Sudden Hearing Loss and Multiple Cranial Nerve Palsies in Autoimmune disease: A Case Report

Document Type : Case Report

Authors

1 Department of Otorhinolaryngology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, 575001, Karnataka, India.

2 Department of Neurology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, 575001, Karnataka, India.

3 Department of Rheumatology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, 575001, Karnataka, India.

Abstract

Introduction:
The relationship between autoimmune disease and   sensorineural loss is well documented in literature. Immune mediated sudden hearing loss is asymmetric, bilateral and rapidly progressive but responds well to steroid therapy. However association of cranial nerve neuropathies with sudden hearing loss
is rare.
 
Case Report:
A 41 year old female presented with sudden mixed hearing loss and developed multiple cranial nerve palsies within a month. Blood and Cerebrospinal fluid analysis revealed an undiagnosed rheumatoid arthritis. She responded well to definitive therapy with cyclophosphamide and azathioprine.
 Conclusion:
If sudden hearing loss is associated with cranial neuropathy, an autoimmune work-up is highly recommended.

Keywords

References

  1. Emamifar A, Bjoerndal K, Hansen IM. Is hearing impairment associated with rheumatoid arthritis? a review. The open rheumatology journal. 2016; 10:26.
  2. El Aoud S, Frikha F, Salah RB, Snoussi M, Loukil H, Bahloul Z. Multiple cranial nerve palsy revealing hypertrophic pachymeningitis with positive myeloperoxidase-antineutrophil cytoplasmic antibody. Reumatismo. 2013 Dec 18: 248-52.
  3. Mancini P, Atturo F, Di Mario A, Portanova G, Ralli M, De Virgilio A et al. Hearing loss in autoimmune disorders: Prevalence and therapeutic options. Autoimmunity Reviews. 2018;17(7):
    644-652.
  4. Rossini B, Penido N, Munhoz M, Bogaz E, Curi R. Sudden Sensorioneural Hearing Loss and Autoimmune Systemic Diseases. International Archives of Otorhinolaryngology. 2016;21(03):213-223.

 

 

Iranian Journal of Otorhinolaryngology
Volume 33, Issue 1
January and February 2021
Pages 45-48

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