Hearing and vestibular impairment in temporal lobe epilepsy

Objective of the study was to report a case of fluctuating hearing loss, dizziness as the presentation of temporal lobe epilepsy.A 40-year-old woman presented with intermittent symptoms of right-side hearing loss and tinnitus, episodic vertigo accompanied by nausea and more intensive noise the day before the attack. Between vertigo attacks the dizziness remains. Pure tone audiometry revealed moderate sensorineural hearing loss from the affected site. Symptoms resembled Meniere's disease, while caloric response was symmetric but oculomotor tests showed contralateral hypofunction. Besides negative MRI and relatively benign evolution of signs, patient never experienced seizures. Based on founded dysfunctionality in the right fronto-temporal lobe in the electroencephalography (EEG) she was subsequently diagnosed with temporal lobe epilepsy by the neurologist. No family history of neurologic either otological diseases has presented, her other medical history is unremarkable. Anticonvulsant therapy immediately resulted in the disappearance of dizziness and hearing loss and noise. However, after 3 years dizziness occurred but hearing impairment manifested in more severe pattern, moreover, a fluctuating speech recognition and hyperacusis were appeared, no seizures have been reported. As well, EEG showed more intense dysfunction in the right fronto-temporal-parietal lobe and it is spread to the contralateral temporal lobe, but hyperventilation provokes dysrhythmia in both occipital lobes. Keywords: fluctuating hearing loss, vertigo, temporal epilepsy. Hearing loss and vertigo as a presentation of temporal lobe epilepsy are infrequent in otolaryngological and neurological practice. The case emphasizes the importance of environmental testing, in particular repeated electrophysiological tests, as well as an interdisciplinary approach to controlling the symptoms of the disease while maintaining the patient's quality of life. The hearing rehabilitation in this case seems to be controversial as overstimulation of acoustic stimulus can increase the pathologic brain stimulation of the auditory pathways.