case_images: PMC6735209_01
case_images: Hearing of the patient was normal as seen on pure tone audiometry. (a) Right ear. (b) Left ear.
case_images: CRIOT2019-6040852.001.jpg
case_images: PMC6735209_01_CRIOT2019-6040852.001.jpg
case_images: fig1
case_images: She had normal hearing (Figure 1).
case_images: Vestibular evoked myogenic potentials (cervical) following tone-burst sound stimuli of 95 dB nHL with rarefaction polarity, 5 Hz stimulus repetition rate, 1 ms rise/fall time, and 2 ms plateau time delivered at 500 Hz. Normal waveforms were seen on both sides. But, the P1N1 amplitude decreased on the right side (red drawing, recording from RE; blue drawing, recording from LE). Comparative analysis of the amplitude of the right and left side was less than 20%.
case_images: CRIOT2019-6040852.002.jpg
case_images: PMC6735209_01_CRIOT2019-6040852.002.jpg
case_images: fig2
case_images: But, comparison of both sides was within normal limits (Eclipse EP25, Interacoustics, USA) (Figure 2).
case_images: Magnetic resonance imaging of the temporal bone. (a) Axial T2 (T2-TIRM) fluid-attenuated view to suppress cerebrospinal fluid shows extensive edema of the right temporal lobe. (b) Coronal T2 image shows intracranial inflammation (I) and soft tissue located supralabyrinthine area of the right inner ear (II). (c) Coronal T1 view with gadolinium contrast shows dural thickening with contrast enhancement throughout the right tegmen (I). Soft tissue with contrast enhancement is also seen at the supralabyrinthine area (II).
case_images: CRIOT2019-6040852.003.jpg
case_images: PMC6735209_01_CRIOT2019-6040852.003.jpg
case_images: fig3
case_images: Magnetic resonance imaging (MRI) at T2 showed hyperintense widespread inflammatory gliosis of the right temporal lobe of the brain, and temporal bone computerized tomography (CT) showed isolated destruction of the right superior semicircular canal (Figures 3(a)-3(c), 4(a), and 4(b)).
case_images: Computerized tomography of the temporal bone. (a) Axial cut crossing the supralabyrinthine area shows soft tissue filling the supralabyrinthine air cells. (b) Coronal view shows isolated destruction of the superior semicircular canal (marked with I). Normal aeration of the mastoid air cells is seen.
case_images: CRIOT2019-6040852.004.jpg
case_images: PMC6735209_01_CRIOT2019-6040852.004.jpg
case_images: fig4
case_images: Magnetic resonance imaging (MRI) at T2 showed hyperintense widespread inflammatory gliosis of the right temporal lobe of the brain, and temporal bone computerized tomography (CT) showed isolated destruction of the right superior semicircular canal (Figures 3(a)-3(c), 4(a), and 4(b)).