(898) Vestibular Complaints in Lyme Disease: Pooled Prevalence of Dizziness in a Systematic Review and Meta-analysis

Introduction: Dizziness is one of the most frequently reported otolaryngologic symptoms among patients with Lyme disease, however, published estimates vary widely across clinical settings and study designs. A pooled estimate may help quantify the overall symptom burden and inform otolaryngologists evaluating suspected or confirmed Lyme disease.

Methods: A systematic review and meta-analysis were conducted to estimate the pooled proportion of dizziness among patients with Lyme disease. Three databases were searched, and after study screening and eligibility assessment, four studies met the inclusion criteria (excluding symptom-enriched otolaryngology/vestibular cohorts) (n = 744). A single-proportion meta-analysis was performed in R/RStudio using inverse-variance weighting. Between-study variance was estimated using a restricted maximum-likelihood (REML) estimator, with heterogeneity assessed using Cochran’s Q and I². Proportions were pooled without transformation.

Results: After screening, four total studies were included in this systematic review. Across four studies, 169/744 Lyme disease patients reported dizziness. The pooled proportion of dizziness was 22% (95% CI: 19%–25%). Heterogeneity was low to moderate (Q = 4.01, df = 3, p < 0.2599; I² = 25.3%; τ² < 0.0001), suggesting a relatively consistent prevalence of dizziness across the included cohorts.

Conclusions: Approximately one in five patients with Lyme disease reported dizziness in pooled analysis. Estimates were reasonably consistent across the studies, though dizziness remains a nonspecific symptom and prevalence may vary across studies. These findings highlight the importance of standardized vestibular symptom definitions and stratifying results by key clinical factors (e.g. disease stage and care setting). Future prospective studies should prioritize prospective designs, include standardized dizziness/vertigo symptom scales, and objective vestibular testing in patients presenting with dizziness who are subsequently diagnosed with Lyme disease, to better characterize prevalence and clinical correlates.