Symptoms of Acoustic Neuroma (Vestibular Schwannoma)

Early Symptoms

Early symptoms of acoustic neuroma (vestibular schwannoma) can be mistaken for other medical issues, and may be ignored or overlooked, thus making diagnosis a challenge. Approximately 90% of patients have single-sided hearing loss at the time of diagnosis. Hearing loss with acoustic neuroma is usually subtle and more pronounced in higher frequencies, although sudden hearing loss can occur. Sometimes the patient or doctor attributes hearing loss to aging, noise exposure, or allergies.

Approximately 70% of patients report tinnitus (ringing or noise in the ear) at the time of diagnosis, and 55% report vertigo/dizziness or balance issues. Other presenting symptoms can include a feeling of fullness/plugging in the ear, headache, facial weakness/paralysis, fatigue, eye problems, cognitive changes, and oral/swallowing issues. Some people find that these acoustic neuroma symptoms may come and go or fluctuate over time.

Since the balance portion of the eighth nerve is where the tumor arises, unsteadiness, vertigo, dizziness, or what many describe as ‘wonky-headedness’ may occur during the growth of the tumor. Acoustic neuroma patients often experience balance issues before diagnosis. The remainder of the balance system sometimes compensates for this loss, and, in some cases, no imbalance will be noticed.

Larger tumors can press on the trigeminal nerve, causing facial or tongue numbness and tingling, constantly or intermittently. Tumor-related increase of intracranial pressure may cause headaches, clumsy gait, and mental confusion. This can be a life-­threatening complication requiring urgent treatment. Even though the facial nerve (the nerve that moves the face) may be compressed by the tumor, it is unusual for patients to experience weakness or paralysis of the face from acoustic neuroma, although this may occasionally occur, either short or long term.

Typical Symptoms Overview

1. Unilateral Hearing Loss (on one side only) - This can sometimes occur suddenly (sudden hearing loss), but it generally can be very gradual, over months or years. In most acoustic neuroma patients, the loss is more pronounced in the higher frequencies. Unilateral hearing loss is usually the first symptom that leads to discovery of this benign brain tumor.

2. Tinnitus (ringing or buzzing in the ears) - Most AN patients do have tinnitus both before and after treatment. Not all patients with tinnitus have a brain tumor.

3. Feeling of fullness in the ear - Acoustic neuroma patients sometimes complain of a feeling that their ear is plugged or "full.”

4. Balance problems, vertigo - Acoustic neuroma patients often experience balance issues before diagnosis. It can occur very gradually and may go unnoticed as the body has many compensating mechanisms.

5. Headaches - Acoustic neuroma patients sometimes recall, after diagnosis, that they had unexplained headaches.

6. Facial pain, numbness, paralysis - Acoustic neuromas are usually discovered before they cause facial symptoms. However, if they are large or impacting one of the facial nerves, they can cause numbness, tingling or even facial paralysis.