Supplementary Material for: Vestibular Schwannoma Presenting as Acute Vertigo Mimicking Vestibular Neuritis

Vestibular schwannoma (VS) is commonly accompanied by hearing loss, tinnitus, and dizziness and tends to be chronically progressive in nature. We report a case of VS presenting as left vestibular neuritis (VN) in a previously healthy 57-year-old patient. Right-beating horizontal-torsional spontaneous nystagmus was observed, and the bedside head impulse test revealed a left catch-up saccade. The bithermal caloric test showed left canal paresis, and pure-tone audiometry revealed an average threshold of 22.5 dB bilaterally. Brain magnetic resonance imaging (MRI) demonstrated a 0.7-cm enhancing mass in the left internal auditory canal, consistent with VS. The patient was administered with high-dose systemic corticosteroids and vestibular suppressants with antiemetic, which relieved acute vertigo. Although dizziness in VS is chronically progressive in nature, VS may present as an acute vestibular syndrome that mimics VN. VS should be considered a potential cause of acute vestibular syndrome, and thorough neurological examination with MRI may be helpful for accurate diagnosis.

前庭神经鞘瘤（Vestibular schwannoma, VS）常伴随听力损失、耳鸣及眩晕，且多呈慢性进展性特征。本文报告1例既往健康的57岁患者，其前庭神经鞘瘤以左侧前庭神经炎（Vestibular neuritis, VN）为首发表现。查体可见右向水平扭转性自发性眼震，床边头脉冲试验显示左侧追及性扫视。双温热量试验提示左侧半规管麻痹，纯音测听示双侧平均听阈为22.5分贝。颅脑磁共振成像（Magnetic Resonance Imaging, MRI）显示左侧内听道内存在一枚直径0.7cm的强化肿块，符合前庭神经鞘瘤表现。予患者大剂量全身糖皮质激素联合止吐前庭抑制剂治疗后，急性眩晕症状得以缓解。尽管前庭神经鞘瘤的眩晕多呈慢性进展性特征，但该病亦可表现为酷似前庭神经炎的急性前庭综合征。临床需将前庭神经鞘瘤纳入急性前庭综合征的潜在病因，结合全面神经系统检查与磁共振成像检查，有助于实现精准诊断。