Differential Diagnosis for Sudden Loss of Bilateral Hearing
Single Most Likely Diagnosis
- Idiopathic Sudden Sensorineural Hearing Loss (ISSNHL): This condition is characterized by a sudden loss of hearing in one or both ears, often without an identifiable cause. It is the most common diagnosis for sudden bilateral hearing loss, and its exact cause remains unknown, though it is thought to be related to viral infections, vascular issues, or immune system disorders.
Other Likely Diagnoses
- Noise-Induced Hearing Loss (NIHL): Prolonged exposure to loud noises can cause damage to the hair cells in the inner ear, leading to hearing loss. This is a common issue in individuals working in loud environments or frequently exposed to loud music.
- Ototoxicity: Certain medications, such as antibiotics (e.g., gentamicin) and chemotherapy drugs, can be toxic to the ear, causing hearing loss. The risk is higher with prolonged use or high doses.
- Meniere's Disease: An inner ear disorder that involves vertigo, tinnitus, hearing loss, and the feeling of ear fullness. While it typically affects one ear, it can affect both ears in some cases.
Do Not Miss Diagnoses
- Stroke or Cerebrovascular Accident (CVA): Although less common, a stroke affecting the auditory pathways in the brain can cause sudden hearing loss. It is critical to identify and treat promptly to minimize brain damage.
- Multiple Sclerosis (MS): This autoimmune disease can affect any part of the brain and spinal cord, including areas responsible for hearing, leading to sudden hearing loss.
- Acoustic Neuroma: A non-cancerous tumor on the nerve connecting the inner ear to the brain can cause hearing loss, usually in one ear, but in rare cases, it can affect both ears if there are bilateral tumors.
Rare Diagnoses
- Autoimmune Inner Ear Disease (AIED): A rare condition where the body's immune system attacks the inner ear, leading to hearing loss, which can be sudden and bilateral.
- Cogan Syndrome: A rare disorder characterized by recurrent corneal inflammation and vestibular-auditory symptoms, including hearing loss.
- Sjögren's Syndrome: An autoimmune disorder that can cause dryness in the eyes, mouth, and other areas, and in some cases, can lead to hearing loss due to inflammation in the inner ear.
- Neurosyphilis: A complication of untreated syphilis infection that can affect the brain and cause a variety of symptoms, including hearing loss.