Hearing Loss and Vertigo in Lyme Disease
Hearing loss in Lyme disease can occur when infection affects the inner ear or the vestibulocochlear nerve (cranial nerve VIII). Patients may also experience vertigo, tinnitus, dizziness, and balance problems—symptoms that are a recognized feature of Lyme disease symptoms when the auditory and vestibular systems become inflamed.
A recently published study by Sowula and colleagues provides further evidence that Lyme disease can trigger hearing loss and vertigo. In their article “Vertigo as one of the symptoms of Lyme disease,” the authors examined the frequency of vertigo symptoms and possible labyrinth damage in patients diagnosed with Lyme disease.4
The study included 38 patients between the ages of 20 and 77 who were hospitalized at University Hospital in Krakow, Poland between 2018 and 2019 because of vertigo or dizziness.
Lyme Disease and Inner Ear Symptoms
“One alleged group of diseases which can trigger vertigo involves infectious diseases of the nervous system,” the authors explain.
“Many pathogens are said to be in part responsible for inflammation; among them are spirochetes of Borrelia as well as other pathogens transmitted by ticks.”
Lyme disease can affect both hearing and balance because the infection may involve the inner ear structures responsible for auditory and vestibular function.
Study Findings: Hearing Loss, Vertigo, and Tinnitus
The study reported several important findings among Lyme disease patients:
- 76% of patients reported vertigo symptoms
- Vertigo occurred more frequently in women (54%) than men (22%)
- Hearing loss and tinnitus frequently accompanied vertigo
- Approximately one-third of patients developed sensorineural hearing loss
- The hearing loss primarily affected high frequencies rather than low frequencies
- Tinnitus was reported in 3 out of 5 patients and was typically high frequency
Sensorineural hearing loss was bilateral in two individuals and appeared as sudden deafness in two other patients.
“Increasingly, tick-borne illnesses such as Lyme disease are a potential cause of neurological symptoms reported by patients, including hearing loss, tinnitus, ataxia and vertigo.”
Possible Inner Ear Damage in Lyme Disease
The authors concluded that vertigo symptoms in Lyme disease may result from dysfunction of the inner ear (labyrinth) or the vestibulocochlear nerve.
“Vertigo is frequently connected with labyrinth damage and hearing-organ impairment, which suggests that in the course of this disease the inner ear or nerve VIII is dysfunctional,” the authors note.
Encouragingly, the investigators reported that antibiotic therapy was effective in reducing many of these otoneurological symptoms.4
Clinical Takeaway
Hearing loss is an underrecognized neurologic manifestation of Lyme disease. When the infection affects the vestibulocochlear nerve or inner ear structures, patients may develop hearing loss, tinnitus, vertigo, and balance disturbances.
In Lyme-endemic areas, clinicians should consider Lyme disease in the differential diagnosis of unexplained hearing loss or vertigo, particularly when patients report tick exposure or accompanying neurologic symptoms.
Related Reading
References
- Logigian EL, Kaplan RF, Steere AC. Chronic neurologic manifestations of Lyme disease. N Engl J Med. 1990.
- Selmani Z, Pyykkö I. Cochlear and vestibular functional study in patients with sudden deafness and Lyme disease.
- Ishizaki H, Pyykkö I, Nozue M. Neuroborreliosis in the etiology of vestibular neuronitis.
- Sowula K, Szaleniec J, Dworak M, et al. Vertigo as One of the Symptoms of Lyme Disease. J Clin Med. 2021.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
I still have vertigo after 1 year 3 months of treatment with 4 antibiotics and hydroxychloroquine. Has anyone found anything to stop the vertigo?
5 mg valium has helped symptoms for my vertigo and dizziness, been fighting it since 2016. also i have lyme and coinfections. ENT dr says ears are fine.
I have a family member who has Lyme disease has anyone found a doctor who will help. Seven so far have refused him treatment or even a blood test. Please help> We live in the Richmond Hill area
I have just started the vertigo and need a Doctor so bad, is there a good doctor in Colorado I can trust ? Will this ever go away?
I have just started the vertigo and need a Doctor so bad, is there a good doctor in Colorado I can trust ? Will this ever go away?
I had GK (gammaknife) surgery for an acoustic neuroma in 2016. A few MRIs with gadolinium before and after my radiation. I have been getting dizzier every year since, and now I haven’t been able to sleep for months, and feel like I did when I had Lyme meningitis along with stiff, painful neck. Could antibiotics help? Please advise. I’m miserable. Thx.
I typically advise my patients to look a second time at Lyme disease. There may be two issues. The acoustic neuroma may not be the whole story. There are often other cluse that help the doctor make a decision.
I typically advise my patients to look a second time at Lyme disease. There may be two issues. The acoustic neuroma may not be the whole story. There are often other cluse that help the doctor make a decision.
I had GK (gammaknife) surgery for an acoustic neuroma in 2016. A few MRIs with gadolinium before and after my radiation. I have been getting dizzier every year since, and now I haven’t been able to sleep for months, and feel like I did when I had Lyme meningitis along with stiff, painful neck. Could antibiotics help? Please advise. I’m miserable. Thx.
Hi,
I have Lyme and hearing loss (which could be some thing I inherited, since relatives on both sides have very poor hearing).
I can not wear my hearing aides, after 2-3 hours I get slightly dizzy and then a massive migraine and have to take two days to recover. I am not prone to migraines.
My regular ENT sees nothing wrong and an ENT who specializes in dizziness thinks it maybe nerve damage from the lyme.
Could what I have be the same physical issues as outlined in this blog with different symptoms?
Thanks
Great question. I advise my patients to be carefully worked up for other causes which you certainly have done. I have some patients who have benefited from looking again at Lyme disease and some who have not. Four of 27 neurologic cases in the 1990 NEJM article by Logigian et al had hearing loss but the authors did not indicate whether their antibiotic treatment worked.
Great question. I advise my patients to be carefully worked up for other causes which you certainly have done. I have some patients who have benefited from looking again at Lyme disease and some who have not. Four of 27 neurologic cases in the 1990 NEJM article by Logigian et al had hearing loss but the authors did not indicate whether their antibiotic treatment worked.
Hi,
I have Lyme and hearing loss (which could be some thing I inherited, since relatives on both sides have very poor hearing).
I can not wear my hearing aides, after 2-3 hours I get slightly dizzy and then a massive migraine and have to take two days to recover. I am not prone to migraines.
My regular ENT sees nothing wrong and an ENT who specializes in dizziness thinks it maybe nerve damage from the lyme.
Could what I have be the same physical issues as outlined in this blog with different symptoms?
Thanks
Yes. I am still dizzy after treating lyme too
Dramamine and lorazepam help sometimes.
Wish I could get it to stop
I have experienced hearing loose as well. Thankfully it’s only happened to one ear.
Me too.. I also have hearing loss in one ear. And I also have experienced vertigo on and off.
I get my ears candeled every few months and it helps with itching in the ears and hearing.
I had vertigo the whole 3 years I had full blown Lyme. I had an MRI and I have damage in my left ear, most likely due to Lyme Disease.
Hi, I’ve haven’t been diagnosed with Lyme yet but I have all the symptoms, especially tinnitus, dizziness, muscle fatigue. Also, last 3 brain MRIs show white matter not associated with MS. About a year ago one of my Lyme titors were positive but the others were negative, so they said I didn’t have it.
I was bitten by a tick when I was a child a long time ago. It was actually inbedded in my skin.
Is it possible, I could have it and not be diagnosed from 50 years ago?
Appreciate your opinion
Yes , latent infections can emerge later in life . Your personal immune was handling it , mostly probably not completely though . Induced for mental and physical trauma and other illnesses especially C… Lyme can also be the root cause for white matter , but your Neuro willlabel you with MS. Conventional cdc Lyme testing is NOT reliable . Soooo many including myself only had one band on a Western blot . Again, bad testing , bad suggestive guide lines and unknowledgeable MD’s. Find a Lyme literate MDfor specialized testing
I have not been diagnosed yet. Because of my vertigo dizziness nausea, spins, sweats and severe fatigue that’s progressively gotten worse…my doctor tested for Lyme and it was negative. But other labs showed I’m B12 and Iron deficient + Low Hemoglobin. She referred me to an ENT, they did an audiogram then told me I was fine and dismissed my tick bite. I now have to come out of pocket to get more testing. My PCP does give me a monthly prescription of meclizine and Zofran which is the only thing that gets me through the day when I have an episode. It’s been 4 years and have to be my own advocate.
I find the tests for tick borne disease not as reliable for my patients as I would like. I often rely on other doctors to rule out other diseases as you have done. I have patients with tick borne disease who have done well with antibiotic treatment who never tested positive.
I have been dealing with Lyme for about 5 years and go through vertigo about once every 4 to 6 months lasting about 3 weeks at the worst all dr’s say is everything looks fine I bring up Lyme disease and they act like it’s a rumor
The only thing I have found so far to help with the Lyme dizziness/vertigo is to move slowly and take ‘Loratadine’. Walk carefully and when I lie down my head swims for a few seconds. I am 74 and have had Lyme for 7 years. Took 3 rounds of antibiotic, but the symptoms remain in a lesser form.
I have patients with similar dizziness due to autonomic problems related to Lyme disease. The dizziness can be worse with lying down or changing position quickly. It typically does not last so long. I have them see other doctors. If they are still ill, I have patients who have done well with retreatment.
In May 2019 I fell a little ill in The Canary Islands, headache and feeling unwell for a day or two. On my way back home to Iceland a few days later I lost all sense of balance for about two weeks. The doctors put me through all kinds of tests finding nothing and about two weeks later I was ok. At the time I discovered a very suspicious rash, with a distinct bullseye and out ring that slowly went outward to about 3-4 cm(small for Lyme I think). Since then I´ve had strange symptoms but not very serious, little bad knees, eye floaters, knocking in my ear and loosing balance again for a few days.
Forward to this summer, it started with a searing headache in my left temple, then numbness in my right foot and now I´m tingling non stop in both feet, right arm, all face, tongue and throat and feeling like my breathing is laboured and tight.
Is it possible, although my rash was smaller than what is normal and the Canaries not really known for Ticks and Lyme disease although there have been reported a few cases, that I have Lyme disease?Best regards
Adam
It is particularly important to rule out other illnesses if the exposure is less likely and the rashes are under 2 inches in diameter. I have patients who were infected with tick borne illness from somewhere else that they suspected. I also have patients who were infected with Lyme disease at some other place at some other time.
Thank you for your response 🙂
The doctors here are in the process of ruling out other illnesses as well as Lyme disease.
My 38 year old daughter started having vertigo and loss of hearing. Drs can’t find any reason other than meniers. My daughter was diagnosed years prior with Lyme disease. What can we do to find help. No Drs go beyond one tier on Lyme testing.
There were patients with chronic neurologic Lyme disease described with dizziness and hearing loss by Drs in 1990 in the NEJM. I have seen the same issues despite working with neurologists and ENT specialists. I have had to use clinical judgment if the tests are negative.
I’m just getting over my 3rd attack of vertigo which lasts for two to five month, on my left side, the left side of my head is still slightly numb. I had Lyme Meningitis and Lymphocytosis Pleocytosis in my spine in August of 2019. My ears and hearing are fine. Some issues have cleared up; still dealing with nerve pain in my arms and chest, severe fatigue, some fevers. During the vertigo attacks I have problems reading. The doctors in Syracuse won’t confirm post treatment Lyme disease syndrome. The Infectious Doctor I met with was horrible and doubted I ever had Lyme. I found a bulls eye on my right hip in 2022, my GP didn’t have time to get me in and my Rheumatologist, who I saw, said she didn’t want to see it and “didn’t want to get involved”. Five months later I had a very painful effusion on my right knee. I was given Doxycycline but they didn’t test the infection. Now I have pain in my hips and legs from time to time. I would’ve been a great test subject.
I hope get all better