Journal of Audiology & Otology  2015;19(2):104-107

doi:10.7874/jao.2015.19.2.104

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

Yong Won KIM 1 ; Jung Eun SHIN ; Yong Sik LEE ; Chang Hee KIM

Affiliations

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Keywords

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

Country

Republic of Korea

Language

English

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.