INFO - Autoimmune inner ear disease

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eMedicine.com

" Inner Ear, Autoimmune Disease " :

http://www.emedicine.com/ent/topic496.htm

Excerpt:

CLINICAL

History:

Hearing loss: The hallmark of immune-mediated inner ear disease is

SNHL, which usually is bilateral and occurs rapidly over weeks to months.

Fluctuation: Sensorineural loss can fluctuate and stabilize at a

certain level, or it can progress without fluctuation.

Laterality: Bilateral hearing loss occurs in most patients (79%).

Occasionally, only one ear is involved initially, with the contralateral ear

developing hearing loss later. In bilateral cases, audiometric thresholds

can be symmetric or asymmetric.

Speech discrimination scores: Discrimination scores often are poor in

immune-mediated inner ear disease. Therefore, in cases of unilateral or

bilateral-asymmetric disease, include diagnostic imaging and serologic

studies in the workup to exclude retrocochlear disease and syphilitic inner

ear disease.

Vestibular symptoms: Approximately 50% of patients complain of

vestibular symptoms typical of Ménière disease. Vestibular symptoms can

include disequilibrium, ataxia, motion intolerance, positional vertigo, and

episodic vertigo.

Tinnitus and aural fullness: As many as 25-50% of patients also have

symptoms of tinnitus and aural fullness, which can fluctuate in severity.

Systemic autoimmune disease: Coexisting systemic autoimmune disease

occurs in 15-30% of patients. Diagnoses include rheumatoid arthritis,

ulcerative colitis, systemic lupus erythematosus, and polyarteritis nodosa.

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Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org