Orthostatic hearing loss: audiovestibular manifestations of spontaneous intracranial hypotension

Frederick Schon; Arun Karunakaran; Sarah Shanmuganathan; Arani Nitkunan

doi:10.1136/practneurol-2019-002479

Orthostatic hearing loss: audiovestibular manifestations of spontaneous intracranial hypotension

Pract Neurol. 2020 Sep 29:practneurol-2019-002479. doi: 10.1136/practneurol-2019-002479. Online ahead of print.

Authors

Frederick Schon¹, Arun Karunakaran², Sarah Shanmuganathan³, Arani Nitkunan⁴

Affiliations

¹ Department of Neurology, Croydon University Hospital, Croydon, UK.
² Department of Audiology, Croydon University Hospital, Croydon, UK.
³ University of Glasgow, Glasgow, UK.
⁴ Department of Neurology, Croydon University Hospital, Croydon, UK anitkunan@nhs.net.

PMID: 32994365
DOI: 10.1136/practneurol-2019-002479

Abstract

A 36-year-old woman with severe postural headaches caused by spontaneous intracranial hypotension developed bilateral hearing loss. Her hearing loss varied in severity and also at times affected one ear more than the other. She noticed her hearing returned to normal on lying flat, and this was confirmed on audiometry. Her hearing fully recovered after treatment with blood patches. Audiovestibular symptoms affect up to 70% of people with spontaneous intracranial hypotension but are probably under-reported. Cerebrospinal fluid and inner ear fluids are related in two separate channels: the vestibular and the cochlear aqueducts. We discuss their role in the postural hearing loss of spontaneous intracranial hypotension.

Keywords: HEADACHE; NEUROOTOLOGY.