Two cases of proved sarcoidosis with impaired hearing and vertigo occurred. Results in one patient suggested a labyrinthine lesion. Induced positional nystagmus had slow eye speed and appeared in two positions only; there was a latent period and early fatigability; audiometry showed mixed deafness with no recruitment. In the other patient a more central lesion was suspected, the speed of the slow component of the nystagmus in the positional tests was rapid, with no latent period, and was not fatigable; a right sensorineural hearing loss was found with no recruitment. Typically, the impairment of hearing and presence of vertigo fluctuated as is characteristic of sarcoid symptoms. Neither patient had other neurological signs but both had uveitis. The pathogenesis and site of cranial nerve lesions in sarcoid remains obscure due to lack of autopsy material.
Hooper R, Holden H. Acoustic and Vestibular Problems in Sarcoidosis. Arch Otolaryngol. 1970;92(4):386–391. doi:10.1001/archotol.1970.04310040074014
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