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This study aimed to evaluate the extent to which hearing disorders may be a result of tick-borne Borrelia burgdorferi infection. 98 patients with different patterns of hearing dysfunction were studied. The patients had a history of sudden hearing loss, disorders similar to Menière’s
disease, or hearing loss in combination with acute facial palsy or with vertigo. Serum antibodies against the B burgdorferi antigen were determined during the acute and convalescent periods. 17 patients (17%) showed serological evidence of borreliosis (reciprocal titre of 320 or above). All but 3 of these patients also had vertigo and 3 subjects had peripheral facial palsy. All the 17 patients were treated with high doses of intravenous benzylpenicillin. The hearing of 5 patients improved on treatment. Although the specificity of antibody production against borrelia antigen has not been completely clarified, it is concluded that repeated serological examinations are worthwhile in patients with unexplained hearing disorders.