Vestibular schwannoma with absent vestibular evoked myogenic potentials to clicks but normal ABR, caloric responses and vestibular evoked myogenic potentials to 500 Hz tone bursts

Abstract

We report a case of vestibular schwannoma with absent vestibular evoked myogenic potentials (VEMPs) to clicks but normal auditory brainstem responses, caloric responses, and vestibular evoked myogenic potentials to 500 Hz tone bursts. This patient visited our clinic with complaint of sudden right hearing loss. This was the third episode of hearing loss in his right ear. Due to atypical medical history, he underwent further neuro-otological and neuroradiological examinations. Among the neurophysiological tests, only VEMPs to clicks showed abnormal findings (absent responses on the right). MRI revealed a small vestibular schwannoma in the right internal auditory meatus, which was considered to be of inferior vestibular nerve origin. This case suggested that VEMPs to clicks should still be included in the test batteries for the diagnosis of vestibular schwannoma.

Keywords::

• Acoustic neuroma
• vestibular schwannoma
• VEMP
• ABR
• inferior vestibular nerve

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.