General Signs And Symptoms Of Lyme Disease:
The clinical course of Lyme begins with a skin lesion , several days after a tick bite. After this, neurological, cardiac, chronic skin, or joint involvement develops. Similar to the situation with syphilis, Lyme is divided into several stages — an acute localized one, with later dissemination divided into early and late stages.
In the late stage , there may be chronic encephalomyelitis. Patients present with spastic paraparesis, ataxia, cranial nerve palsies such as facial weakness and deafness, bladder dysfunction, and cognitive impairment.
According to Garcia-Monco , the most common clinical presentations are painful radiculitis, cranial palsy , and headache. Thus these are symptoms primarily of nerve damage. In the US, lymphocytic meningitis is the most common and single early manifestation. Headache is the main complaint.
Signs And Symptoms Of Untreated Lyme Disease
Seek medical attention if you observe any of these symptoms and have had a tick bite, live in an area known for Lyme disease, or have recently traveled to an area where Lyme disease occurs.
Untreated Lyme disease can produce a wide range of symptoms, depending on the stage of infection. These include fever, rash, facial paralysis, and arthritis.
The appearance of the erythema migrans rash can vary widely.
- Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of rash
- Erythema migrans rash :
- Occurs in approximately 70 to 80 percent of infected persons
- Begins at the site of a tick bite after a delay of 3 to 30 days
- Expands gradually over several days reaching up to 12 inches or more across
- May feel warm to the touch but is rarely itchy or painful
- Sometimes clears as it enlarges, resulting in a target or bulls-eye appearance
- May appear on any area of the body
- Does not always appear as a classic erythema migrans rash
Swollen Knee
- Severe headaches and neck stiffness
- Additional EM rashes on other areas of the body
- Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
- Intermittent pain in tendons, muscles, joints, and bones
- Heart palpitations or an irregular heart beat
- Episodes of dizziness or shortness of breath
- Inflammation of the brain and spinal cord
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What Should Audiologists Know
Audiologists cant know what causes SSNHL most of the time, but they can and should be familiar with the usual and the unusual suspects. Sudden sensensorineural hearing loss is a topic of its own that weve written about at HHTM before. SSNHL associated with Lyme disease is not reported or connected very often by physician or audiologist.
Its easy to miss the connection. Lyme disease, known as the great imitator, can be misdiagnosed . It can take weeks to manifest after the tick bite, with symptoms rolling out insidiously. In contrast, SSNHL is, by definition, sudden, dramatic, and impossible to miss. Who would think to link sudden devastation of a single sensory channel with slow debilitation of a variety of body systems?
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How To Protect Against Lyme Disease
Ideally, the best way to prevent Lyme disease-related hearing loss is to prevent Lyme disease in the first place. If you spend a lot of time outside, whether youre playing, gardening, or hiking, you should avoid grassy, brushy, or wooded areas, according to the Centers for Disease Control and Prevention .
The CDC also recommends checking your clothes for ticks once you come back inside. Clothes should be washed in hot water. You should also take a shower within two hours of coming inside. It can help wash ticks off your body and is also a good opportunity to check your body for ticks. During a tick check, you should examine your entire body, using a mirror when necessary.
If you do find a tick attached to you, remove it as soon as you see it. Follow the guidelines set by the CDC or a similar medical organization. Watch for signs of illness and see a doctor immediately if they develop.
An audiologist will be able to help you determine the extent of any hearing damage and will come up with a treatment plan best suited for your needs. Lyme disease is a serious condition, and if you do contract it our doctors will do everything they can to help you with your hearing.
This blog is for informational purposes only. For specific medical questions, please consult your physician. To make an appointment with an audiologist, call 704-295-3000. You can also schedule an appointment online or through myCEENTAchart.
Do You Have A Question For Dr Ellie
Email DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.
Dr Ellie can only answer in a general context and cannot respond to individual cases, or give personal replies. If you have a health concern, always consult your own GP.
Statins which lower cholesterol have a reputation for causing a range of side effects.
Critics have claimed inaccurately up to a third of patients suffer things like muscle aches and fatigue on the pills.
But research which involved more than four million patients published this week showed that 90 per cent of people who take the pills suffer no side effects at all.
Of course I have patients who genuinely have a hard time with the tablets.
Usually, when we switch to a different brand, the problems resolve.
And if they dont, there are other cholesterol-lowering drugs to try.
Statins are remarkable medicines that play an important role in preventing heart attacks and strokes.
If theyre recommended, it means youre at risk, so dont be put off by those scare stories.
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Borrelia Burgdorferi And Sudden Sensorineural Hearing Loss
The final symptom listed above, facial nerve palsy, may trigger a thought in the minds of Audiologists and those who have encountered shingles affecting the auditory system . Facial nerve palsy can occur when the herpes virus spreads into the geniculate body of the facial nerve near the inner ear, causing nerve damage that affects your hearing, in a condition called Ramsay-Hunt.
Viruses are not bacteria, so why did we bring this up? Because a survey study published several years ago draws a link between Lyme disease and sudden sensorineural hearing loss :
4 relevant and valid articles confirm positive serology for Borrelia burgdorferi suggesting active Lyme disease as a cause in patients with sudden sensorineural hearing loss.
The same study also provides a case report of a female with confirmed Lyme disease who presented with SSNHL followed by facial paralysis. The latter resolved with antibiotic therapy, the hearing loss did not show recovery. The timing of symptoms and blood work suggested the Lyme disease-hearing loss link.
If Lyme disease does cause hearing loss, it may well do so by attacking the vestibulocochlear nerve or facial nerve, perhaps at the geniculate body as happens with Ramsay Hunt. Nobody knows but the first step has been taken a link has been established between disease and hearing loss.
Vertigo And Severe Balance Instability As Symptoms Of Lyme Diseaseliterature Review And Case Report
- 1Balance Disorders Unit, Department of Otolaryngology, Medical University of Lodz, The Norbert Barlicki Memorial Teaching Hospital, Lodz, Poland
- 2Nofer Institute of Occupational Medicine, Balance Disorders Unit, Department of Audiology and Phoniatrics, Lodz, Poland
- 3Department of Infectious Diseases and Hepatology, Medical University of Lodz, Lodz, Poland
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A Far More Common Cause Of Vertigo
It is a fairly rare occurrence when Lyme disease is actually the underlying factor in vertigo incidence. A far more common problem that leads to vertigo is a misalignment in the C1 and C2 vertebrae. This type of misalignment can affect blood flow to the brain and ears and lead to vestibular problems either of a peripheral or central nature.
Audiologist: There’s A Huge Connection Between Lyme Disease And Profound Hearing Loss
Health, entertainment and LGBT writer
Tracy Murphy, Au.D., a member of the American Academy of Audiology Board of Directors
In September, I was contacted by a representative of the American Academy of Audiology, who wrote that the AAA is working on educating the public of the many factors that can contribute to hearing loss and the seriousness of that loss. The message recounted the story of Teresa Jennings, who was diagnosed with Lyme disease in 2011. As if chronic fatigue and other Lyme symptoms were not enough, within a year and a half after her diagnosis, her hearing in both ears began to severely decline. Her story continues:
Jennings started treatment at a clinic in Washington, D.C. where she traveled from Illinois every three months for medical care. When her hearing first began to decline, she saw several audiologists for hearing aids but the cost was not affordable so she went to a large, national big-box discount store and purchased hearing aids.
Tracy Murphy, AuD, is an Illinois-based clinical audiologist who works with North Shore Audio-Vestibular Lab and a member of the American Academy of Audiology Board of Directors. Murphy is the audiologist who treated Jennings.
Many Lyme patients lose their hearing from the disease, Murphy said. Teresas hearing loss was severe to profound.
I spoke with Murphy by phone in September to discuss her knowledge of Lyme-related hearing loss.
Hmm, she said. Thats a really good question.
End of Tangent
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What Should Audiologists Do
Audiologists should include Lyme disease as a consideration when taking the history of anyone who presents with SSNHL. Even if the disease is not reported, the history should query outdoor activities by region also it should document physical complaints that fall within the constellation of Lyme disease pathologies.
As always, close professional working relationships with physicians are a must for Audiologists who see patients with SSNHL.
Hearing Loss And Lyme Disease
There isnt one way hearing loss can be affected by Lyme disease. Its different for everyone and rather complex. It also depends on the stage of Lyme disease one might have. On the other hand, some Lyme patients may not even develop hearing loss at all. However, its all too common not to address.
One study in the Journal of Otology and Neurotology by Bertholon , indicates that looking at Lyme in stages can help us better understand hearing loss associated with the disease. For instance, in the early disseminated stage of disease , a common type of hearing loss is sudden unilateral sensorineural hearing loss. In late-stage Lyme disease , the common type of hearing loss seen is progressive bilateral sensorineural hearing loss.
Read more: What is sensorineural hearing loss?
However, this is not to say that these are the only types of hearing loss that can be associated with Lyme disease. In my personal experience, which I will detail more below, I have Lyme disease with multiple co-infections. While my hearing loss is presumably progressive and bilateral, its not sensorineural as I was born with a conductive hearing loss at birth.
Read more: How does conductive hearing loss affect the brain?
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Can Lyme Disease Cause Walking Problems
As mentioned above, Lyme disease can cause issues with balance, which will lead to problems with walking. The inner ear maintains balance so that we can move around without feeling dizzy or disconnected from our footing. Walking problems can also arise for a person with the condition because of the way it affects the joints. Although the pain tends to be intermittent in the affected joints, it can hinder a persons ability to walk as they used to. This symptom of Lyme disease is referred to as Lyme arthritis.
Autoimmune Inner Ear Disorder
The autoimmune disease most directly connected to hearing is autoimmune inner ear disorder . In this rare disorder, immune cells attack the inner ear, leading to progressive hearing loss that may fluctuate. The hearing loss can be sudden, but according to an article in the Hearing Journal, the onset of AIED is usually slower, taking days to months.
It can occur on its own, but data shows that about one-third of AIED patients also have a systemic autoimmune disorder, such as lupus or RA.
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How Are Autoimmune Diseases Linked To Hearing Loss
Not all autoimmune disorders affect hearing, but many of them do. Often the hearing damage is related to harmful inflammation in the delicate ear anatomy, or disrupted blood flow to the ear. The severity of the hearing loss can vary. Depending on the underlying disease, it can affect one or both ears, may develop suddenly or slowly, and may affect different frequencies .
Given how complex both hearing and the immune systems are, it’s not always possible to know what role an autoimmune disorder played in hearing loss. Autoimmune disorders can flare up and then go into remission, and a person may not ever realize the link to their hearing loss.
“In many cases, though the hearing loss is permanent, the cause of the damage can be transitory, so there’s no way to diagnose the cause of the damage after it has happened,” explained Aaron Abend, executive director of the Autoimmune Registry, Inc.
Treatment may include corticosteroids that limit blood vessel inflammation and the immune attack on the inner ear. For some autoimmune diseases, plasma transfers can clear the antibodies that attack phospholipids from the blood. Other treatments increase blood flow to the inner ear or suppress the immune system. When the hearing loss is permanent, hearing aids may be recommended.
Viral Or Bacterial Labyrinthitis
There is no reliable test to determine whether labyrinthitis is caused by a viral or bacterial infection because testing for infection would damage the labyrinth.
Doctors can usually safely assume that labyrinthitis is the result of a viral infection unless there is strong evidence to suggest otherwise, such as:
- the labyrinthitis is in a very young child
- labyrinthitis occurs in someone who is already known to have a bacterial infection
- you have common bacterial labyrinthitis symptoms, such as nausea, vomiting and complete hearing loss
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Labyrinthitis And Vestibular Neuritis Treatment
With time and vestibular physical therapy, there is gradual improvement and the prognosis is generally good.
If the doctor believes the persons condition is due to shingles, an anti-viral medication may be prescribed. Although prednisone or other types of steroids may be given and could help hasten recovery, it is not conclusively proved that these medications benefit in the final outcome.
Anti-nausea medications and medications used to treat the dizziness/vertigo should not be taken more than several days after symptom onset, since their use can delay normal compensation.
Diagnosis Of Labyrinthitis And Vestibular Neuritis
Depending on the eye movement and vestibular examination, a test such as an MRI of the brain may or may not be necessary.
People experiencing these symptoms should see a doctor, especially since a stroke can have similar symptoms. Strokes are more common in people who have a history of smoking, high blood pressure, high cholesterol, diabetes, or previous stroke or heart attack.
With that in mind, call 911 immediately if symptoms are accompanied by:
-
Numbness or tingling
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Could Your Vertigo Be Connected To Lyme Disease
Vertigo is as a symptom rather than a condition all its own. Of course, the most common form of vertigo is benign paroxysmal positional vertigo, which is basically a fancy way of saying vertigo without a known cause. It is generally assumed the condition happens due to a problem with the fluid in the inner ear. Thus, certain head positions or moving the head too quickly are blamed for flare-ups.
At other times, false sense of movement is a symptom of a more serious condition. While you wont see vertigo on most symptom lists for Lyme, it is something that can occur during the later stages. Having the disease for an extended period of time can lead to cranial neuritis. If the condition affects the eighth cranial nerve , then vertigo and other balance issues may result.
Dr Ellie Cannon: I’ve Felt Dizzy For Over Three Years Is It Lyme Disease
17:00 EST, 19 February 2022 | Updated:
I have had severe balance problems for more than three years. Ive read that it could be due to Lyme disease. Is that true?
Lyme disease is a bacterial infection caused by a bite from an infected tick, an insect in the spider family that normally lives on animals.
Usually, patients remember being bitten. Its uncommon in the UK only 3,000 people in England and Wales are affected every year.
It is true it can cause neurological problems, including dizziness and feeling off-balance, but its rare for such symptoms to be the only complaint.
However balance problems are incredibly common, and feeling off-balance all the time can be debilitating, affecting every aspect of ones daily routine.
It can be hard to find an answer, but often the problem lies with the area of the inner ear responsible for balance, called the labyrinth.
Lyme disease is a bacterial infection caused by a bite from an infected tick , an insect in the spider family that normally lives on animals
It is true it can cause neurological problems, including dizziness and feeling off-balance, but its rare for such symptoms to be the only complaint
The most common conditions are benign paroxysmal positional vertigo , chronic labyrinthitis, Menieres disease or vestibular neuronitis.
All of these problems affect specific balance mechanisms in the inner ear. In neuronitis, for instance, its the nerves that are malfunctioning.
But some dietary choices can make it worse.
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