Vertigo, hearing loss, and tinnitus.

Accepted 19 November 1997 A 39-year-old Caucasian man presented to his general practitioner with an episode of vertigo, right-sided hearing loss and tinnitus. He was treated with betahistine. Two weeks later, he also experienced left-sided hearing loss with tinnitus and was hospitalised. There were no other otological symptoms. His medical history included ulcerative colitis for three years and he was taking sulphasalazine. There were no prior ear problems. Otoneurological examination did not show any abnormality apart from the obvious hearing loss (figure 1). Magnetic resonance imaging of the internal acoustic meati and cerebellopontine angles was normal. Routine haematological and biochemical profiles showed that the total plasma protein and its IgG fraction were significantly increased and the erythrocyte sedimentation rate (ESR) was 38 mm/h.