Hearing Loss - Reasons

[Leah77]

Hi,

I have had two recent audiograms - one last spring, one in August. I had these because I had been noticing that it had become very difficult for me to hear in crowded settings, and hard to hear especially men's voices.

The first showed near-normal hearing in my left ear (right about 20dB), except in the low frequencies (1000-500 Hz), where the hearing was about 30dB. In my right ear, the hearing was about 25 dB, except in the lower frequencies (1000-250 Hz) where it was about 40 dB.

At the first appointment, the ENT suspsected Meniere's Disease, because I'd been having episodes of vertigo/tinnitus/hearing loss/full feelings in both ears. He did the audiogram & ordered further testing. However, I didn't go back for any more testing, because at the same time, the neurologist I had seen for the problem first told me that it was all due to conversion disorder & stress (he'd done MRI's & EMGs). So rather than wasting time & having more negative results, I figured I'd just wait the symptoms out.
I then started seeing a therapist.

After a few months, the symptoms did get better, all except the hearing loss.

It kept seeming worse, so I went to the audiologist again. The second test showed a slight worsening of the hearing in each ear, but pretty close.

What I'm wondering is - is it possible that this hearing loss is due to conversion disorder? If so, is it possible that it will improve?

Also, is it possible that I've always had it? I had hearing tests in school. I was 6 weeks premature w/jaundice.

Could it be medication related? I have taken Depakote (for bipolar disorder) which I have heard could cause this type of thing?

What else could cause that?

Thank you!

[Kevin Pho, MD]

There can be many reasons for hearing loss.  The tests you have had would have ruled out most of the more common causes.  Hearing loss can be classifed as sensorineural (involving the inner ear, cochlea, or the auditory nerve) or conductive (involving any cause that in some way limits the amount of external sound from gaining access to the inner ear).

You have had a pretty comprehensive evaluation, include audiologic testing, MRI scans and EMG tests.  You can also consider blood tests to rule out some systemic causes of hearing loss - such as diabetes, thyroid disorders or anemia.

Conversion disorder is possible - but should be considered if more serious causes have been ruled out first.

Although possible, I am not aware of Depakote leading to hearing loss.

You can always consider another ENT opinion if a cause cannot be elucidated.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[Leah77]

Sorry, I should have added - or, could this level of hearing simply be normal? I'm 25 years old. Thanks, again.

[B_Johnson]

Low tone hearing loss can be a normal finding in many individuals.  'Normal' meaning that it is a deficiency that is only measured in a test and most individuals can go about their daily lives with no noticable difficulty in fuctioning.

Although hearing loss and outright deafness have been reported by other individuals taking depakote, it is a very small percentage.  If this is a concern for you, you should speak to your doctor or a neurologist about other pharmacological options or perhaps lowering your dosage.

I very much doubt that your hearing is a complication of your birth history. Unless you were treated with certain antibiotics which are known to be associated with ototoxicity.

-Dr. J

[Searching for Knowledge]

I will be 45 years old in two mnonths and for 15 years I have not been able to hear in my right year.  I assuemd this was due to acute sound.  However, last month I had a stapedectomy.  The 3rd bone in the ear was removed and replaced with a prosthesis.  Upon awaking in revcovery, I noticed a marked improvement in hearing.  You may want to consider.