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Kim I, Kim H. Management of Sudden Sensorineural Hearing Loss in Multiple Sclerosis: A Comprehensive Case Report of a Patient with Bilateral Loss and Literature Review. Life (Basel) 2024; 14:83. [PMID: 38255698 PMCID: PMC10817240 DOI: 10.3390/life14010083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
In multiple sclerosis (MS), the occurrence of sudden sensorineural hearing loss (SSNHL) is considered rare, with reported cases predominantly being unilateral. Bilateral cases are even rarer. Here, we report a case of bilateral SSNHL in a 20-year-old male diagnosed with MS. The patient, undergoing corticosteroid therapy for the management of MS, additionally received an intratympanic dexamethasone injection; however, it could not achieve significant improvement. Subsequently, the systemic dosage was increased for one week, resulting in substantial hearing improvement in both ears after three months. A review of MS-related SSNHL cases from 1987 to 2022 revealed 39 ears in the literature, with only five ears showing no hearing recovery. A remarkable 87.2% exhibited restored hearing, presenting a more favorable prognosis compared with idiopathic SSNHL. Although there were slight variations in administration methods and duration, all documented treatment approaches involve systemic corticosteroids. In some instances, SSNHL manifested as the initial symptom of MS. When SSNHL occurs in MS, auditory brainstem response (ABR) tests may reveal prolonged abnormalities, making ABR testing effective in cases where MS is suspected following SSNHL. In conclusion, the treatment of MS-related SSNHL appears appropriate with systemic corticosteroids, showing a significantly superior prognosis compared with idiopathic SSNHL.
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Affiliation(s)
- Ikhee Kim
- Department of Otorhinolaryngology–Head and Neck Surgery, Konyang University College of Medicine, Daejeon 35365, Republic of Korea;
- Department of Medicine, the Graduate School of Konyang University, Daejeon 35365, Republic of Korea
| | - Hantai Kim
- Department of Otorhinolaryngology–Head and Neck Surgery, Konyang University College of Medicine, Daejeon 35365, Republic of Korea;
- Konyang University Myunggok Medical Research Institute, Daejeon 35365, Republic of Korea
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Gür E, Binkhamis G, Kluk K. Effects of multiple sclerosis on the audio-vestibular system: a systematic review. BMJ Open 2022; 12:e060540. [PMID: 35977771 PMCID: PMC9389089 DOI: 10.1136/bmjopen-2021-060540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/29/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Systematically investigate the effects of multiple sclerosis (MS) on the audio-vestibular system. METHODS Systematic review of literature investigating audio-vestibular conditions in persons with MS (PwMS) aged ≥18 years. PubMed, Scopus, NICE and Web of Science were searched. Randomised controlled trials, and cohort, case-control, observational and retrospective studies in English, published from 2000 to 21 November 2021, evaluated PwMS with at least one outcome (pure tone audiometry, auditory brainstem response, otoacoustic emissions, cortical auditory evoked potentials, functional MRI assessing auditory function, vestibular evoked myogenic potentials, videonystagmography, electronystagmography, posturography, rotary chair, gaps in noise, word discrimination scores, duration pattern sequence test), were included. Study selection and assessments of bias were independently conducted by two reviewers using the Risk of Bias Assessment Tool for Non-randomized Studies, Newcastle-Ottawa Scale (NOS) and the NOS adapted for cross-sectional studies. RESULTS 35 studies were included. Auditory function was evaluated in 714 PwMS and 501 controls, vestibular function was evaluated in 682 PwMS and 446 controls. Peripheral auditory function results were contradictory between studies; some found abnormalities in PwMS, and others found no differences. Tests of brainstem and central auditory functions were more consistently found to be abnormal in PwMS. Most vestibular tests were reported as abnormal in PwMS, abnormalities were either peripheral or central or both. However, quantitative analyses could not be performed due to discrepancies between studies in results reporting, test stimulus and recording parameters. CONCLUSIONS Although abnormal results on auditory and vestibular tests were noted in PwMS, specific effects of MS on the audio-vestibular system could not be determined due to the heterogeneity between studies that restricted the ability to conduct any quantitative analyses. Further research with consistent reporting, consistent stimulus and consistent recording parameters is needed in order to quantify the effects of MS on the auditory and vestibular systems. PROSPERO REGISTRATION NUMBER CRD42020180094.
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Affiliation(s)
- Evrim Gür
- Manchester Centre for Audiology and Deafness (ManCAD), School of Health Sciences, Ellen Wilkinson Building, The University of Manchester, Manchester, UK
| | - Ghada Binkhamis
- Manchester Centre for Audiology and Deafness (ManCAD), School of Health Sciences, Ellen Wilkinson Building, The University of Manchester, Manchester, UK
- Communication and Swallowing Disorders, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Karolina Kluk
- Manchester Centre for Audiology and Deafness (ManCAD), School of Health Sciences, Ellen Wilkinson Building, The University of Manchester, Manchester, UK
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Hearing abnormalities in multiple sclerosis: clinical semiology and pathophysiologic mechanisms. J Neurol 2022; 269:2792-2805. [PMID: 34999960 DOI: 10.1007/s00415-021-10915-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/14/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
Auditory manifestations from multiple sclerosis (MS) are not as common as the well-recognized sentinel exacerbations of optic neuritis, partial myelitis, motor weakness, vertiginous episodes, heat intolerance, and eye movement abnormalities. This paper discusses four cases of auditory changes, secondary to MS, and describes the first case, to our knowledge, of palinacousis, the perseveration of hearing, despite cessation of the sound stimulus. For each we characterize the initial complaint, the diagnostic work up, and ultimately, underscore the individualized treatment interventions, that allowed us to achieve a remission in all four cases. Individually codifying the treatment regimens served to mitigate, if not to abolish, the clinical derangements in hearing. Special attention is focused upon examination of the clinical manifestations and the pathophysiologic mechanisms which are responsible for them. We further emphasize the differential diagnostic considerations, and physical exam findings, along with the results of laboratory testing, neuro-imaging sequences, and lesion localization. Taken together, such information is germane to organizing cogently coherent strategic treatment plan(s). We believe that this small case series represents a clinically pragmatic example of 'precision medicine'; a principal theme and goal throughout this paper, the achievement of such in MS, but also as an illustration for the assessment and management schema for neuroimmunologic disorders in general.
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The audiovestibular manifestations as early symptoms of multiple sclerosis: a scoping review of the literature. Ir J Med Sci 2021; 191:391-400. [PMID: 33544333 DOI: 10.1007/s11845-021-02508-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/06/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Multiple sclerosis (MS) is an immune-mediated, demyelinating disease of the nervous system, which may impact the audiovestibular pathway at different stages of the disease. The auditory and vestibular manifestations of MS as a presenting or early symptom are an area in which more investigation is needed. AIMS The aim of this review is to determine the auditory and vestibular symptoms, which may occur at the presenting stage of multiple sclerosis. This clinical knowledge will allow a clinician to facilitate early diagnosis and intervention of MS through appropriate onward referral. Audiological and vestibular test results, as well as magnetic resonance imagery results, will also be examined to try to determine the impact of MS on the auditory and vestibular pathways. METHODS A scoping search of the electronic databases PubMed, Scopus, Web of Science, ScienceDirect, and EBSCO was conducted in March 2020 to obtain studies specifically of patients with audiovestibular symptoms at the early or presenting stages of multiple sclerosis. Data was extracted from studies which met the inclusion criteria and studies were subsequently critically appraised and assessed for risk of bias. RESULTS Eighteen papers met the inclusion criteria for this study. Results of the study found that the most common audiovestibular manifestation as a presenting symptom of MS was unilateral, moderate-profound, fluctuating, and sudden sensorineural hearing loss across all frequencies (250 Hz-8000 Hz). Other symptoms include tinnitus, balance abnormalities, aural pain and aural fullness, which may accompany SSHL or occur independently. The peripheral involvement of the immune-mediated mechanisms of MS was suggested by peripheral findings in vestibular examination results and the involvement of wave I ABR in patients with irreversible hearing loss. Demyelinating lesions associated with MS were suggested by results obtained from evoked potentials measurements, including ABR, VEMPs, and MLR. CONCLUSION An understanding of the sensitivity of evoked potentials in the detection of demyelinating lesions as well as the most common audiovestibular presentations of the disease allows the practitioner to provide an appropriate onward referral for MRI which may lead to early diagnosis and intervention of MS. We suggest that there is enough evidence to include evoked potentials complementary to MRI in the detection and monitoring of MS. As the review suggests evidence of involvement of the immune-mediated mechanisms of MS on peripheral structures like the inner ear, further clinical research is recommended to explore this mechanism. Key points 1. The most common audiovestibular manifestation as an early symptom of MS was unilateral moderate to profound SSHL across all frequencies (250 Hz-8000 Hz). 2. Findings of the review indicated the involvement of the immune-mediated mechanisms of MS in the peripheral structures of the inner ear. 3. These findings included peripheral results in the vestibular test of the patients involved in the study and secondly, the three studies which reported an absence of full recovery of hearing loss were also three papers which within their ABR results showed abnormality of wave I 4. This is the first paper to support the theory (Di Stadio et al. 2018) [32] that immune-mediated processes of MS can spread to peripheral inner ear structures 5. The review highlighted the sensitivity of evoked potentials in detecting MS lesions in the presenting stage, particularly ABR which demonstrated that in instances in which hearing loss recovered ABR results remained abnormal.
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Valente P, Pinto I, Aguiar C, Castro E, Condé A, Larangeiro J. Acute vestibular syndrome and hearing loss mimicking labyrinthitis as initial presentation of multiple sclerosis. Int J Pediatr Otorhinolaryngol 2020; 134:110048. [PMID: 32353617 DOI: 10.1016/j.ijporl.2020.110048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/10/2020] [Accepted: 04/10/2020] [Indexed: 12/16/2022]
Abstract
Acute vestibular syndrome is most often caused by vestibular neuritis or stroke, although demyelinating diseases may be responsible for 4% of all AVS episodes. The authors present the case of a previously healthy 17-year-old female patient complaining of spontaneous vertigo and right-sided hearing loss. Otoneurological examination suggested a peripheral vestibular cause and video head impulse test revealed a reduced vestibulo-ocular reflex gain. The presence of sensorineural hearing loss raised the suspicion of a central cause and prompted imaging evaluation. A brain MRI evidenced demyelinating lesions in the right middle cerebellar peduncle and the patient was ultimately diagnosed with Multiple Sclerosis.
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Affiliation(s)
- Pedro Valente
- Department of Otorhinolaryngology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, S/n, 4434-502, Vila Nova de Gaia, Porto, Portugal.
| | - Isabel Pinto
- Department of Otorhinolaryngology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, S/n, 4434-502, Vila Nova de Gaia, Porto, Portugal
| | - Cristina Aguiar
- Department of Otorhinolaryngology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, S/n, 4434-502, Vila Nova de Gaia, Porto, Portugal
| | - Eugénia Castro
- Department of Otorhinolaryngology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, S/n, 4434-502, Vila Nova de Gaia, Porto, Portugal
| | - Artur Condé
- Department of Otorhinolaryngology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, S/n, 4434-502, Vila Nova de Gaia, Porto, Portugal
| | - João Larangeiro
- Department of Otorhinolaryngology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, S/n, 4434-502, Vila Nova de Gaia, Porto, Portugal
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Subclinical cochlear dysfunction in newly diagnosed relapsing-remitting multiple sclerosis. Mult Scler Relat Disord 2019; 33:55-60. [DOI: 10.1016/j.msard.2019.05.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/23/2019] [Accepted: 05/26/2019] [Indexed: 01/10/2023]
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Cabbarzade C, Özgen B, Sennaroglu L. Radiological quiz. Sudden sensorineural hearing loss due to multiple sclerosis. Otolaryngol Pol 2014; 68:264-7. [DOI: 10.1016/j.otpol.2013.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 09/20/2013] [Indexed: 10/26/2022]
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Leite HFB, Leite JDCB, Melo MHDA, Vasconcelos CCF, Alvarenga RMDP. Deafness in patients with multiple sclerosis. Audiol Neurootol 2014; 19:261-6. [PMID: 25170548 DOI: 10.1159/000360750] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 02/18/2014] [Indexed: 11/19/2022] Open
Abstract
Multiple sclerosis (MS) is a demyelinating disease and is considered the most debilitating neurological disorder among young adults. Sudden deafness has been reported in MS patients. This article describes cases of sudden deafness related to acute bouts in MS patients. A survey was conducted using 405 records of MS patients attended to at a reference center in the city of Rio de Janeiro between 2011 and 2012 to identify cases of sudden deafness. Seven patients were identified, 6 with a relapsing-remitting course and 1 with progressive disease at onset. Five patients had unilateral deafness and 2 bilateral. The recovery was complete in 4 and partial in 1, and there was no recovery in 2 patients. It was not possible to establish a topographical correlation between deafness and brainstem lesions. Audiometric examinations revealed severe hearing loss during the bout and recovery of hearing in 5 cases after remission.
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Affiliation(s)
- Hugo Fraga Barbosa Leite
- Postgraduation Program of Neurology, Universidade Federal do Estado do Rio de Janeiro UNIRIO, Rio de Janeiro, Brazil
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Chatard-Baptiste S, Martin C, Pouget J, Veyret C. Surdités brusques : intérêt de l’imagerie. ACTA ACUST UNITED AC 2009; 90:1823-35. [DOI: 10.1016/s0221-0363(09)73588-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Coelho A, Ceranić B, Prasher D, Miller DH, Luxon LM. Auditory Efferent Function Is Affected in Multiple Sclerosis. Ear Hear 2007; 28:593-604. [PMID: 17804975 DOI: 10.1097/aud.0b013e31812f716e] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study evaluated efferent medial olivocochlear (MOC) function in patients with multiple sclerosis (MS). Various afferent auditory abnormalities have been described in MS, but there is a paucity of data on efferent function. The brain stem is a site of predilection for MS plaques and the efferent MOC pathway may be affected at this level. METHODS The study included 30 patients who had normal hearing. According to MRI findings, they were divided into two groups: those with an identifiable brain stem lesion (n = 10) and those with MS lesions in other parts of the central nervous system but without demonstrable MS plaques in the brain stem (n = 20). MOC function was evaluated by the olivocochlear suppression test, using transient evoked otoacoustic emissions. All subjects underwent standard auditory tests, including pure-tone audiometry and recording of auditory brain stem evoked responses. Twenty-two healthy subjects with normal hearing, matched for age and gender, served as a reference group for the auditory data. RESULTS The results showed that 66.6% of all patients had reduced MOC function, particularly those (90%) with identified lesions of the brain stem on MRI. Furthermore, abnormal MOC function was found in 55% patients without evidence of a brain stem lesion on MRI. CONCLUSIONS This study provides the evidence for a deficit of efferent auditory function in the majority of patients with MS. Taking into consideration the possible roles of the MOC system in processing of auditory information, abnormal MOC suppression in patients with MS may explain a variety of auditory presentations that are currently largely overlooked. This study also highlights the diagnostic value of the MOC suppression test as a site-of-lesion diagnostic test in MS and in identifying subtle brain stem lesions undetected by MRI, suggesting that subtle brain stem lesions may exist and that the MOC suppression test is sufficiently sensitive to detect them. Accordingly, the MOC suppression test may provide a tool for an early diagnosis of MS.
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Affiliation(s)
- Albert Coelho
- Department of Neuro-Otology, The National Hospital for Neurology and Neurosurgery, United Kingdom
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Aarnisalo AA, Suoranta H, Ylikoski J. Magnetic Resonance Imaging Findings in the Auditory Pathway of Patients With Sudden Deafness. Otol Neurotol 2004; 25:245-9. [PMID: 15129100 DOI: 10.1097/00129492-200405000-00008] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of this study were to evaluate magnetic resonance imaging (MRI) findings of patients with sudden sensorineural hearing loss (SSNHL) and to grade the findings based on their clinical importance. STUDY DESIGN A prospective clinical study. SETTING A tertiary referral center (university hospital). PATIENTS MRI findings of 82 consecutive patients with SSNHL fulfilling the inclusion criteria. MAIN OUTCOME MEASURES We studied 1.0-T MR images that were analyzed by one experienced neuroradiologist. RESULTS Of the six cases (7%) in which clearly hearing loss was obviously associated with the observed pathology, four patients had an acoustic neuroma in the internal auditory canal or cerebellopontine angle, one patient had changes at the level of pons, and one patient had an obliterated internal carotid artery. Of the six other patients (7%) in which MRI revealed changes that suggest a possible etiology to hearing loss, two patients showed a demyelinating process and four patients showed blood vessel abnormalities such as caroticocavernous fistula, abnormally locating vertebral or basilar artery, and a venous angioma. CONCLUSIONS Enhanced MR imaging seems to be a useful examination in patients with SSNHL. The aim should not be only to exclude specific retrocochlear etiologies, but by appropriate techniques, MRI could reveal both peripheral and central abnormalities.
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Affiliation(s)
- Antti A Aarnisalo
- Department of Otorhinolaryngology, University of Helsinki, Haartmanink, Finland.
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Abstract
A surdez súbita se caracteriza como uma surdez sensorioneural de aparecimento abrupto e sem causa conhecida. Seu acometimento é quase sempre unilateral, sendo acompanhada de zumbidos em aproximadamente 80 por cento dos casos e de tonturas em 30 por cento. O diagnóstico diferencial inclue algumas doenças infecciosas, hematológicas, neurológicas e, principalmente, o schwannoma vestibular. A etiopatogenia da surdez súbita é desconhecida, sendo portanto aventadas algumas hipóteses: a hipótese vascular é muito bem aceita, sendo comprovada em alguns estudos experimentais; a hipótese viral, também bastante reconhecida, tem sérias dificuldades na sua comprovação laboratorial; a hipótese auto-imune, mais recentemente relatada, tem o forte respaldo de estudos imunolaboratoriais a seu favor; finalmente, a hipótese de ruptura de membranas (teoria da fístula) vem perdendo terreno em função da sua difícil comprovação. A tendência atual é considerar a surdez súbita como uma afecção de etiopatogenia multifatorial. O tratamento da surdez súbita é o tópico de maior controvérsia. Os corticóides e as drogas vasodilatadoras são as opções mais utilizadas muito em função de sua fácil prescrição associada ao baixo custo. O estudo individualizado de cada caso tende a preconizar diferentes atitudes terapêuticas nos pacientes acometidos pela surdez súbita. Desta forma, diferentes formas de tratamento devem ocupar o espaço dos famosos protocolos de tratamento descritos por inúmeros autores.
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Affiliation(s)
| | - Samir Cahali
- Hospital do Servidor Público Estadual de São Paulo
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Schick B, Brors D, Koch O, Schäfers M, Kahle G. Magnetic resonance imaging in patients with sudden hearing loss, tinnitus and vertigo. Otol Neurotol 2001; 22:808-12. [PMID: 11698800 DOI: 10.1097/00129492-200111000-00016] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The etiopathogenesis in audiovestibular symptoms can be elusive, despite extensive differential diagnosis. This article addresses the value of magnetic resonance imaging (MRI) in analysis of the complete audiovestibular pathway. STUDY DESIGN Retrospective evaluation. SETTING Tertiary referral center. PATIENTS Consecutive sample of 354 patients (mean age 49 years, range 8 to 86 years) with audiovestibular disorders. INTERVENTION Contrast-enhanced MRI of the head with thin-slice investigation of the inner ear, internal auditory meatus, and cerebellopontine angle. MAIN OUTCOME MEASURE All MRIs were evaluated by experienced independent investigators. Statistical analysis was performed using the Statistical Package of Social Sciences data analysis 9.0. RESULTS MRI abnormalities were seen in 122 of 354 patients (34.5%). The MRIs revealed the following: 4 pathologic conditions (1.1%) of the cochlea/labyrinth, 23 abnormalities (6.5%) at the internal auditory meatus/cerebellopontine angle, 12 pathologic lesions (3.4%) that involved the central audiovestibular tract at the brainstem, 78 microangiopathic changes of the brain (22%), 3 focal hyperintensities of the brain that turned out to be the first evidence of multiple sclerosis in 2 patients and sarcoidosis in 1 patient, and 1 temporal metastasis. Other pathologic conditions, such as parotid gland or petrous bone apex tumors, were unrelated to the audiovestibular symptoms. CONCLUSIONS This study indicates that contrast-enhanced MRI can be used to assess a significant number of different pathologic conditions in patients with audiovestibular disorders.
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Affiliation(s)
- B Schick
- Department of Ear, Nose, and Throat Diseases, Head and Neck Surgery, University Hospital Homburg/Saar, Kirrberger Strasse, D-66421 Homburg/Saar, Germany
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Staffen W, Biesinger E, Trinka E, Ladurner G. The effect of lidocaine on chronic tinnitus: a quantitative cerebral perfusion study. AUDIOLOGY : OFFICIAL ORGAN OF THE INTERNATIONAL SOCIETY OF AUDIOLOGY 1999; 38:53-7. [PMID: 10052836 DOI: 10.3109/00206099909073002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The cerebral perfusion of a 55-year-old female patient with chronic tinnitus was investigated quantitatively by single photon emission computed tomography (SPECT) with the xenon133 inhalation method. The first investigation was performed under standard conditions, the second during suppression of tinnitus with intravenous injection of lidocaine. As a reference a healthy volunteer was included under the same conditions. The global cortical perfusion was identical on both sides except for increased perfusion in the auditory cortex, especially on the right side when tinnitus lasted during the first measurement. The second investigation under treatment with lidocaine and during the tinnitus-free interval showed a decrease of the global cortical perfusion with a slightly higher value at the temporal cortex bilaterally. In comparison to the first investigation, a difference between right and left auditory cortex could no longer be demonstrated, and also the difference between regional and global perfusion decreased. A cerebral effect under treatment of tinnitus with lidocaine was shown by the quantitative measurement of brain perfusion. It is debatable whether this effect on cerebral activity results from the medication or as a reaction to the tinnitus-free interval.
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Affiliation(s)
- W Staffen
- Neurological Department, Landesnervenklinik Salzburg, Austria
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Ozünlü A, Mus N, Gülhan M. Multiple sclerosis: a cause of sudden hearing loss. AUDIOLOGY : OFFICIAL ORGAN OF THE INTERNATIONAL SOCIETY OF AUDIOLOGY 1998; 37:52-8. [PMID: 9474439 DOI: 10.3109/00206099809072961] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Sudden hearing loss is a clinical entity which has numerous aetiologies. In cases where the aetiology is not determined, evaluation and treatment of sudden hearing loss are very difficult. A case of probable multiple sclerosis with sudden hearing loss as the initial symptom is reported. The pure-tone audiometry showed a quasi-total sensorineural hearing loss in the left ear; the left side displayed only wave I in the auditory brainstem response (ABR). Electronystagmographic examination revealed hypometric dysmetria and saccadic pursuit abnormalities. Magnetic resonance imaging (MRI) showed high-intensity lesions with multiple foci. After steroid therapy, the patient's hearing loss, vertigo and visual problems improved, but the ABR findings remained unchanged. We have decided to present this case because of the interesting ABR finding revealing the presence of wave I and the absence of all other waves after the normalization of the hearing.
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Affiliation(s)
- A Ozünlü
- Gülhane Military Medical Academy, Department of Otolaryngology-Head and Neck Surgery, Etlik-Ankara, Turkey
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Qiu WW, Stucker FJ, Nguyen HH, Yin SS. Effects of Brain Stem Lesions on Cochlear Function: Mechanism of Hearing Improvement after Removal of a Brain Stem Tumor. Otolaryngol Head Neck Surg 1996. [DOI: 10.1016/s0194-59989670012-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- William W. Qiu
- Shreveport, Louisiana
- Department of Otolaryngology–Head Neck Surgery, Louisiana State University Medical Center in Shreveport
| | - Fred J. Stucker
- Shreveport, Louisiana
- Department of Otolaryngology–Head Neck Surgery, Louisiana State University Medical Center in Shreveport
| | - Henry H. Nguyen
- Shreveport, Louisiana
- Department of Otolaryngology–Head Neck Surgery, Louisiana State University Medical Center in Shreveport
| | - Shengguang S. Yin
- Shreveport, Louisiana
- Department of Otolaryngology–Head Neck Surgery, Louisiana State University Medical Center in Shreveport
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