A RARE PRESENTATION OF BILATERAL VESTIBULAR SCHWANNOMAS

Abstract

Abstract : OBJECTIVE We report a rare presentation of
bilateral vestibular schwannomas with left eye ptosis with
ophthalmoplegia.CASE REPORT An 18 year old female
patient was referred from Ophthalmology department to ENT
department with one year history of left eye lid drooping and
hard of hearing left ear. Pure tone audiogram showed left ear
moderate SN hearing loss and right ear mild SN hearing loss.
Brain Stem Evoked Response Audiogram showed wave III
and wave V latency on both sides more on left
side.Gadolinium enhanced MRI brain showed bilateral
acoustic neuroma with neurofibromatous changes in the left
eye retro orbital area with medial rectus
hypertrophy.CONCLUSION Ptosis with ophthalmoplegia has
rarely been reported in NF2. In our case described, left eye
ptosis with ophthalmoplegia was caused by mechanical effect
of mass in retro orbital area.In this case since the tumors on
the both sides more than 1.5cm, the best option is regular
follow up eventhough she had moderate hearing loss on the
left side. Patient was advised for correction of left eye ptosis,
but she was not concerned about it and deferred surgery. So
she was advised regular follow up annually for clinical,
audiological and radiological evaluation.
Keyword :Bilateral Vestibular Schwannomas, Brain Stem
Evoked Response Audiogram, Gadolinium