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Recurrent laryngeal nerve paralysis due to subclinical Lyme borreliosis

Published online by Cambridge University Press:  10 September 2009

T Karosi ,
T Rácz ,
É Szekanecz ,
Á Tóth  and
I Sziklai
T Karosi*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, University Medical School of Debrecen, Debrecen, Hungary
T Rácz
Affiliation:
Department of Otolaryngology Head and Neck Surgery, University Medical School of Debrecen, Debrecen, Hungary
É Szekanecz
Affiliation:
Department of Clinical Oncology, University Medical School of Debrecen, Debrecen, Hungary
Á Tóth
Affiliation:
Department of Otolaryngology Head and Neck Surgery, University Medical School of Debrecen, Debrecen, Hungary
I Sziklai
Affiliation:
Department of Otolaryngology Head and Neck Surgery, University Medical School of Debrecen, Debrecen, Hungary
*
Address for correspondence: Dr Tamás Karosi, University Medical School of Debrecen, Department of Otolaryngology Head and Neck Surgery, Debrecen, Nagyerdei Krt 98, H-4012, Hungary. Fax: +36 52 414 763 E-mail: [email protected]
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Abstract

Objective:

We report an extremely rare case of recurrent laryngeal nerve paralysis due to subclinical Lyme borreliosis.

Method:

Case report presenting a 15-year-old girl referred with hoarseness and soft voice.

Results:

Right-sided recurrent laryngeal nerve paralysis was observed using videolaryngoscopy. Imaging was used to exclude intracranial, cervical and intrathoracic embryological lesions, vascular malformations and tumours. Laboratory and electrophysiological investigations were used to exclude inflammatory and paraneoplastic processes, endocrinopathy and metabolic disorders. Serological testing was positive for Lyme disease. Parenteral ceftriaxone therapy was commenced. The patient's nerve paralysis showed complete recovery on the seventh day of antibiotic treatment; this was confirmed by videolaryngoscopy.

Conclusion:

Recurrent laryngeal nerve paralysis is an extremely rare complication of neuroborreliosis associated with Lyme disease. In patients with recurrent laryngeal nerve paralysis in whom the clinical history is uncertain and the usual diagnostic methods give negative results, screening with anti-borrelia immunoglobulin M is suggested.

Keywords

Lyme DiseaseNeuroborreliosisRecurrent Nerve ParalysisCephalosporins
Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 3 , March 2010 , pp. 336 - 338
Copyright
Copyright © JLO (1984) Limited 2009

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References

1Stanek, G, Strle, F.Lyme borreliosis. Lancet 2003;362:1639–47CrossRefGoogle ScholarPubMed
2Nadelman, RB, Wormser, GP.Erythema migrans and early Lyme disease. Am J Med 1995;98:15–23CrossRefGoogle ScholarPubMed
3Pinto, DS.Cardiac manifestations of Lyme disease. Med Clin North Am 2002;86:285–96CrossRefGoogle ScholarPubMed
4Steere, AC, Glickstein, L.Elucidation of Lyme arthritis. Nat Rev Immunol 2004;4:143–52CrossRefGoogle ScholarPubMed
5Neuschaefer-Rube, C, Haase, G, Angerstein, W, Kremer, B.Unilateral recurrent nerve paralysis in suspected Lyme borreliosis. HNO 1995;43:188–90Google ScholarPubMed
6Lormeau, G, Reignier, A, Soubeyrand, L, Ambar, G, Ferroir, JP.Recurrent paralysis disclosing Lyme disease. Presse Med 1994;23:1357Google ScholarPubMed
7Schroeter, V, Belz, GG, Blenk, H.Paralysis of recurrent laryngeal nerve in Lyme disease. Lancet 1988;2:1245CrossRefGoogle ScholarPubMed
8Wormser, GP, Ramanathan, R, Nowakowski, J, McKenna, D, Visintainer, P, Dornbush, R et al. Duration of antibiotic therapy for early Lyme disease. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 2003;138:697–704CrossRefGoogle ScholarPubMed