Is AN possible with symmetriic (mild to moderate ) hearing loss?

[windingshores]

I have left side tinnitus, facial numbness (sometimes pain), dizziness. Facial pain, numbness and tinnitus all worse in the last few months. I went to a top otoneurologist to rule out AN, mainly, and he said that without asymmetric hearing loss, I don't have an AN and he would not order an MRI for my symptoms, He basically said "go to neurology."


I do have cervical stenosis, myelopathy, and he mentioned radiculopathy so the pull on nerves from neck could be an explanation.

My PCP already ordered MRI of brain, angio brain, and neck but if it is truly not possible to have an AN without asymmetric hearing loss, then I will forego the MRI's.

I had breast cancer but am not concerned about metastasis with this picure.

[Derby]

I'm no expert, but there are absolutely people diagnosed with AN who have had minimal to no hearing loss.

It's good that your PCP was willing to step up. Get the MRI and keep us updated!

[mwatto]

I had no hearing loss at diagnosis but did have hyperacusis (a sign of acoustic nerve damage) My last audiology report (due for next in Feb) showed close to 90% still in AN ear 5 years post CK. My only symptom for two years up to diagnosis was earache on that side and sometimes pulsitile tinnitus. I still get this stabbing ear pain. All that being said I do think this next report at 6 years will show a trend to hearing loss in some frequencies (have noticed that my husband's snoring has become less of an issue!).

[windingshores]

So of the following MRI's, which are priorities:  MRI brain, MRI brain angio, cervical spine?  I am nervous about tinnitus getting worse with the noise so having just one of these makes sense if possible.  Worth it to spend the $$$$



This was a top doc (Castleton Connelly), ata t op ENT facility,  with great reviews and could not have been more dismissive of an AN possibility. He heard all my symptoms and did not seem interested in any alternative explanations other than to say that his tiinnitus got worse when he moved his neck, so you may never know the reason for the facial pain, numbness and dizziness in response to noise. Just one of those mysterious things to accommodate apparently!  I asked if the closeness of the auditory and facial nerves could be relevant and he said they were too far apart.

My area of the country has medical care that is very evidence-based. I am lucky to have overall great doctors who work with me. I'll keep going with my PCP and neuro (Neuro thinks it is neck but first suggested AN three years ago; he thinks the negative MRI w/out contrast was definitive.)

I am pretty accepting of symptoms until they reach a point where I am not!  I am selling a condo I just bought because the pain and numbness triggered by an AC noise downstairs is unbearable.  I feel like a fool with some people who don't understand.

[Derby]

I asked if the closeness of the auditory and facial nerves could be relevant and he said they were too far apart.

That's a weird thing to say...Cranial Nerve VIII & CN VII are literally right next to each other. Thats why hemi-facial spasm (CN VII dysfunction) is a well-known side effect of SRS.

...he thinks the negative MRI w/out contrast was definitive.

Did you have an MRI already?  How long ago? Sometimes very small tumors can be missed without contrast. And while tumor size and symptoms are most often correlated, there are cases of people with small tumors and severe symptoms, as well as people with large tumors who are completely asymptomatic.

All this to say that if you had a negative MRI w/o contrast some time ago, but now have worsening symptoms, I don't think an MRI w/ contrast is a ridiculous step by any measure.

Obviously, if your PCP/neurologist wants you to get all the studies, then follow his/her advice. But the MRI brain w/ contrast will at the very least let you know if AN is a part of the big picture.

I hope you get answers soon.

[windingshores]

Thank you!

My last MRI w/out contrast was 8/21 and was specifically to check for acoustic neuroma.  Things have gotten worse, yes.

I think i will do a process of elimination. MRI of brain first. I'll ask about no contrast since kidneys aren't great or if they have the new contrast that is more benign.  If they need contrast, so be it.

If that is clear, I might do neck but I already know the issues there!   I am concerned about effect of MRI on tinnitus!!

ps that doctor had a lot of weird things to say!

[Derby]

I am concerned about effect of MRI on tinnitus!!

Have you heard this somewhere?
AFAIK, MRIs have no effect on tinnitus.

[windingshores]

Derby I had the impression that an MRI in 2015 caused my initial tinnitus, which was constant but at a lower level. Of course it could have been coincidence.  There was some discussion of his on Tinnitus Talk, a forum I have not visited in some years.

Speaking of forums, this one is probably the nicest one I have ever visited- you are all very helpful.