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Lyme disease patients can experience an extreme sensitivity to sound, also known as auditory hyperacusis. In some patients it is limited to louder sounds, but in the more severe cases "ordinary" sounds can be very debilitating. The impact can be felt throughout the body, and this condition can affect every aspect of daily living. Patients can experience heightened awareness and an inability to tolerate conversation, running water, page turning, the humming of electronic devices, other people's breathing, etc. These normal everyday sounds become painful and unbearable, and as a result the individual's ability to leave the home is greatly limited. Patients may also experience an increased startle response and an "electric shock" type feeling.

Sounds can also induce dizziness, and this is called Tullio's phenomenon or audiogenic seizure disorder. According to Jenifer Nields, MD, "This peculiar short-circuiting of the inner ear's auditory and vestibular functions is known as the Tullio phenomenon. This phenomenon has been deemed pathognomonic for syphilis (43) but, as it appears, can occur in Lyme disease as well (41), and thus provides one more example of the "new great imitator," Lyme disease, imitating the old "great imitator," syphilis (1)." (Psychiatric Quarterly, Spring 1992). Vestibular Hyperacusis can also affect the autonomic nervous system.

Sometimes another central auditory processing disorder, tinnitus (buzzing or ringing in the ear), can accompany hyperacusis. Lyme disease patients can also experience sensitivities to light, smells, taste, touch, motion and/or temperatures.


The best treatment is often determined based on trial and error, and the results vary from patient to patient. Treatment can include a combination of sound avoidance, sound reduction devices, tinnitus retraining, relaxation, medication and nutrients. The use of ear protection is an individual decision and can be complicated. On the one hand ear plugs can cause a vicious cycle where the brain adjusts and becomes even less tolerant to noises, but on the other hand some may find it absolutely necessary. Some patients like ear plugs, but others prefer headphones such as Shooter's or Bose. For various reasons, some patients may not tolerate ear protection at all and find it creates other problems.

It is important to discuss all treatment options with your physician. In the case of Lyme disease, hyperacusis may or may not resolve or reduce with antibiotic treatment, and other treatments may also be necessary. There are some psychiatrists with expertise in Lyme who are knowledgeable about the different treatment options for Lyme-induced hyperacusis.

Individual nutrient deficiencies can be determined by testing at functional medicine laboratories, ie. Metametrix ION test. There is no drug specifically designed for hyperacusis, and it can be highly frustrating to find one that helps. Any medications used for this condition are considered experimental, and as with any other treatment results vary. The following medications, which are organized by type, are listed here to aid in discussion with your personal physician. It is important to note that if a medication in a category does not work, this does not rule out other medications in the same category.

Gabapentin (Neurontin), Carbamazepine (Tegretol), Tiagabine (Gabitril), Divalproex (Depakote), Topiramate (Topamax). See Anti-Convulsants ; See Nutrient Depletion
Amitriptyline (Elavil), Clomipramine (Anafranil), Doxepin HCL (Sinequan). See TCAs
Zolmitriptan (Zomig), Rizatriptan (Maxalt), Sumatriptan (Imitrex). See SRAs
Clonazepam (Klonopin), Lorazepam (Ativan), Diazepam (Valium), Alprazolam (Xanax). See Benzodiazepines
Antivert (Meclizine). See Meclizine
Lemon Bioflavonoid, Magnesium, B Vitamins (ie. B1, B6, complex), Vitamin A, Zinc, NAC, Gingko, Vinpocetine
Thiamin Deficiency and Lyme
Ear Protectors
Tinnitus Treatment Options
Drugs for Tinnitus
Retraining Therapy
More on TRT
Noise Sensitivity and Magnesium
rTMS and tDCS for tinnitus
Tinnitus Treatment List
Bose noise cancellation headphones
Pink Noise CD
Homeopathic Guide
Gingko Biloba
Vitamin A
HearAll Formula
Arches Tinnitus Relief Formula

Hyperacusis Resources:

Hyperacusis Focus
Hyperacusis Network
Tullio's Phenomenon
Tinnitus and Hyperacusis Center
Canadian Center
Oregon Tinnitus & Hyperacusis Center

Additional Articles:

Carbamazepine in Lyme Hyperacusis
Audiologic manifestations of patients with Lyme disease
Lyme Disease and Cognitive Impairments
LymeInfo: Neuropsychiatric Lyme disease
Hyperacusis and 5-HT dysfunction
Binaural Integration
List of Ototoxins
Ototoxic Medications
Hyperacusis Overview
Additional "Audiology Online" Articles
Hearing Beyond the Ears
Hyperacusis General Info
Migraine Associated Vertigo
Tinnitus (and Hyperacusis) FAQ
Intro to Central Pain Syndrome