One year after infection, patient shows signs of Lyme meningitis

Woman with Lyme meningitis getting an ear exam.

Sudden sensorineural hearing loss can be due to various factors but most often, the exact cause is unknown. This case report describes how undiagnosed Lyme disease with neuroborreliosis could induce sudden sensorineural hearing loss and facial nerve palsy – as long as one year after the infection with Borrelia burgdorferi.

 

In their article “Lyme neuroborreliosis as a cause of sudden sensorineural hearing loss and facial palsy,” Nitro and colleagues present a case involving a woman in her 40’s who developed a sudden loss of hearing in both ears, along with facial palsy and was later diagnosed with Lyme meningitis.¹

“Bilateral hearing loss is rare,” the authors point out.

The patient was admitted to the emergency department reporting hearing loss in both ears and tinnitus. Her symptoms had been ongoing for 3 days. She also complained of dizziness, neck pain and stiffness.

She was admitted to the hospital overnight for observation and received oral amoxicillin/clavulanate for a possible ear infection. “During the night, a new urgent neurological consult was requested following sudden right facial palsy,” the authors wrote.

Patient with neuroborreliosis presented with a sudden sensorineural hearing loss and rapidly progressive facial palsy.

The patient was then started on intravenous methylprednisolone, valaciclovir and intravenous ceftriaxone.

Over the next 2 days, her neck pain improved but her hearing loss and facial palsy did not get any better.

Lyme meningitis diagnosed 1 year after tick bite

Upon further questioning, the patient mentioned that one year earlier she had removed a tick from her right ear canal.

Tests results were positive for Lyme disease and an MRI showed suggestive signs of Lyme meningitis with multiple cranial nerve involvement.

The woman was treated successfully with IV steroids and ceftriaxone. “At the end of the therapy, the patient showed a complete resolution of the meningeal inflammation, facial palsy, and sensorineural hearing loss.”

“The most challenging feature of this case was identifying a diagnostic connection between SSNHL [Sudden sensorineural hearing loss] and rapidly progressive unilateral facial palsy.”

Authors Takeaways:

  • “This case report highlights the importance of collecting a complete medical history in all cases of facial palsy and sudden hearing loss while presenting an infrequent clinical presentation of early disseminated Lyme disease with neuroborreliosis.”
  • “… no literature reports association or correlation between [sudden sensorineural hearing loss] and facial palsy except for one case report in which they have been described after a tick bite.”
  • “One of the most peculiar features of neuroborreliosis can manifest up to 1 year after a disseminated infection, as in this case report.”
References:
  1. Nitro L, Martino B, Fuccillo E, Felisati G, Saibene AM. Lyme neuroborreliosis as a cause of sudden sensorineural hearing loss and facial palsy. Clin Case Rep. 2022 Oct 11;10(10):e6412. doi: 10.1002/ccr3.6412. PMID: 36245466; PMCID: PMC9552548.


5 Replies to "One year after infection, patient shows signs of Lyme meningitis"

  • Debbie Palminteri
    11/02/2022 (1:31 pm)
    Reply

    I’m Debbie, I’m struggling with lyme for over a year. Severe rt. ear pain, neuropathy like, left ear has mild pains . Severe jaw pain which shoots deep into my ear. Mild to severe dizziness and nausea. Neuropathy on my rt side from chest to toes. Leg, knee and foot are effected. Arthritis in my Rt. knee is bad, mild in left. My ENT feels the pain in my jaw is arthritis. The debilitating headaches and neck pain are helped tremendously with magnesium and turmeric. Potassium helps with other pains. Nothing helps my jaw . Nothing helps the horrible collagen loss and elasticity loss. Weight has dropped terribly. I was 130ish and went to a steady 119 lbs. I’ve been trying to gain anything and can’t. My memory is effected sporadically and is scary. I eat healthy, sober 38 yrs. in AA, no illicit drugs, go to yoga, art class, therapy for depression etc, but can’t find any Dr that can help me. I’m seeing a new neuro., rheumatologist, oral surgeon eventually, cardiologist, endocrinologist. I’ve seen 4 I.D. Drs who were invalidating, challenging, disrespectful, causing me to feel victimized not supported or helped. I research lyme and bought a book, which is where I get validation and knowledge. In a year I’ve met 31 other (what I call) Lyme-A-Ticks and we feel like Luna-ticks because we can’t get the help we need and deserve. I’m coordinating a support group as soon as I feel healthier. If you feel you can help PLEASE let me know. I really appreciate your time.

    • Dr. Daniel Cameron
      11/03/2022 (4:50 pm)
      Reply

      I am sorry you have struggled. Call my office at 914 666 4665 if you are interested in an evaluation.

  • Sydney Hampton
    10/26/2022 (2:40 pm)
    Reply

    Hi
    I have off and on tinnitus. Thinking I was loosing my hearing I bought a pair of hearing aids from the tv. Can’t figure how to use them. Facial palsy, mine started below the left eye year and half ago I suppose. Last few months it’s both sides of face and sometimes my whole head.
    So many strange symptoms with this Lyme and Babesia.
    My blood work changes, kidney issues, then Liver enzymes are high. My cholesterol levels over the top. I thing LDL is over 200. Overall is 278. Never had issues.
    I’m obsessed with worries of these ever changing symptoms. I can’t get out and walk, jog, or run 1/2 marathons anymore. Lack of the exercises I done before I know contribute to the cholesterol numbers but what do we do when we’re falling apart inside. Because we look decent on the outside. People think we are just fine.

  • Rebecca
    10/20/2022 (11:44 am)
    Reply

    Hi Dr. Cameron, I’m one of your patients for Lyme Disease. I have had bad tinnitus for several years. It is inconsistent, comes and goes. But at times it is extremely loud. Could this be a result of Borrelia? Thanks, Rebecca

    • Dr. Daniel Cameron
      10/20/2022 (2:26 pm)
      Reply

      I have patients with tinnitus who so well with treatment for Lyme disease.


Join the Lyme Conversation
(Note: comments are moderated. You will see your comment after it has been reviewed.)

Some html is OK