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Re: Sudden onset vertigo and hearing loss
Posted By CCF Neuro[P] MD, RPS on April 06, 1999 at 20:59:29:

In Reply to: Sudden onset vertigo and hearing loss posted by TJ on April 06, 1999 at 11:22:18:

I am a white, male, 36 years of age previously in general good health.  Two months ago I developed severe sudden onset vetigo and hearing loss w/ tinnitus.  Hearing loss continued to decline over 72 hr period.  Hearing test after 3rd week indicated hearing loss of 70% left 100% right. Very gradual improvement since onset.  After two months I still have noticable balance dysfunction, tinnitus, some hearing loss, fatigue, and diminished ability to concentrate.  Treatment consisted of Steroids; 1 injection and next week began 12 day series, and Diazepam for dizziness.  Results of all blood work were within normal limits.  I am now able to get up and around, returned to work in a limited capacity.  I have difficulties walking if in a crowded area or when surrounded by movement.  Also have difficulty wallking in a moderate wind.  Can not distinguish direction of sounds.  I have extreem difficulty listening to conversations in a crowded room or when there is moderate background noise.  Little to no improvement in any of the mentioned symtoms in the past week.  ENT did not try to make a difinitive diagnosis, Family Dr. suggested a viral infection of the inner ear.  Should I be concerned about any other possible causes?  Any additional tests that should be run?  Thanks for any assistance you can provide!    

Dear TJ;
Sorry to hear about your problems.  Sounds like it could one of two things.  If the vertigo (room spinning feeling) is recurrent, sudden, and severe, lasting 1-2 hours and then resolves but returns then you might have Meniere's disease.  After multiple attacks there is hearing loss and residual tinnitus.  The other disorder is acute labyrinthitis, which may be secondary to a viral or bacterial infection.  Here the onset may be sudden or gradual, with severe vertigo and gastrointestinal symptoms.  Hearing may or may not be affected.  The first disorder is treated symptomatically during the attacks and if unresolved may need surgery (Alan Shepard the astronaut had this condition).  The second disorder is just treated symptomatically.  Given time the latter usually has a pretty good outcome.
If there are any cranial nerve dysfunction such as loss of corneal reflex, then you will need an MRI with contrast to rule out the possibility of a schwannoma occuring at the CP angle.  Usually, this would not present as a sudden vertigo.
Without examining you it is difficult for me to tell you the exact diagnosis.  My guess would be acute labyrinthitis but I would just make sure that you have no cranial nerve dysfunction.
CCF Neuro[P] MD

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