Case 5 — Slowly progressive unilateral hearing loss with mild unsteadiness
Vignette
A 56-year-old man reports three years of slowly progressive left-sided hearing loss with intermittent left-sided tinnitus. There is no rotational vertigo. He has noticed mild unsteadiness on his recent hiking trip but feels normal in routine activities. Word recognition on the left is disproportionately poor compared with his pure tone thresholds. vHIT is obtained as part of his workup, before MRI.
Six-canal vHIT
Audiogram
Which finding most strongly supports vestibular schwannoma over vestibular neuritis?
References
- Halmagyi GM, Chen L, MacDougall HG, Weber KP, McGarvie LA, Curthoys IS. The video head impulse test. Frontiers in Neurology 2017;8:258.