J Audiol Otol.  2015 Sep;19(2):104-107. 10.7874/jao.2015.19.2.104.

Persistent Positional Vertigo in a Patient with Sudden Sensorineural Hearing Loss: A Case Report

• Kim YW
• Shin JE
• Lee YS
• Kim CH

• KMID: 2052091
• DOI: http://doi.org/10.7874/jao.2015.19.2.104

Abstract

Because inner ear organs are interconnected through the endolymph and surrounding endolymphatic membrane, the patients with sudden sensorineural hearing loss (SSNHL) often complain of vertigo. In this study, we report a patient with SSNHL accompanied by persistent positional vertigo, and serial findings of head-roll tests are described. At acute stage, head-roll test showed persistent geotropic direction-changing positional nystagmus (DCPN), which led to a diagnosis of SSNHL and ipsilateral light cupula. Although vertigo symptom gradually improved, positional vertigo lasted for more than 3 weeks. At this chronic stage, persistent apogeotropic DCPN was observed in a head roll test, which led to a diagnosis of the heavy cupula. Although the mechanism for the conversion of nystagmus direction from geotropic to apogeotropic persistent DCPN is unclear, the change of specific gravity of the endolymph might be one of the plausible hypothetical explanations.

Keyword

Sudden sensorineural hearing loss; Direction-changing positional nystagmus; Light cupula; Heavy cupula; Head-roll test; Positional vertigo

MeSH Terms

Diagnosis
Ear, Inner
Endolymph
Head
Hearing Loss, Sensorineural*
Humans
Membranes
Nystagmus, Physiologic
Specific Gravity
Vertigo*