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Doença de Lyme e hipoacúsia
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Resumo(s)
A Doença de Lyme é a doença transmitida por carraças mais prevalente na Europa. Em 5-10% dos casos ocorre Neuroborreliose, sendo a hipoacúsia neurossensorial uma das possíveis manifestações.
O propósito desta revisão de literatura é apelar à consideração da Doença de Lyme no diagnóstico diferencial de hipoacúsia. Isto por se tratar de uma causa reversível e que, na ausência de tratamento pode evoluir para doença grave. Para este efeito o presente trabalho caracteriza o quadro de apresentação de hipoacúsia por Doença de Lyme, e revê os exames complementares de diagnóstico e o tratamento de Neuroborreliose.
A hipoacúsia é neurossensorial e mais frequentemente descrita como unilateral, sendo que se pode apresentar como surdez súbita ou ter um decurso insidioso. Frequentemente acompanha-se por outros sintomas otorrinológicos. A presença de paralisia facial periférica ou radiculopatia dolorosa deve fazer suspeitar Neuroborreliose. Para o diagnóstico procuram-se sinais inflamatórios no LCR, bem como a produção intratecal de anticorpos específicos. A antibioterapia deve ter em conta a fase da doença, sendo ceftriaxona I.V ou doxiciclina oral opções a considerar.
Lyme Disease is the most common tickborne disease in Europe. In 5-10% of cases, there is involvement of the central or peripheral nervous system, being sudden onset of sensorineural hearing loss a possible presenting symptom. This review aims to increase awareness of Borreliosis as na aetiological factor in sensorineural hearing loss, since it’s a reversible cause that with adequate treatment may provide total recovery and prevent more severe forms of Lyme Disease. In this work it’s described the otological manifestations, such as hearing loss of Neuroborreliosis, its diagnostic approach and therapeutics options. The hearing loss is sensorineural, unilateral (in most cases) and can have a sudden onset or a progressive course. It is frequently associated with other otolaryngological symptoms. The presence of peripheral facial palsy or painful radiculopathy should raise the suspicion of Neuroborreliosis. For the diagnosis, inflamatory signs in the CSF and intrathecal production of specific antybodies should be searched. The stage of Lyme Disease influences the antybiotic choice, being IV ceftriaxone or oral doxycycline possible treatments.
Lyme Disease is the most common tickborne disease in Europe. In 5-10% of cases, there is involvement of the central or peripheral nervous system, being sudden onset of sensorineural hearing loss a possible presenting symptom. This review aims to increase awareness of Borreliosis as na aetiological factor in sensorineural hearing loss, since it’s a reversible cause that with adequate treatment may provide total recovery and prevent more severe forms of Lyme Disease. In this work it’s described the otological manifestations, such as hearing loss of Neuroborreliosis, its diagnostic approach and therapeutics options. The hearing loss is sensorineural, unilateral (in most cases) and can have a sudden onset or a progressive course. It is frequently associated with other otolaryngological symptoms. The presence of peripheral facial palsy or painful radiculopathy should raise the suspicion of Neuroborreliosis. For the diagnosis, inflamatory signs in the CSF and intrathecal production of specific antybodies should be searched. The stage of Lyme Disease influences the antybiotic choice, being IV ceftriaxone or oral doxycycline possible treatments.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
Palavras-chave
Hipoacúsia Perda auditiva Doença de Lyme Neuroborreliose Otorrinolaringologia