CASE STUDY INVESTIGATION | The Unexpected Hearing Loss in a Dizzy Kid

By Patricia Gaffney

This article is a part of the May/June 2018, Volume 30, Number 3, Audiology Today issue.

History

Five-year-old female (DK) was referred for vestibular testing and an audiogram by the pediatric ENT to investigate vestibular neuritis as a cause of dizziness. DK’s mother relayed the history information—she thinks the dizzy episodes were related to vaccinations.

The initial episode happened at two years old, DK was seen by her pediatrician for her wellness check and she received a varicella vaccine. The episode began 11 days after her vaccine, the symptoms lasted five to 40 minutes over a period of seven days. She described the dizziness at the time as “the room is moving.” Her mother also noted that DK was having a difficult time walking. She was taken to the emergency room and diagnosed with ataxia. Blood and urine testing, MRI, and EEG were all negative. After seven days the symptoms resolved. The second episode happened four months later, lasting five days, approximately 30 days after receiving a hepatitis B vaccine. DK’s mother noted that the patient was very tired, and her eyes were moving back and forth. DK was taken to the ER for this episode as well, and all testing was negative. The most recent episode was four months before testing. DK’s mother noted that she had been sick for about a week before the episode.

In addition to the symptoms stated earlier, DK also has an infrequent history of a beeping tone in her ears and fullness, and denied a history of hearing loss and visual impairment. There is a family history of dizziness (paternal grandmother) and migraines (mother and aunt). DK’s mother partly filled out the Dizziness Handicap Inventory-Patient Caregiver (DHI-PC), but she did not want it to be part of the medical report since the symptoms were not consistent. The patient is currently in school and participates in horseback riding, swimming, ice skating, and tennis. When asked, DK’s mother stated that her coaches noted she has good balance. When asked, DK reported that she enjoys school and her activities.