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Recurrent laryngeal nerve paralysis due to subclinical Lyme borreliosis

  • T Karosi (a1), T Rácz (a1), É Szekanecz (a2), Á Tóth (a1) and I Sziklai (a1)...

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.

Copyright

Corresponding author

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: karositamas@gmail.com

References

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7Schroeter, V, Belz, GG, Blenk, H.Paralysis of recurrent laryngeal nerve in Lyme disease. Lancet 1988;2:1245
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;138:697704

Keywords

Recurrent laryngeal nerve paralysis due to subclinical Lyme borreliosis

  • T Karosi (a1), T Rácz (a1), É Szekanecz (a2), Á Tóth (a1) and I Sziklai (a1)...

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