 10⁶ cells/L and a positive blood antibody production or intrathecal Borrelia burgdorferi antibody titer together with symptoms of LNB. Vestibular assessments included video head impulse test and a caloric test. Hearing was assessed by pure-tone audiometry at discharge and 30 days after hospitalization and compared to a healthy age-and sex-matched control dataset. Symptoms were assessed by a structured interview and the Dizziness Handicap Inventory (DHI). RESULTS: Nineteen patients were included in the study. Four (21%) patients had vestibular dysfunction; 2 were unilateral and 2 were bilateral. The lateral semicircular canal was dysfunctional in 3 patients, the anterior semicircular canal in 2 patients, and the posterior semicircular canal in 1 patient. Sensorineural hearing loss, defined by audiometry, was present in 9 (47%) patients according to the audiometry at discharge and 10 (59%) patients during the follow-up audiometry. Hearing did not differ significantly from the age-and sex-matched control dataset. Vestibular dysfunction was not significantly associated with the total DHI score or with the mean PTA (Pure tone audiometry). The most commonly reported symptoms were peripheral nerve palsy (47%), dizziness (32%), fatigue (32%) and headache (32%). CONCLUSION: Audio-vestibular function was affected in patients with LNB but correlated poorly with the patients’ self-reported audio-vestibular symptoms.