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Cochlear vestibular paraneoplastic disease is a syndrome characterized by sudden or rapid hearing loss and vestibular dysfunction, which can detect malignant tumors and/or laboratory evidence of known high-risk paraneoplastic antibodies
.
Previous case reports described it being related to various malignancies including breast cancer, 2 cases of small cell lung cancer, 3 cases of thymoma and lymphoma
Cases identified through electronic medical record (EMR) screening (January 2007 to February 2021, n=5675) are cross-referenced with the neuroimmunology laboratory database to determine whether patients undergoing serum and/or cerebrospinal fluid assessment have adverse effects Tumor nerve-specific antibodies (n=144)
.
Exclude other causes of hearing loss
Among the 144 patients identified by EMR screening, the findings of 26 patients were consistent with paraneoplastic cochlear vestibular disease
.
The majority are males (n=23, 88%), and the median age is 45 years (range: 28-70 years)
Paraneoplastic antibody correlation
Neurological examination revealed a variety of common symptoms, including limb rhythm disorders (n=19, 73%), hyperreflexia (n=11, 42%), tremor (n=14, 54%) and nystagmus (n=15, 58%)
.
In addition, 11 patients (42%) had gaze paralysis
The timeline of paraneoplastic lesions of the cochlear vestibule shows the onset of cochlear vestibular involvement, signs and symptoms of rhomboid encephalitis/encephalomyelitis
Except for one patient, all patients' brain MRI images are available
.
The median duration from the onset of symptoms to the first MRI study was 6 months (range: 1-28)
In short, acute-onset unilateral hearing loss and tinnitus with rapid progression involving the contralateral ear with/without acute vertigo are still difficult to cure with symptomatic treatment, and paraneoplastic causes should be considered
.
The examination results of many of these cases suggest that the central nervous system is involved, especially brain stem or cerebellar lesions occurring at the same time
HammamiMB ,EggersSDZ ,MadhavanA HammamiMBHammami EggersSDZEggers MadhavanAMadhavan, et alParaneoplastic cochleovestibulopathy: clinical presentations, oncological and serological associationsJournal of Neurology, Neurosurgery & Psychiatry
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