Preclinical detection of initial vestibulocochlear abnormalities in a patient with multiple sclerosis.
A 49-year-old woman presented with a third-degree continuous spontaneous nystagmus to the left which was followed by a sudden, almost complete deafness of her left ear. These symptoms were established as the sole initial presenting manifestations of multiple sclerosis (MS). Magnetic resonance imaging demonstrated a lesion within the left eight nerve root-entry zone and multiple small central lesions beneath the lateral ventricles. Pure-tone audiometry returned to normalcy after 2 weeks and speech discrimination was 100% after 10 weeks. Auditory brainstem responses (ABRs) showed abnormal parameters during a 10-month follow-up period after the acute hearing loss. Furthermore, desynchronization in ABR testing could be demonstrated 2 days before onset of hearing loss, which was interpreted as a prodromal ABR sign of the incipient MS attack.
Gstoettner
W
W
First ENT Department, University of Vienna, Austria.
Swoboda
H
H
Müller
C
C
Burian
M
M
D000328:Adult; D001301:Audiometry, Pure-Tone; D002552:Cerebral Ventricles / Q000473:pathology; D004584:Electronystagmography; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D003639:Hearing Loss, Sudden / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D009759:Nystagmus, Pathologic / Q000209:etiology* / Q000503:physiopathology; D014725:Vestibular Nerve / Q000473:pathology