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Auditory Hypersensitivity in Children with Lyme Disease

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Auditory Hypersensitivity in Children with Lyme Disease Central Annals of Pediatrics & Child Health Review Article *Corresponding author Jay R Lucker, Department of Communication Sciences & Disorders, School of Communication, 4th and Bryant Auditory Hypersensitivity in Streets, Howard University, NW, Washington, DC 20059, USA, Tel: 301-254-8583; Email: Submitted: 29 November 2014 Children with Lyme Disease Accepted: 31 January 2015 Jay R Lucker* Published: 02 February 2015 Department of Communication Sciences & Disorders, Howard University, USA Copyright © 2015 Lucker Abstract OPEN ACCESS Four cases of children with Lyme disease having auditory hypersensitivity are Keywords 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 Lyme disease should consider audiological testing to include LDL measures. Treatments • Auditory hypersensitivity for auditory hypersensitivity are discussed. • Loudness discomfort • Auditory processing • Systematic desensitization AUDITORY PROBLEMS IN CHILDREN WITH LYME • Listening therapy DISEASE Some research h Parents who have children with Lyme disease are very auditory manifestations of people after they have contracted concerned with the impact of the disease on their children’s Lyme disease. Shotlandas etbeen al. [5] done reported looking a reduction specifically in loudness at the bodies. One factor that is not well addressed with such children tolerance in 31% of their subjects. They further reported this is how the Lyme disease may affect the child’s abilities to process reduced loudness tolerance was seen in many subjects in spite what is heard. Hearing abilities relate to two factors. One is of having normal hearing or minimal loss of hearing. Bamiou, threshold sensitivity, and hearing loss has been reported in some people with Lyme disease [1]. For example, [2] reported that (APD) could be due to Lyme disease and may remain with these hearing problems were found in 48% of patients with late stage peopleMusiek, long & Luxon after treatment[4] stated of that the auditorydisease has processing been successful. deficits Lyme disease. The other factor is auditory processing which has What is missing from their study is that they do not indicate the to do with how we take in and use the auditory information we hear. with Lyme disease or whether the problems were seen in adults, childrenspecific types or both of auditoryage groups. processing problems present in people 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 children who contracted Lyme disease and for whom concerns In the course of the author’s clinical work, he has met some sound. The University of California Medical Center at San Francisco has a website focusing on auditory hypersensitivity which they and understanding what they heard. One group of patients includedwere observed three children with these all fromchildren the samehaving family difficulties who contracted listening Lyme disease after going on a family camping trip. The other todefine everyday using sounds”another [6,7].term Somecalled soundshyperacusis. can be Hyperacusiseveryday ones is patient is a high school student who noticed problems listening suchdefined as doorsby them closing as “a orreduced children tolerance crying [3]. and Baguley increased [8] sensitivity describes hyperacusis as intolerance to ordinary, environmental sounds When discussing the medical histories regarding these four and “hearing” one year after he had been treated for Lyme disease. that lead to the person with hypersensitive hearing to react cases, the parents and adolescent reported that they were told inappropriately compared with how other people with the same by the children’s primary care physicians about the Lyme disease normal hearing would react to such sounds. Often, the reactions 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 cases,are autonomic some have nervous referred system to this responsesover sensitivity such asas phonophobia in the “fight that their hearing was normal. Thus, it appeared that hearing or misophoniaflight” reaction [9]. a person may have when frightened. In such lossthey wasmight the experience only focus onceof hearing the medical concern professionals raised by the identified medical Research has demonstrated that people with Lyme disease professionals, but their doctors never discussed problems with who report they were able to tolerate sounds prior to contracting auditory intolerance also known as auditory hypersensitivity. the disease notice an intolerance to loud sounds afterwards [2,4,5]. This intolerance can become so severe that it has even to sound which might be treatable. The following is a discussion led to people taking their own lives [3]. ofYet, the all auditory four of theseprocessing patients results have found significant for these hypersensitivities four cases with Cite this article: Lucker JR (2015) Auditory Hypersensitivity in Children with Lyme Disease. Ann Pediatr Child Health 3(1): 1035. Lucker (2015) Email: Central a general discussion of what might be recommended regarding normally expected levels (see Lucker, 2013) [9]. When asked treatment. For all cases, parents provided written informed about this low level of tolerance, he reported that this was one of consent allowing their children’s records to be used in this study. the listening problems he noticed during the past few months. He stated that prior to this time, he had no problems tolerating loud CASE STUDIES sounds, but now, a little over one year post treatment for Lyme Case of a 16 year old, high school student evendisease, his hefriends found calling he could to each not tolerate other. loud noises such as traffic began noticing problems understanding his teachers in class and noise, motorcycles, sirens from fire trucks and ambulances, and evenThe conversations first case is with of a his16 friends,year old, especially high school when student. there were He Results of the auditory processing tests for this subject noises present, about a year after having been diagnosed with Lyme disease. His complaints led his mother to bring her son to his primary care physician. measures.are presented As canin (Table be seen 1). from Information this table, in LDL that results table indicatesrevealed normal findings vs. abnormal findings for each of the APD Background information of this boy indicated that he lived in of speech understanding in noise tests were normal so the the state of Maryland and had gone camping with his family in the annoyingsignificantly effect lower reported than normally for background expected noises [9]. However,did not interfere results mountain area of West Virginia not far from Harpers Ferry, WV. with the boy’s abilities to understand speech in noise. Other than The family spent a summer vacation in that area including outdoor camping one weekend of that summer. However, the symptoms leading to the boy seen by his medical doctor were not noticed heardthe LDL in problem,the same the order only in deficit which found they onwere APD heard, tests butwas being with until about three months after the family returned from their ableorganization to repeat (i.e., back difficulties all of the correct repeating words back in a differentseries of order).words summer vacation. The boy complained of joint pain, intolerance Otherwise, his auditory processing abilities were found to be to sound, being annoyed by the noises in the street and at school, normal except for the hypersensitivity. are other noises present, especially loud, background noises. THREE CHILDREN FROM THE SAME FAMILY and difficulties listening in class and in conversations when there When the boy’s medical doctor checked him out, the lab tests The second case report is of three children from the same family. The children were a 7 year old boy, a 9 year old girl, and a that he suspected the boy had been bitten by a tick during one of 12 year old girl. They came in for the auditory processing testing theverified family’s that outingshe had Lymeduring disease. their camping The doctor trip in told the the mountains parents six months after they had been diagnosed with and treated for of West Virginia. The doctor believed that the boy had been Lyme disease by their pediatrician. The parents reported noticing infected with borrelia burgdorferi bacterium due to being bitten what they heard starting a few months after the Lyme disease developing Lyme disease. The doctor then prescribed the use of wasdifficulties diagnosed with and all treatmentthree children for the listening Lyme disease and understanding was started. antibioticsby a black-legged to cure tickthe Lymecalled disease Ixodes andscapularis reduce which the symptoms. led to him The Lyme disease was diagnosed in the three children after The medical doctor also checked the boy’s ears via otoscopic returning from a family camping trip in the Blue Ridge Mountains to have the boy’s hearing tested by an audiologist. The audiologist Table 1: completedexamination a findingstandard they hearing looked evaluationnormal and including referred thepure mother tone children with Lyme disease. Results are indicated only for those Audiological and auditory processing test findings in four and speech (SRT) thresholds, word recognition testing in quiet, measures that were abnormal (Low for LDL is abnormal). All other measures were normal as noted at the end of the table.* otoacoustic emission testing (OAE), and middle ear immittance testing (tympanometry). Audiological testing revealed normal Measures Case 1 Case 2 Case 3 Case 4 hearing thresholds and normal middle ear functioning as well Age in Years 16 7 9 12 as excellent word recognition in quiet. Thus, there were no Gender Male Male Female Female hearing problems for the child. Furthermore, the parents and LDL Low Low Low Low the boy reported that he had no symptoms of upper respiratory infection or allergies or exposure to loud sounds.
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