Acoustic neuroma history and symptoms: Difference between revisions

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* Hoarseness
* Hoarseness
The below table summarize information about the frequency of major symptoms and signs of acoustic neuroma:
The below table summarize information about the frequency of major symptoms and signs of acoustic neuroma:
{| style="border: 3px; font-size 60%; margin: 1px; width: 700px;"
! colspan="4" style="background: #191970; " | {{fontcolor|#FFF|Table 1}}
|-
! colspan="2" style="background: #191970; " | {{fontcolor|#FFF|Major signs and symptoms}}
! colspan="2" style="background: #191970; width: 250px;" | {{fontcolor|#FFF|Diagnostic accuracy of clinical features in predicting the tumor progress}}
|-
! style="background: #191970; " | {{fontcolor|#FFF|Signs and symptoms}}
! style="background: #191970; " | {{fontcolor|#FFF|Frequency}}
! style="background: #191970; " | {{fontcolor|#FFF|Sensitivity}}
! style="background: #191970; " | {{fontcolor|#FFF|Specificity}}
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Hyperacusis|Hypacusis]]
! style="padding: 4px 4px; background: #6495ED; " | The most common
! style="padding: 4px 4px; background: #6495ED; " | High
! style="padding: 4px 4px; background: #ADD8E6; " | low
|-
! style="padding: 4px 4px; background: #dcdcdc; " | Facial paresthesia
! rowspan="3" style="padding: 4px 4px; background: #6495ED; " | Commonly seen
! rowspan="3" style="padding: 4px 4px; background: #6495ED; " | Moderate
! rowspan="3" style="padding: 4px 4px; background: #87ceeb; " | Moderate
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Gait abnormality|Instability of gait]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Tinnitus]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Hearing impairment|Hearing loss]]
! rowspan="5" style="padding: 4px 4px; background: #87ceeb; " | Occasionally seen
! rowspan="5" style="padding: 5px 4px; background: #87ceeb; " | low
! rowspan="5" style="padding: 4px 4px; background: #6495ED; " | high
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Headache]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Facial nerve paralysis|Facial paralysis]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Vertigo]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | Absent corneal reflex
|-
! style="padding: 4px 4px; background: #dcdcdc; " | Bucking
! rowspan="10" style="padding: 4px 4px; background: #ADD8E6; " | Rarely seen
! rowspan="10" style="padding: 4px 4px; background: #ADD8E6; " | Very low
! rowspan="10" style="padding: 4px 4px; background: #6495ED; " | Very high
|-
! style="padding: 4px 4px; background: #dcdcdc; " | Visual disorder
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Nausea and vomiting]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Nystagmus]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Movement disorder]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | Mastication disorder
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Romberg's test|Romberg sign]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Dysphonia|Hoarseness]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Cranial nerves|Abduction disorder]]
|-
! style="padding: 4px 4px; background: #dcdcdc; " | [[Otalgia|Ear pain]]
|}


==References==
==References==

Revision as of 20:16, 7 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Symptoms of acoustic neuroma may vary depending on the cranial nerve involvement, cerebellar compression, mass size and tumor progression. hearing loss and tinnitus almost always are seen in cochlear nerve involvement, while unsteadiness is common among patients with involvement of the vestibular nerve. Trigeminal nerve involvement occurs among one-sixth of patients and usually presents with facial paresthesia or hypesthesia. Facial paresis, taste disturbances, xerophthalmia, paroxysmal lacrimation, and xerostomia are less common symptoms which may present due to involvement of the facial nerve.

History and Symptoms

Symptoms of acoustic neuroma may vary depending on the cranial nerve involvement, cerebellar compression, mass size and tumor progression. hearing loss and tinnitus almost always are seen in cochlear nerve involvement, while unsteadiness is common among patients with involvement of the vestibular nerve. Trigeminal nerve involvement occurs among one-sixth of patients and usually presents with facial paresthesia or hypesthesia. Facial paresis, taste disturbances, xerophthalmia, paroxysmal lacrimation, and xerostomia are less common symptoms which may present due to involvement of the facial nerve..[1][2][3]

History

  • Chronic gradual unilateral hearing loss is the most common symptom presents in 95 percent of patients. Tinnitus is associated symptom among patients with the involvement of cochlear nerve.
  • True spinning vertigo is very uncommon presenting symptoms among patients with acoustic neuroma. Approximately 50% of patients with acoustic neuroma report disequilibrium and sense of unsteadiness while walking.

Common Symptoms

  • Chronic gradual unilateral hearing loss
  • Tinnitus
  • Disequilibrium
  • Facial numbness
  • Facial hypesthesia
  • Facial pain

Less Common Symptoms

  • Facial paresis
  • taste disturbances
  • Xerophthalmia,
  • Paroxysmal lacrimation
  • Xerostomia
  • Ataxia
  • Dysarthria
  • Dysphagia
  • Aspiration
  • Hoarseness

The below table summarize information about the frequency of major symptoms and signs of acoustic neuroma:

Table 1
Major signs and symptoms Diagnostic accuracy of clinical features in predicting the tumor progress
Signs and symptoms Frequency Sensitivity Specificity
Hypacusis The most common High low
Facial paresthesia Commonly seen Moderate Moderate
Instability of gait
Tinnitus
Hearing loss Occasionally seen low high
Headache
Facial paralysis
Vertigo
Absent corneal reflex
Bucking Rarely seen Very low Very high
Visual disorder
Nausea and vomiting
Nystagmus
Movement disorder
Mastication disorder
Romberg sign
Hoarseness
Abduction disorder
Ear pain

References

  1. C. Matthies & M. Samii (1997). "Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation". Neurosurgery. 40 (1): 1–9. PMID 8971818. Unknown parameter |month= ignored (help)
  2. Hart, Robert G.; Davenport, John (1981). "Diagnosis of Acoustic Neuroma". Neurosurgery. 9 (4): 450–463. doi:10.1227/00006123-198110000-00021. ISSN 0148-396X.
  3. Xiang Huang, Jian Xu, Ming Xu, Liang-Fu Zhou, Rong Zhang, Liqin Lang, Qiwu Xu, Ping Zhong, Mingyu Chen, Ying Wang & Zhenyu Zhang (2013). "Clinical features of intracranial vestibular schwannomas". Oncology letters. 5 (1): 57–62. doi:10.3892/ol.2012.1011. PMID 23255894. Unknown parameter |month= ignored (help)

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