Goto Fumiyuki, Arai Miki, Kitamura Mitusru, Otomo Tomoko, Nagai Ryoto, Minami Shuujiro, Shimada Takanobu, Matsunaga Tatsuo, Tsunoda Kouichi, Fujii Masato
Department of Otorhinolaryngology, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.
Iran J Otorhinolaryngol. 2016 Mar;28(85):149-52.
The aim of this case report was to investigate the relationship between sleep disorders and audio vestibular symptoms.
A case of undiagnosed sleep disorder, presenting as a temporary auditory processing difficulty, is presented. The disorder was initially treated as sudden deafness with dizziness. A 23-year-old male patient complained of acute hearing disturbance despite normal results on pure tone audiometry. The patient was initially administered a steroid injection in the hospital. After treatment, his hearing symptoms improved only slightly and he reported balance difficulty with rightward spontaneous nystagmus. Vestibular rehabilitation was performed. We also suspected that his hearing symptom was due to an auditory processing difficulty. Despite steroid treatment and vestibular rehabilitation, neither of his symptoms improved. We subsequently identified the presence of insomnia. He was prescribed zolpidem 5 mg, which slightly improved his symptoms, and referred to a sleep specialist for further examination. Polysomnography was performed, which identified restless leg syndrome and sleep disturbance with delayed sleep phase syndrome. After pharmacological treatment, his sleep disturbance, hearing difficulty, and balance disorder completely resolved.
Sleep disorders may provoke reversible auditory processing difficulties. We should carefully evaluate patients for a potentially undiagnosed sleep disorder, even in patients chiefly complaining of intractable sensory dysfunction such as hearing or balance disturbance.
本病例报告旨在研究睡眠障碍与听觉前庭症状之间的关系。
本文呈现了一例未确诊的睡眠障碍病例,表现为暂时性听觉处理困难。该病症最初被当作突发性耳聋伴头晕进行治疗。一名23岁男性患者,尽管纯音听力测试结果正常,但仍主诉急性听力障碍。该患者最初在医院接受了类固醇注射治疗。治疗后,其听力症状仅略有改善,且他报告存在平衡困难并伴有向右的自发性眼球震颤。于是进行了前庭康复治疗。我们还怀疑他的听力症状是由听觉处理困难所致。尽管进行了类固醇治疗和前庭康复治疗,他的两种症状均未改善。随后我们发现他存在失眠问题。给他开了5毫克唑吡坦,症状稍有改善,并转诊至睡眠专科医生处进行进一步检查。进行了多导睡眠图检查,结果显示存在不宁腿综合征以及伴有睡眠时相延迟综合征的睡眠障碍。经过药物治疗后,他的睡眠障碍、听力困难和平衡障碍完全消失。
睡眠障碍可能引发可逆性听觉处理困难。即使对于主要抱怨存在难治性感觉功能障碍(如听力或平衡障碍)的患者,我们也应仔细评估其是否存在潜在的未确诊睡眠障碍。