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 × 106cells/L anda positive blood antibody production or intrathecal Borrelia burgdorferi antibody titer together with symptoms of LNB. Vestibular assessmentsincluded 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 DizzinessHandicap 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 in1 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. Vestibulardysfunction was not significantly associated with the total DHI score or with the mean PTA (Pure tone audiometry). The most commonly reportedsymptoms 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.