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Persistent Positional Vertigo in a Patient with Sudden Sensorineural Hearing Loss: A Case Report
Yong Won Kim1, Jung Eun Shin1, Yong-Sik Lee1
1Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Journal of Audiology & Otology
|September 29, 2015
Summary
Sudden sensorineural hearing loss (SSNHL) patients experiencing vertigo may have positional vertigo. A case study shows a shift from geotropic to apogeotropic nystagmus, suggesting endolymph changes.
Area of Science:
- Otolaryngology
- Neurology
- Vestibular System Disorders
Background:
- Inner ear organs are interconnected via endolymph, leading to vertigo in sudden sensorineural hearing loss (SSNHL) patients.
- Persistent positional vertigo can accompany SSNHL, indicating complex vestibular involvement.
Purpose of the Study:
- To report a case of SSNHL with persistent positional vertigo.
- To describe serial head-roll test findings and their diagnostic implications.
Main Methods:
- A patient with SSNHL and persistent positional vertigo was monitored.
- Serial head-roll tests were performed to assess nystagmus direction and characteristics.
Main Results:
- Acute stage: Persistent geotropic direction-changing positional nystagmus (DCPN) indicated SSNHL with ipsilateral light cupula.
- Chronic stage (after 3 weeks): Persistent apogeotropic DCPN suggested a heavy cupula diagnosis.
Conclusions:
- The conversion from geotropic to apogeotropic DCPN in SSNHL with positional vertigo is not fully understood.
- Changes in endolymph specific gravity are a potential explanation for the observed nystagmus shift.
