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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: karositamas@gmail.com
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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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