With these symptoms, could I possibly *not* have an acoustic neuroma?

[ANGuy]

All hearing loss is not equal.  The typical profile of the graph for an AN patient's hearing test can only be caused by two things, Meniere's disease or an AN.  I'm sure in the history of all hearing loss there are exceptions to this, but basically, if your graph looks like mine, and all of ours, it is only going to be caused by one of two things. 

That is why I was referred for and MRI.  It was because I had low frequency and high frequency loss and close to normal in between and this can only be caused by Meniere's or an AN.

As for CT scans, it seems like an attempt to save money while exposing the patient to high doses of radiation unnecessarily. 

[Jill_S]

Well, the insurance finally came through and I had the MRI this morning. I was worried about claustrophobia and loud noises. I had no problems whatsoever with the claustrophobia. I did however ask to plug my good ear as well as the bad ear when we had a break 1/2 way through. It was uncomfortably loud without the earplugs.

I will have the results either: On Monday, if the ENT office calls as soon as it gets the images; On Tuesday, if I am game enough to go in and pick up the CD myself; or at the latest on Thursday when I have an appointment with the ENT.

I am trying not to freak myself out, but I did notice that the RMI technician went from relatively cold and blase before my exam, to warm and solicitous afterwards. Not exactly a poker face, but maybe he was just happy that I didn't freak out and got through the exam OK, after I mentionned that I was potentially claustrophobic.

I have one-sided moderate to severe hearing loss only in the high frequencies. Below 4,000 hz, I am fine in the bad ear. This seems like an AN-pattern to me.

I have had an additional complication since the last time I posted. Very early Monday morning (say 12:30am) I woke up with my heart absolutely racing and beating very erratically. I got myself to the ER and they diagnosed me with atrial fibrillation (pulse was between 130 and 150 bps). My first ever episode! They admitted me, put me on a calcium channel blocker and gave me a shot of a blood thinner. My heart converted back to normal sinus rhythm after about 2-3 hours on the meds. Now, I am out of the hospital and on a beta blocker. I'm not sure if the beta blocker (metopronol) is doing any good and it is giving me lots of side effects: fatigue; brain fog; diarrhea; and worst of all worsening tinnitus!!! The drug is ototoxic! (On the plus side, it might have helped me keep calm during the MRI.)

Anyway, I am going to try to convince my cardiologist to help me get off them when I see him this afternoon. I am a little concerned about this because when I mentionned the sudden hearing loss in the hospital they just brushed it off and seemed totally unconcerned. I am also concerned because of the potential rebound effect if I try to stop the beta blocker on my own w/o medical supervision.

They did all kind of tests and everything came up within normal range. My blood pressure before the medication was 117/70 (now it's 100/70); lipids in the normal or very good range; thyroid on the high side, but still within normal. I am fit and not at all overweight (5'6" 116). There is no pattern of early onset heart disease in my large extended family. My hunch is that the episode was triggered by Prednisone withdrawal. It came on one day after my last dose, so it really seems like too much of a coincidence. Besides, I have been really stressed out recently.

Hopefully, I can get the cardiologist on board with this theory and convince him to help me wean off this new drug.

And, of course, waiting for the results of the MRI.

[rkrose31]

I am in the same situation. Instead of tingling I have had some nerve pain albeit on the other side of my mouth. In reading up I also see vertigo is an early symptom which I had many years ago. As if I couldn't be any more traumatized I now question why the ent did not sound an alarm 7 years ago when I was first diagnosed with nerve hearing loss. My current ent says not to worry but how does one not spend every waking moment not worrying?

[jaqiday]

I had a similar episode with high blood pressure and getting put on beta blockers. I ended up with low blood pressure and I couldn't even stand without almost passing out.  Stress does many things to our bodies. I know now I do not have high blood pressure unless I am in a dr office (white coat syndrome  

This is all very stressful. Try taking a walk and get your mind off all this. Hard I know but helpful.

[ANGuy]

I have one-sided moderate to severe hearing loss only in the high frequencies. Below 4,000 hz, I am fine in the bad ear. This seems like an AN-pattern to me.

That is not the pattern of hearing loss that typically accompanies an AN.


Why do you say metoprolol is ototoxic?

[Jill_S]

I have one-sided moderate to severe hearing loss only in the high frequencies. Below 4,000 hz, I am fine in the bad ear. This seems like an AN-pattern to me.

That is not the pattern of hearing loss that typically accompanies an AN.

....

So, what is the typical pattern then?

[ANGuy]

I have one-sided moderate to severe hearing loss only in the high frequencies. Below 4,000 hz, I am fine in the bad ear. This seems like an AN-pattern to me.

That is not the pattern of hearing loss that typically accompanies an AN.

....

Okay, after reading a couple of articles I have come to the conclusion that there is no "typical" audiogram for AN patients.  You could have anything from normal, to complete deafness, and any type of high, mid  or low range loss and have, or not have, an AN.

Really, the only way to be sure of whether you have an AN or not is to get an MRI, which you did.

All of the various test like audiogram, ABR, ENG/VNG etc give your Dr important information, but do not indicate with any real certainty if you have an AN.

[Jill_S]

Had the MRI Friday morning. The technician said that they would be read by the radiologist Friday after and my ENT would have them on Mon. (i.e. today). I haven't heard anything from the office all day. I'm thinking no news is probably good news!

[Jill_S]

I am very happy to report that my MRI turned out to be totally normal. I am so happy, relieved (and surprised!) On the down side, though, I still have no clue what is causing my one-sided hearing loss and facial numbness. But, really not complaining that much!

I also want to apologize for taking the time of those who do have acoustic neuromas ... and thank you for all the support. This is a terrific forum!

I wish you all the best.

[CHD63]

Hi Jill_S .....

While we all are ecstatic your MRI was normal, it is frustrating to not have answers for your hearing loss.  I would urge you to continue to seek answers about that.

If I were you, I would also monitor my facial tingling/numbness and if it gets worse to notify my doctor.  Although extremely unlikely, if your MRI was done on a smaller or older machine and not a Tesla 3, it is possible to miss a teeny, tiny AN in between the slices.  All this is not to frighten you ..... just be aware of any changes for the worse that could mean growth of something.

Thoughts and prayers and let us know what you find out about a diagnosis.

Clarice

[Jill_S]

Well, maybe I'll have a look at the images myself.

I've gone from elation to tears today. I hadn't self-tested my hearing in two weeks. I thought it might be getting worse, but didn't really want to know. Buoyed by the positive MRI results, I went ahead a re-tested myself. The hearing in my left ear is a lot worse. In just two weeks. And I still have absolutely no idea why or what to do about it (the Prednisone treatment has obviously not worked at all.) I hate to say it, but at least with an acoustic neuroma diagnosis, I would have had some idea where to start and what I could possibly do about the problem.

Anyway.

[PaulW]

I have not researched thoroughly what I am going to post but from memory is correct.
Sensineural Hearing loss in one ear does happen without explanation and it's reasonably common.
A similar thing happens in Bells Palsy where your facial nerve stops working on one side.
Bells Palsy is thought to be a latent effect of a viral infection but cause remains unknown.
Likewise hearing loss without any identifiable cause does happen, and it's most likely similar to Bells Palsy in the way it works.. It's happens more often than an Acoustic Neuroma. So it could be just that and you may never find the exact cause.. Except the current theory that it's related to late viral effects.

[Jill_S]

I have not researched thoroughly what I am going to post but from memory is correct.
Sensineural Hearing loss in one ear does happen without explanation and it's reasonably common.
A similar thing happens in Bells Palsy where your facial nerve stops working on one side.
Bells Palsy is thought to be a latent effect of a viral infection but cause remains unknown.
Likewise hearing loss without any identifiable cause does happen, and it's most likely similar to Bells Palsy in the way it works.. It's happens more often than an Acoustic Neuroma. So it could be just that and you may never find the exact cause.. Except the current theory that it's related to late viral effects.

Thanks Paul! Yeah, that corresponds with what I've read on-line and what I've heard from my ENT. I actually felt a little sorry for my ENT at my appointment today. It was clear he had nothing. No idea as to the real cause or the prognosis. I told him I'd spent the better part of the last three weeks w/ Dr. Google and that was what I'd seen online too (yes, I looked at real research. :-) ).

They had me re-do the hearing test and told me that there was "no change." I told him that I had indeed noticed that my hearing loss was getting worse. His response: "Well, that's why we have tests - so, we can be objective!" So, I asked to see the actual test results and believe it or not, they actually showed an additional 15Db loss at 8,000 hz (from 60 Db to 75 Db) as well as a 20% drop in speech recognition (from 100% to 80%). I asked him why he considered that: "unchanged" when it was clearly worse. He said that given my response to most of the pure tone test, I shouldn't have had that much drop in speech recognition. Therefore they are not counting it as a negative change. His explanation is that that is my brain, not my ear (i.e. not my department), or rather that I was "having a bad day." Um, well, I have noticed a significant drop in speech recognition on that side over the past few weeks, so it is not my just "having a bad day."

I am wondering if my brain has somehow "given up" on that side and needs to be trained or reminded to pay attention to it. Does this make any sense? Should I try to get a referral to a oto-neurologist? Is this something they deal with? (My ENT did not offer a referral, BTW.)

Sorry. I know .. I need to move on and get a new forum, since my issues are no longer AN related.

[ANGuy]

You need to get a new ENT.  The guy tells you that the test is objective, then applies subjective standards to it.  20% of something is significant.  There may not be anything that can be done about it, or maybe there is, but 20% is something tangible.

I don't know what is the cause of your symptoms, unfortunately PaulW might be right.  But, with this particular ENT's enthusiasm for even identifying that a problem exists, let alone finding a solution, he will never find an answer no matter what.

Scoop up your records and find a new ENT and see what they have to say.

[PaulW]

I can see where your ENT is coming from. Your symptoms appear to be nerve related on the inside of the skull. Not an  area of expertise for an ENT..Its nice to know a cause for something but sometimes there isn't a clear answer. Un fortunately and it is quite common where there is no clear answer for the cause of sensorineural hearing loss. It looks like your ENT has exhausted his suite of tests and has proved that it is the nerve or brain.. again not unusual