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[Differential perilymph fistula diagnosis]
M van Ophoven1, F Schmäl, W Stoll
1HNO-Klinik der Westfälischen Wilhelms-Universität, Kardinal-von-Galen-Ring 10, 48149 Münster. ophovem@uni-muenster.de
HNO
|October 12, 2001
Summary
Sudden deafness and vertigo during childbirth may indicate a perilymph fistula. In this case, a cerebellar cavernoma caused these symptoms, resolving spontaneously.
Area of Science:
- Neurology
- Otolaryngology
Background:
- Sudden unilateral deafness with vertigo during childbirth can suggest perilymph fistula.
- Rupture of the round window membrane due to pressure is a potential cause.
Observation:
- A 35-year-old woman experienced sudden deafness, vertigo, and nystagmus on the day she delivered triplets.
- Examination revealed right-sided deafness, hyposensitivity, and direction-fixed gaze nystagmus.
- Cranial nerve deficits affecting the fifth and eighth nerves were noted.
Findings:
- MRI revealed a hemorrhagic cerebellar cavernoma compressing adjacent cranial nerves.
- The symptoms were attributed to perifocal edema from the cavernoma.
Implications:
- Cerebellar cavernoma should be considered in the differential diagnosis of sudden sensorineural hearing loss with vertigo during childbirth.
- Spontaneous resolution of neurological deficits and hearing loss is possible with cerebellar cavernoma.
- Less invasive management may be appropriate for certain cerebellar lesions causing cranial nerve compression.