Serum and cerebrospinal fluid pathology in patients with sudden sensorineural hearing loss

The serum and cerebrospinal fluid (CSF) pathology of patients with sudden s ensorineural hearing loss (SHL), both seropositive and seronegative to Borr elia burgdorferi (Bb), was prospectively studied. Nineteen consecutive pati ents were included and trends between the degree of hearing recovery and se rum/CSF pathology and given therapy were examined. The pilot study showed a high prevalence (68%) of pathology in serum and CSF in patients with SHL. In 54% of the patients, elevated levels of CSF proteins and/or pathological CSF cell counts were present without positive antibodies to Bb. Positive l evels of antibodies against Bb or pathological proteins in CSF were associa ted with better hearing recovery (means of 47.2 and 51.7%, respectively). T he audiometric configuration "high frequency sloping" hearing impairment wa s associated with the lowest degree of hearing recovery. Patients with SHL and positive serology to Bb who received antibiotic treatment (oral tetracy cline), with or without steroids, had the best hearing recovery in this stu dy (61.7 and 48.4%, respectively). In conclusion, we found a high prevalenc e of serum and CSF pathology in a consecutive group of patients with SHL. E arly appropriate antibiotic treatment may prevent the development of major late complications of Lyme disease/borreliosis. We also find it justified t o perform more general serological analyses, including CSF analysis, in pat ients with SHL. A more liberal approach to testing and development of test protocols for SHL patients will increase our knowledge in this field.