ears Lyme disease can result in clinical manifestations, such as musculoskeletal pain, erythema migrans, weakness, etc. Can Lyme disease cause deafness? Mostly, hearing loss is associated with aging or trauma. In this blog, we will discuss how deafness and Lyme disease are related. The case studies shared in this blog will help you understand the link between Lyme disease and deafness.
What are the causes of deafness? It was estimated that around 700 million people will be suffering from hearing loss by 2050. An individual, who is not able to hear normally suffers from deafness (hearing threshold of 20 dB). Assisted devices or hearing aids can help people who experience hearing loss. Causes: Genetic factors Meningitis Presence of severe ear infections Exposure to loud sounds Trauma Hyperbilirubinemia Deafness Deafness can lead to problems, such as loneliness and social stigma. The management strategies can vary, depending on the root cause. If deafness occur in Lyme disease, the condition can be managed with antibiotics. Conditions, such as sensorineural deafness can be managed using cochlear implants. These medical devices can cause direct stimulation of the auditory nerve. A bone conduction hearing aid (BAHA) can also be used to provide excellent results. Additionally, speech therapy and auditory rehabilitation are essential that improve the communication skills of the individual. Patients with deafness will be experiencing anxiety, depression, etc. Hence, psychological and emotional support play a predominant role in coping with the challenges.

Can deafness occur in Lyme disease?

Deafness/hearing loss is observed as a clinical symptom of Lyme disease. It can significantly impair hearing health. If left untreated, Lyme disease can affect the vestibulocochlear nerve and the facial nerve. The associated manifestations of Lyme disease comprise

  • Vertigo
  • Sensorineural hearing loss
  • Sensitivity to loud sounds
  • Tinnitus

vertigo

As a result of the inflammatory response in Lyme disease patients, there can be damage to the nerve fibers or hair cells that play a major role in hearing. Sometimes, hearing loss can also occur as a result of an immune response to the bacteria that can affect the functioning of healthy tissues. In a study conducted by Lorenzi et al, antibodies against the bacteria were detected in some patients with deafness.

Enzyme-linked immunosorbent Assay (ELISA) and Western blot tests were used to identify the presence of antibodies. In patients with sensorineural hearing loss, IgG antibodies were detected.

What are the different types of audiological tests that help in detecting Lyme-related deafness?

Deafness in Lyme disease can be diagnosed based on three factors:

  • Serological tests
  • Audiometric analysis
  • Present history

Pure-tone audiometry (PTA) is one of the most frequently used diagnostic tests to evaluate the hearing threshold. Lyme disease may result in sensorineural hearing loss, that can be unilateral or bilateral.

Hearing impact can be assessed using a speech audiometry that determines how a patient can analyse and understand speech. Tympanometry can help to assess the function of the middle ear. Cochlear damage can be detected at an early stage using otoacoustic emissions. These tests can contribute to the early detection and intervention of Lyme disease.

test

Can antibiotics help with deafness in Lyme disease patients?

Auditory symptoms occur when Lyme disease affects the 8th cranial nerve (vestibulocochlear nerve). Antibiotics (doxycycline or amoxicillin) can help relieve the symptoms if Lyme disease is detected at an early stage. These medications can help in alleviating the bacterial infection. If there is a delay in diagnosis, the chance of reversal is less.

In later stages, antibiotics cannot reverse the damage but may reduce the progress of the disease. If patients are not responding to antibiotics, cochlear implants or auditory rehabilitation are required.

Case reports:

A 23 year old female patient was suffering from tinnitus and headache for 2 months. Suddenly, she developed a bilateral hearing loss. Other symptoms, such as skin rashes or facial nerve paralysis were not observed. On clinical evaluation, auricles and tympanic membranes were normal. Upon performing the auditory test, complete hearing loss was noted in the left ear.

Blood tests were conducted that indicated the presence of antibodies (IgM) against the bacteria. The test was negative for IgG. Western blot test was performed after 10 days, that confirmed the results. Antibiotics were prescribed for a period of 21 days for managing neuroborreliosis. But, the patient didn’t experience any improvement in hearing loss. Hence, other treatment modalities were considered (cochlear implants).

A 40-year old female patient was experiencing sudden sensorineural hearing loss and facial nerve paralysis. Investigations revealed the presence of bacteria (Borrelia burgdorferi). MRI scan revealed meningitis, along with the involvement of multiple cranial nerves. After confirming the diagnosis, ceftriaxone was administered intravenously that lead to complete recovery from facial palsy and sensorineural hearing loss.

A 61-year old female patient was suffering from progressive bilateral hearing loss, along with a gait disorder. She was also experiencing depression and migraine. Her MRI scan was normal. Serum inflammatory markers were also found to be normal. On examining the cerebrospinal fluid, there was lymphocytic pleocytosis.

Serology tests confirmed the presence of Lyme disease. Antibiotic treatment was initiated that gradually improved the clinical symptoms. Initially, ceftriaxone was administered followed by doxycycline. Progressive bilateral sensorineural hearing loss is a clinical manifestation that occurs in later stages of Lyme disease. (Stage 3). 4

Conclusion:

When Lyme disease affects the auditory nerves, deafness and other hearing-related issues can occur. The above case studies highlight how Lyme disease affects auditory nerves and result in deafness. Early diagnosis and proper treatment plays a major role in preventing further progression of the disease. A delayed diagnosis can often lead to severe clinical symptoms, such as deafness that require appropriate interventions.

References:

  1. World Health Organization. Deafness and hearing loss [Internet]. Geneva: World Health Organization; 2024 Apr. [cited 2025 Jul 15]. Available from: https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss
  2. Sessa M, Kragholm K, Hviid A, Andersen M, Andersson M. Lyme Disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan– [cited 2025 Jul 15]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542323/
  3. Project Lyme. Lyme disease and hearing loss [Internet]. 2024 Jan 25 [cited 2025 Jul 15]. Available from: https://projectlyme.org/lyme-disease-and-hearing-loss/
  4. Sowula K, Szaleniec J, Stolcman K, Ceranowicz P, Kocoń S, Tomik J, et al. Association between sudden sensorineural hearing loss and Lyme disease. J Clin Med [Internet]. 2021 Mar 8 [cited 2025 Jul 15];10(5):1130. Available from: https://www.ncbi.nlm.nih.gov/articles/PMC7962810/
  5. Rochd S, Benhoummad O, Salhi S, Lakhdar Y, Rochdi Y, Raji A, et al. Isolated sudden bilateral neurosensory hearing loss as a presentation of Lyme neuroborreliosis: a case study. J AudiolOtol [Internet]. 2024 Jan [cited 2025 Jul 15];28(1):72–5. Available from: https://ejao.org/journal/view.php?doi=10.7874/jao.2023.00129
  6. 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 [Internet]. 2022 Oct 11 [cited 2025 Jul 15];10(10):e6412. Available from: https://pubmed.ncbi.nlm.nih.gov/36245466/
  7. Ackermann R, Rehse‑Küpper B, Gollmer E, Schmidt R. Bilateral sensorineural hearing loss and cerebellar ataxia in late stage Lyme disease. Braz J Otorhinolaryngol [Internet]. 2015 [cited 2025 Jul 15];81(6):614–20. Available from: https://www.bjorl.org//en-bilateral-sensorineural-hearing-loss-cerebellar-articulo-S1808869415302822

 

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Sophia Williams

Health & Wellness Content Strategist

Sophia Williams is a passionate content writer specializing in health and wellness and is deeply interested in chronic conditions like Lyme disease. With years of experience in creating educational and empathetic content, I aim to raise awareness and provide valuable insights that empower readers to take charge of their health.