clinical features

Last reviewed 01/2018

The clinical features of acoustic neuroma are:

  • occipital pain on the side of the tumour

  • VIII nerve damage
    • about 90% of patients presents with unilateral sensorineural deafness developing gradually over a period of months or years
    • around 5% will have sudden hearing loss
    • vertigo which may be quite mild and tinnitus (around 70%) are common (1)
    • caloric paresis may be demonstrable.
  • V nerve damage - depression of corneal reflex occurs early. Facial pain, paraesthesia and numbness develop (1) .

  • VII nerve damage - facial weakness is unusual.(1)

  • IX, X, XI nerve damage - rare; presents as dysphagia, change in voice, palatal weakness.

  • compression effects of large tumours:
    • on cerebellum - ataxia, loss of co-ordination on ipsilateral side, nystagmus
    • on pons - contralateral hemiparesis
    • on aqueduct and 4th ventricle - raised intracranial pressure, e.g. headache (1)

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