RESUMO
Sudden deafness is rarely ascribed to multiple sclerosis (MS). Sudden deafness and tinnitus were the initial symptoms of MS for the two patients described in this paper. A sensorineural hearing loss was present in one ear in both patients. Brainstem responses (BSRs) showed only the first three waves for the first patient, and only wave I for the second. Magnetic resonance imaging showed focuses of demyelination in the pons (case 1) and on the borderline between medulla and pons (case 2). The placement of plaques and the involvement of the BSR-generating acoustic afferent pathways are discussed. The hearing level measured by tonal audiometry recovered after 1 month in both patients and remained stable during 1 year. BSRs remained pathological after 1 month as well as after 1 year. Sudden hearing loss and tinnitus might be the initial symptoms of MS.
Assuntos
Perda Auditiva Súbita/etiologia , Esclerose Múltipla/complicações , Adulto , Encéfalo/patologia , Feminino , Perda Auditiva Neurossensorial/etiologia , Humanos , Imageamento por Ressonância Magnética , Esclerose Múltipla/diagnóstico , Zumbido/etiologiaRESUMO
Hearing loss is an uncommon symptom in multiple sclerosis. We report two patients in whom unilateral sudden hearing loss was the first monosymptomatic manifestation of multiple sclerosis. We confirmed the initial central auditory dysfunction suggested by audiometric findings and brainstem auditory evoked potentials by MRI, which showed a unilateral pontine lesion in one patient and a lesion in the medulla oblongata in the other.
Assuntos
Transtornos da Audição/etiologia , Esclerose Múltipla/complicações , Adulto , Audiometria , Vias Auditivas/fisiopatologia , Potenciais Evocados Auditivos do Tronco Encefálico , Feminino , Transtornos da Audição/diagnóstico , Transtornos da Audição/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Bulbo/patologia , Ponte/patologiaRESUMO
We analyzed the clinical features and therapeutic response of 6 patients with progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome). The mean duration from the onset to establishing the diagnosis was 2.7 years, with the initial false diagnosis of Parkinson's disease in 4 patients. The most common symptoms at the moment of diagnosing were unsteady gait, speech difficulties, forgetfulness and rigidity, in addition to impairment of vertical gaze. In all the patients therapeutical response was inadequate. Clinical criteria for differential diagnosis of progressive supranuclear palsy are discussed.
