Symmetric sensorineural progressive hearing loss from chronic idiopathic pachymeningitis.
We present the case of a 68 year-old man with a diffused hypertrophic pachymeningitis (HP) involving both internal auditory canals. The clinical symptoms were headache, decreased vision in one eye, progressive bilateral and symmetrical sensory-neural hearing loss (PSNHL) responsive to steroid treatment. Although hearing loss is a frequent manifestation of HP, only few studies reported an adequate audiological assessment and follow-up. Mechanisms related to the auditory involvement are discussed on the basis of audiological data. Gadolinium enhanced MRI is the most adequate technique for HP detection and for the differential diagnosis. A delay in the diagnosis of HP seems to be quite common and the consequences may be severe, especially in cases of optic nerve involvement. For these reasons, a cerebral MRI should probably be included in the assessment of PSNHL, especially when neurological signs coexist or are reported in the medical history.
Bovo
Roberto
R
Department of Audiology, Ferrara University, Ferrara, Italy. roberto.bovo@unife.it
Berto
Anna
A
Palma
Silvia
S
Ceruti
Stefano
S
Martini
Alessandro
A
D000368:Aged; D001301:Audiometry, Pure-Tone; D001921:Brain / Q000473:pathology; D002908:Chronic Disease; D006312:Hearing Loss, Bilateral / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008581:Meningitis / Q000150:complications* / Q000175:diagnosis; D012720:Severity of Illness Index