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Acoustic neuroma - Symptom

Alternative Names

Vestibular schwannoma; Tumor - acoustic; Cerebellopontine angle tumor; Angle tumor

Symptoms:

The symptoms vary based on the size and location of the tumor. Because the tumor grows so slowly, symptoms usually start after the age of 30.

Common symptoms include:

Abnormal sensation of movement (vertigo)
Hearing loss in the affected ear that makes it hard to hear conversations
Ringing (tinnitus) in the affected ear

Less common symptoms include:

Difficulty understanding speech
Dizziness
Headache
- Upon waking up in the morning
- Wakes you from sleep
- Worse when lying down
- Worse when standing up
- Worse when coughing, sneezing, straining, or lifting (Valsalva maneuver)
- With nausea or vomiting
Loss of balance
Numbness in the face or one ear
Pain in the face or one ear
Sleepiness
Vision problems
Weakness of the face

Signs and tests:

The health care provider may diagnose an acoustic neuroma based on your medical history, an examination of your nervous system, or tests.

Often, the physical exam is normal at the time the tumor is diagnosed. Occasionally, the following signs may be present:

Drooling
Facial drooping on one side
Unsteady walk
Dilated pupil on one side only (See: Eyes, pupils different size)

The most useful test to identify an acoustic neuroma is an MRI of the head. Other useful tests to diagnose the tumor and tell it apart from other causes of dizziness or vertigo include:

Head CT
Hearing test (audiology)
Test of equilibrium and balance (electronystagmography)
Test of hearing and brainstem function (brainstem auditory evoked response)
Test for vertigo (caloric stimulation)

Central nervous system

Reviewed last on: 5/31/2011
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Brackmann DE, Arriaga MA. Neoplasms of the posterior fossa. In: Cummings CW, Flint PW, Haughey BH, et al, eds. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 177.

Battista RA. Gamma knife radiosurgery for vestibular schwannoma. Otolaryngol Clin North Am. 2009;42:635-654.

Sweeney P, Yajnik S, Hartsell W, Bovis G, Venkatesan J. Stereotactic radiotherapy for vestibular schwannoma. Otolaryngol Clin North Am. 2009;42:655-663.

Conley GS, Hirsch BE. Stereotactic radiation treatment of vestibular schwannoma: indications, limitations, and outcomes. Curr Opin Otolaryngol Head Neck Surg. 2010 Oct;18(5):351-6.

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