Demyelinating disease as the assumed cause of hearing loss and vertigo

Summary A patient initially presenting typical symptoms of idiopathic sudden deafness later developed disabling episodic vertigo, which led to translabyrinthine eighth nerve transection. Morphological examination of the removed cochlear nerve specimen revealed a demyelinating process in the neuroglial portion of the nerve. The major part of the peripheral, neurolemmal portion of the cochlear nerve was normal. The inferior vestibular nerve was fibrotic. The major part of the superior vestibular nerve was normal. Some of its peripheral bundles showed increased endoneurial fibrosis. It is suggested that a demyelinating process was the cause of the patient's symptoms.