Acoustic neuroma physical examination: Difference between revisions
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{{CMG}}{{AE}}{{Simrat}} | {{CMG}}{{AE}}{{Simrat}} | ||
==Overview== | ==Overview== | ||
Common physical examination findings of acoustic neuroma include lateralization to the normal ear in [[Weber test]], decreased or absent [[ipsilateral]] [[corneal]] [[reflex]], and facial [[twitching]] or hypesthesia. | Common physical examination findings of acoustic neuroma include lateralization to the normal ear in [[Weber test]], decreased or absent [[ipsilateral]] [[corneal]] [[reflex]], and facial [[twitching]] or hypesthesia. | ||
==Physical Examination== | ==Physical Examination== | ||
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*Rinne test is positive | *Rinne test is positive | ||
*[[Rinne test]] is positive: air conduction > bone conduction (both air and bone conduction are decreased equally, but the difference between them is unchanged). | *[[Rinne test]] is positive: air conduction > bone conduction (both air and bone conduction are decreased equally, but the difference between them is unchanged). | ||
*[[Weber test]] lateralizes to normal ear | *[[Weber test]] lateralizes to normal ear | ||
===Eye examination=== | ===Eye examination=== | ||
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===Neurological Examination=== | ===Neurological Examination=== | ||
Often, the physical exam is normal at the time the tumor is diagnosed. Occasionally, the following cranial nerves may be affected: | Often, the physical exam is normal at the time the tumor is diagnosed. Occasionally, the following cranial nerves may be affected: | ||
*[[Cranial nerve]] V- A decreased or absent [[ipsilateral]] [[corneal]] [[reflex]]. | *[[Cranial nerve]] V- A decreased or absent [[ipsilateral]] [[corneal]] [[reflex]]. | ||
*Cranial nerve VII- Facial [[twitching]] or hypesthesia may occur. [[Drooling]] may occur. Drooping on one side of the [[face]] may occur. Loss of taste may occur. | *Cranial nerve VII- Facial [[twitching]] or hypesthesia may occur. [[Drooling]] may occur. Drooping on one side of the [[face]] may occur. Loss of taste may occur. | ||
Revision as of 17:32, 8 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Common physical examination findings of acoustic neuroma include lateralization to the normal ear in Weber test, decreased or absent ipsilateral corneal reflex, and facial twitching or hypesthesia.
Physical Examination
Diagnosis of acoustic neuromas begins with a history and physical examination, followed by otologic testing, and finally radiologic scanning.
Ear Examination
- Sensorineural hearing loss in the affected ear
- Rinne test is positive
- Rinne test is positive: air conduction > bone conduction (both air and bone conduction are decreased equally, but the difference between them is unchanged).
- Weber test lateralizes to normal ear
Eye examination
- Nystagmus may be present
- Papilledema may be present
- Diplopia on lateral gaze may be present
Neurological Examination
Often, the physical exam is normal at the time the tumor is diagnosed. Occasionally, the following cranial nerves may be affected:
- Cranial nerve V- A decreased or absent ipsilateral corneal reflex.
- Cranial nerve VII- Facial twitching or hypesthesia may occur. Drooling may occur. Drooping on one side of the face may occur. Loss of taste may occur.
- Cranial nerve VIII- In sensorineural hearing loss Rinne test is positive and Weber test is abnormal.
- Cranial nerve IX- the back half of the tongue can lose its sense of taste.
- Cerebellum: The following tests may be positive:
- Ataxia may be present.
- Romberg, Hall-Pike, and other balance tests are typically normal.