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rhage, also causes eighth nerve damage and deafness, presumably as a toxic effect of iron deposition in the meninges Episodic deafness in one ear, even without vertigo, proves in most instances to be Meniere disease (see further on) Of equal ` concern to neurologists is the onset in an adult of sudden and permanent unilateral hearing loss without vertigo Little is known about the pathogenesis of this syndrome A vascular causation (occlusion of the auditory artery or its cochlear branch or presumed arterial spasm in the course of migraine) has been postulated, on uncertain grounds We do not know how to interpret the ndings of DeFelice and colleagues as well as others, who report that the posterior communicating arteries are absent in a disproportionate number of patients with sudden hearing loss.

Often color codes are read wrong and the wrong resistor may be installed at a particular location Finally one of the most common causes for errors is the incorrect installation of transistors and integrated circuits Make sure that you can identify the manufacturer s pin-out diagrams and pay particular attention to if the pin-outs are for top or bottom views Have a knowledgeable electronics enthusiast help you scan the circuit for possible mistakes; a second pair of eyes always helps to find errors you may have missed as the builder Once you have located and fixed the problem, you can apply power and re-test the circuit for proper operation..

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A few cases have complicated herpes zoster and mumps parotitis, but aside from these there is no proven relationship to the usual viral respiratory infections In a prospective study of 88 cases of acute sensorineural hearing loss, two-thirds recovered their hearing completely within a few days or a week or two (Mattox and Simmons) In the remaining patients, recovery was much slower and often incomplete; in this latter group, the hearing loss was predominantly for high tones and in some cases was associated with varying degrees of vertigo and hypoactive caloric responses The sudden onset of bilateral sensorineural hearing loss has been reported to follow cardiopulmonary bypass surgery and has been ascribed to microemboli Less often, such an event follows general anesthesia for nonotologic surgery (Evan et al); the pathogenesis is quite obscure.

None of the currently popular therapeutic agents such as histamine, calcium channel blockers, anticoagulants, carbogen inhalation, and steroids seem to affect the outcome of sudden unilateral or bilateral deafness without vertigo Nonetheless, corticosteroids are often prescribed Otologists have described a progressive sensorineural type of hearing loss as a late manifestation of congenital syphilis, allegedly occurring despite prior treatment with adequate doses of penicillin It has been claimed that the long-term administration of steroids may be useful in such cases The pathologic basis of the hearing loss has not been determined and the causal relationship to congenital syphilis remains to be established The auditory nerve may be involved by tumors of the cerebellopontine angle or by mycotic, lymphomatous, carcinomatous, tuberculous, or other types of chronic meningitis and rarely in sarcoidosis.

Lymphomatous meningitis has a particular predilection to cause unilateral hearing loss; we have seen several such cases in which no other cranial nerves were in ltrated Carcinomatous meningitis may do the same but almost always in the context of other cranial and spinal nerve palsies (see Chap 31) Of the solid tumors, the ones that involve the auditory nerve most frequently are schwannomas, neuro bromas, meningiomas, dermoids, and metastatic carcinoma In central neuro bromatosis (type II), the involvement by acoustic neuromas is often bilateral Unilateral deafness may also result from demyelinative plaques, infarction, or tumor involving the cochlear nerve bers or nuclei in the brainstem Rarely, deafness is the result of bilateral lesions of the temporal lobes (Chap 22) The condition called pure word deafness is also due to left temporal lobe disease; despite normal pure-tone perception and audiometry and normal brainstem auditory evoked potentials, spoken words cannot be understood.

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