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Case Reports
- Acute Bilateral Vestibulopathy with Concomitant Progressive Deterioration of Binaural Hearing
- Emil Dahl Overgaard, Dan Dupont Hougaard
- Res Vestib Sci. 2021;20(2):64-68. Published online June 14, 2021
- DOI: https://doi.org/10.21790/rvs.2021.20.2.64
- 5,401 View
- 54 Download
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Abstract
PDF - Bilateral vestibulopathy is a condition with vestibular hypofunction of both inner ears. Patients with this diagnosis will often complain of dizziness and/or imbalance in darkness and when walking in uneven terrain and will often also experience oscillopsia. Predominant etiology is idiopathic. A 73-year old man with complaints of dizziness for 2 days. Objective findings included spontaneous nystagmus, a positive Romberg test with eyes closed, and a pathological video head impulse test. Initial audiometry only revealed bilateral presbycusis. Following gradual non-complete remission of vertiginous symptoms, the patient was discharged and scheduled for follow-up. The patient was later readmitted due to gradual progressive bilateral hearing deterioration alongside persisting vertiginous symptoms. Various additional tests all came out negative, and the condition was classified as idiopathic acute bilateral vestibulopathy with concomitant progressive deterioration of binaural hearing. The patient was later referred to bilateral cochlear implantation. Acute monosymptomatic bilateral vestibulopathy is difficult to diagnose, as it requires very specific tests that are not routinely done by neurologists. Acute bilateral vestibulopathy with concomitant progressive deterioration of binaural hearing leading to bilateral anacusis is indeed so rare that it has not been possible to find any literature describing a similar case.
- Superior Semicircular Canal Dehiscence Syndrome Presenting with Sudden Deafness and Vertigo after Trauma
- Seong Il Kang, Sunjoo Lee, Ji Soo Kim, Ja Won Koo
- Res Vestib Sci. 2013;12(4):132-135.
- 3,997 View
- 66 Download
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Abstract
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- Superior semicircular canal dehiscence syndrome (SCDS) is characterized by cochleovestibular hyper-responsiveness symptoms including sound- and pressure- evoked vertigo and oscillopsia, autophony, hyperacusis and ear fullness. The typical audiometric feature of SCDS is known as conductive hearing loss at low frequency. A 43-year-old man presented with unilateral sudden deafness after several events of heading during soccer game. High-resolution temporal bone computed tomography revealed a dehiscence of superior canal encased by superior petrous sinus. We reviewed audio-vestibular findings in this patient and speculated potential pathogenic mechanisms of sudden deafness in SCDS with literature review.
- Sudden Deafness Concurrent with Ipsilateral Benign Paroxysmal Positional Vertigo
- Youn Ho Kim, Dong Kuck Lee, Jung Im Seok
- Res Vestib Sci. 2011;10(2):74-76.
- 2,788 View
- 49 Download
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Abstract
PDF
- Benign paroxysmal positional vertigo (BPPV) is a disorder caused by otoconia in the inner ear. Its symptoms are repeated episodes of positional vertigo, that is, of a spinning sensation caused by changes in the position of the head. BPPV with simultaneous ipsilateral sudden deafness is rare. A 82-year-old woman was admitted due to acute onset of right ear hearing impairment, tinnitus, and vertigo for a day. She had a history of hypertension for 5 years. On neurologic examination, spontaneous nystagmus was not observed. However, roll test showed direction-changing horizontal geotrophic nystagmus. Vestibular function test showed positional nystagmus compactable with right horizontal semicircular canal-BPPV (canalolithiasis). Brain MRI was unremarkable. Neuro-otologic evaluation reveals right ear sensorineural deafness. Barbecue maneuver was applied for treatment for BPPV. Dexamethasone 10 mg intravenous for 5 days after then methylprednisolone orally for 5 days was done. Vertigo improved after treatment, but deafness still remain. We report a case of sudden deafness concurrent with ipsilateral BPPV and consider the mechanisms of this lesion.
Original Article
- Sudden Deafness and Anterior Inferior Cerebellar Artery Infarction
- Hyung Lee, Sung Il Sohn, Doo Kyo Jung, Yong Won Cho, Jeong Geung Lim, Sang Doe Yi
- J Korean Bal Soc. 2002;1(1):124-131.
- 2,746 View
- 27 Download
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Abstract
PDF
- Background
and objectives : Acute ischemic stroke in the distribution of the anterior inferior cerebellar artery (AICA) is known to be associated with vertigo, nystagmus, facial weakness, and gait ataxia. There have been few reports on deafness associated with the AICA infarction. Furthermore, previous neurological reports have not emphasized the inner ear as a localization of sudden deafness. The aim of this study was to investigate the incidence of deafness associated with the AICA infarction and the sites predominantly involved in deafness. Materials and method : During two years we prospectively identified 12 consecutive patients with unilateral AICA infarction diagnosed by brain MRI. Pure tone audiogram, speech discrimination testing, stapedial reflex testing, and auditory brainstem responses were performed to localize the site of lesion in the auditory pathways. Electronystagmography was also performed to evaluate the function of the vestibular system.
Results
: The most common affected site on brain MRI was the middle cerebellar peduncle (11). Four patients had vertigo and/or acute auditory symptoms such as hearing loss or tinnitus as an isolated manifestation from 1day to 2months prior to infarction. Audiological testings confirmed sensorineural hearing loss in 11 (92%) patients, predominantly involved the cochlea in 6 and retrocochlear in 1. The other 4 patients had a severe to profound hearing loss most likely of cochlear origin. Electronystagmography demonstrated no response to caloric stimulation in 10(83%) patients.
Conclusions
: In our series, sudden deafness was an important sign for the diagnosis of the AICA infarction. Audiological examinations suggest that sudden deafness in AICA infarction is usually due to dysfunction of the cochlea, resulting from ischemia to the inner ear.
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