1/6. dizziness and headache: a common association in children and adolescents.vertigo has long been recognized by the clinician as a frequent accompanying symptom of the adult migraine syndrome. This association has not been so readily identified in the pediatric population, and, as a consequence, children undergo unnecessary evaluations. We reviewed the charts of all children and adolescents referred for vestibular function testing to the Balance Center at the Barrow Neurological Institute between July 1994 and July 2000 (N = 31). Items analyzed included age, gender, symptoms that prompted the referral, test outcomes, family medical history, and final diagnosis. The most common justification for vestibular testing referral was the combination of dizziness and headache. Other less common reasons were "passing out" episodes, poor balance, and blurred vision. Normal test results were obtained from 70% of patients (n = 22). The most common abnormal test outcome was unilateral vestibular dysfunction (n = 5). Bilateral peripheral vestibular dysfunction was present in three patients. One patient had central vestibular dysfunction. The final diagnoses were vestibular migraine (n = 11), benign paroxysmal vertigo of childhood (n = 6), anxiety attacks (n = 3), Meniere's disease (n = 2), idiopathic sudden-onset sensorineural hearing loss (n = 1), vertigo not otherwise specified (n = 1), familial vertigo/ataxia syndrome (n = 1), and malingering (n = 1); in five patients, no definitive diagnosis was established. The stereotypical patient with vestibular migraine was a teenage female with repeated episodes of headache and dizziness, a past history of carsickness, a family history of migraine, and a normal neurologic examination. patients who fit this profile are likely to have migrainous vertigo. Consequently, a trial of prophylactic migraine medication should be considered for both diagnostic and therapeutic purposes. brain imaging and other tests are appropriate for patients whose symptoms deviate from this profile.- - - - - - - - - - ranking = 1keywords = sudden-onset (Clic here for more details about this article) |
2/6. hearing loss as the initial presentation of Creutzfeldt-Jakob disease.Creutzfeldt-Jakob disease is a rare type of spongiform encephalopathy. Affected patients present with constitutional symptoms, which progress to severe mental deterioration and movement disorders. dizziness is the most common early otologic symptom. Few reports in the literature describe patients with Creutzfeldt-Jakob disease who present with sudden-onset hearing loss as their primary symptom for seeking treatment. This paper discusses one such patient and reviews the clinical presentation, treatment options, and relevant literature.- - - - - - - - - - ranking = 1keywords = sudden-onset (Clic here for more details about this article) |
3/6. Sensorineural hearing loss associated with psoriatic arthritis.Autoimmune inner ear disease is a well described entity. We report a case of sudden-onset sensorineural hearing loss in association with psoriatic arthritis, which has not been reported in the literature. The case satisfies the criteria for the presumptive diagnosis of autoimmune hearing loss. A high index of suspicion, with early diagnosis and aggressive treatment with steroids and/or immunosuppressive agents, is essential to prevent irreversible hearing loss. The condition of psoriatic arthritis must be added to the pantheon of autoimmune diseases that can lead to sensorineural hearing loss.- - - - - - - - - - ranking = 1keywords = sudden-onset (Clic here for more details about this article) |
4/6. Leptomeningeal carcinomatosis: an unusual cause of sudden onset bilateral sensorineural hearing loss.We report a 66-year-old woman who developed sudden-onset bilateral sensorineural deafness due to leptomeningeal carcinomatosis involving the vestibulocochlear nerves. The clinical and diagnostic features of leptomeningeal carcinomatosis are discussed.- - - - - - - - - - ranking = 1keywords = sudden-onset (Clic here for more details about this article) |
5/6. Sudden-onset deafness. Serodiagnosis of recent meningococcal infection.An 8.5-year-old boy was evaluated 3 weeks after the occurrence of a febrile illness associated with sudden-onset deafness. An extensive diagnostic evaluation was largely unrewarding. However, unusual epidemiologic features of the case and cerebrospinal fluid abnormalities suggested meningococcal meningitis as the probable etiology. Serologic studies confirmed recent meningococcal infection. The potential etiologies of sudden acquired deafness are diverse, but a thorough evaluation is warranted and may be rewarding, even if it is initiated weeks after onset of deafness.- - - - - - - - - - ranking = 1keywords = sudden-onset (Clic here for more details about this article) |
6/6. Sudden hearing loss and acquired immunodeficiency syndrome.We have presented a case of a male homosexual with documented acquired immune deficiency syndrome in whom sudden sensorineural hearing loss developed after a series of opportunistic infections and before a massive intracerebral hemorrhage. Two major possible causes of his hearing loss are (1) actual involvement of spiral ganglion or acoustic division of the eighth cranial nerve by HTLV III virus, or (2) cryptococcal meningitis. He ultimately died after a series of neurological complications developed. These complications, which are common in patients with AIDS, include progressive dementia, obtundation, and coma. As the number of patients with AIDS in our society increases over the next 5 years, it will become more important for the otolaryngologist to recognize the complications of this disease that involve the ear, nose, throat, head, and neck. Sudden sensorineural hearing loss is one of these complications. The acquired immune deficiency syndrome, at this point, might best be treated by an approach of preventive medicine. However, such an approach would have far-reaching social and political implications--perhaps more so than in other venereally spread diseases. In the interim, the otolaryngologist-head and neck specialist is required to recognize AIDS as it manifests itself in the head and neck. In this case, sudden-onset sensorineural hearing loss was the otolaryngologic presentation of the AIDS.- - - - - - - - - - ranking = 1keywords = sudden-onset (Clic here for more details about this article) |