Auditory Hypersensitivity in Children with Lyme Disease

Four cases of children with Lyme disease having auditory hypersensitivity are presented. Auditory testing revealed no consistent pattern of problems except for the low loudness discomfort levels (LDL) found. Medical professionals who see children with Lyme disease should consider audiological testing to include LDL measures. Treatments for auditory hypersensitivity are discussed. AUDITORY PROBLEMS IN CHILDREN WITH LYME DISEASE Parents who have children with Lyme disease are very concerned with the impact of the disease on their children’s bodies. One factor that is not well addressed with such children is how the Lyme disease may affect the child’s abilities to process what is heard. Hearing abilities relate to two factors. One is threshold sensitivity, and hearing loss has been reported in some people with Lyme disease [1]. For example, [2] reported that hearing problems were found in 48% of patients with late stage Lyme disease. The other factor is auditory processing which has to do with how we take in and use the auditory information we hear. One aspect of auditory processing seen with people who have Lyme disease is hypersensitivity to sound [1-5]. Auditory hypersensitivity relates to a person being overly sensitivity to sound. The University of California Medical Center at San Francisco has a website focusing on auditory hypersensitivity which they define using another term called hyperacusis. Hyperacusis is defined by them as “a reduced tolerance and increased sensitivity to everyday sounds” [6,7]. Some sounds can be everyday ones such as doors closing or children crying [3]. Baguley [8] describes hyperacusis as intolerance to ordinary, environmental sounds that lead to the person with hypersensitive hearing to react inappropriately compared with how other people with the same normal hearing would react to such sounds. Often, the reactions are autonomic nervous system responses such as in the “fight or flight” reaction a person may have when frightened. In such cases, some have referred to this over sensitivity as phonophobia or misophonia [9]. Research has demonstrated that people with Lyme disease who report they were able to tolerate sounds prior to contracting the disease notice an intolerance to loud sounds afterwards [2,4,5]. This intolerance can become so severe that it has even led to people taking their own lives [3]. Some research has been done looking specifically at the auditory manifestations of people after they have contracted Lyme disease. Shotland et al. [5] reported a reduction in loudness tolerance in 31% of their subjects. They further reported this reduced loudness tolerance was seen in many subjects in spite of having normal hearing or minimal loss of hearing. Bamiou, Musiek, & Luxon [4] stated that auditory processing deficits (APD) could be due to Lyme disease and may remain with these people long after treatment of the disease has been successful. What is missing from their study is that they do not indicate the specific types of auditory processing problems present in people with Lyme disease or whether the problems were seen in adults, children or both age groups. In the course of the author’s clinical work, he has met some children who contracted Lyme disease and for whom concerns were observed with these children having difficulties listening and understanding what they heard. One group of patients included three children all from the same family who contracted Lyme disease after going on a family camping trip. The other patient is a high school student who noticed problems listening and “hearing” one year after he had been treated for Lyme disease. When discussing the medical histories regarding these four cases, the parents and adolescent reported that they were told by the children’s primary care physicians about the Lyme disease and the treatment for the disorder, they were told of some of the behavioral manifestations they may encounter, but they were never told by their medical doctors about auditory problems they might experience once the medical professionals identified that their hearing was normal. Thus, it appeared that hearing loss was the only focus of hearing concern raised by the medical professionals, but their doctors never discussed problems with auditory intolerance also known as auditory hypersensitivity. Yet, all four of these patients have significant hypersensitivities to sound which might be treatable. The following is a discussion of the auditory processing results found for these four cases with Central Lucker (2015) Email: Ann Pediatr Child Health 3(1): 1035 (2015) 2/4 a general discussion of what might be recommended regarding treatment. For all cases, parents provided written informed consent allowing their children’s records to be used in this study.