A 66-year-old woman had been monitored for 4 years because of aural fullness in both ears and a mild hearing loss. She had been observed because she had a family history of a conductive hearing loss in an otosclerotic patient (her son). In addition, her father, brother, and maternal uncles had a history of hearing loss. She had recently come to the office complaining of a shaky tremor while standing; the tremor abated with support. She said this feeling would "come and go." She was aware at times that she did not "feel right" while seated. She did not experience this feeling while reclining in bed.
Electronystagmography revealed no spontaneous or positional nystagmus. Alternate binaural bithermal testing showed that she had a reduced vestibular response (RVR) on the right and a slightly hypoactive warm response on the right. Simultaneous binaural bithermal testing elicited a type 2 response with an RVR right, thus identifying a peripheral vestibular disorder.
From Neurotologic Associates, P.C., New York City.
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COPYRIGHT 2002 Gale Group
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