SOME UNCHARACTERISTIC CLINICAL SIGNS AND SYMPTOMS OF ACOUSTIC NEUROMA

Objective: The most common initial symptoms of the acoustic neuroma ar e unilateral hearing loss that evolves gradually, tinnitus, and unstea diness. However, atypical presentations may sometimes occur, more ofte n with a small intracanalicular neuroma or with a large medial neuroma placed in the cerebellopontine angle. Results: In our group of 51 pat ients suffering from acoustic neuroma, atypical presentations were obs erved in 9 cases (17.6%). Two patients had normal hearing function but reported tinnitus; two patients reported sudden hearing loss, with pa rtial recovery; two patients had a history of fluctuating hearing loss ; two patients reported neurologic symptoms (one reported trigeminal p aresthesia and the other had a history of trigeminal paresthesia and r ecurrent headache); and one patient reported profound hearing loss for many years and the recent onset of unsteadiness. Conclusion: Patients with these atypical presentations have to undergo a diagnostic evalua tion for acoustic neuroma and must be evaluated with BAEPs and then wi th gadolinium-enhanced MRI.