Book
Reversible Bilateral Hearing Loss after Heroin Overdose
01 Aug 2008
Abstract
Background: Transient sensorineural hearing loss has been associated with heroin overdose, however, the incidence of this phenomenon is not known. Case Report: A 22 year-old female with a history of recent abstention from intravenous (IV) heroin use presented to the emergency department (ED) obtunded and cyanotic. The patient and a friend each injected a "bag of heroin" nine hours prior to arrival. Within an hour the patient became difficult to arouse. In the ED, the patient was successfully treated with 2 mg of intramuscular naloxone and supplemental oxygen. Upon awakening, the patient reported bilateral hearing loss but denied tinnitus and vertigo. Weber-Rinne testing did not lateralize and her cranial nerve exam was normal save for subjective hearing loss. Within 12 hours after presentation the patient's hearing had grossly recovered. The patient's friend, by contrast, reported no changes in her own hearing. Outpatient audiometric testing was requested but the patient did not attend the appointment. The patient's friend reported that temporary hearing loss after heroin overdose was common knowledge in her local IV heroin using community. Case Discussion: Five cases of heroin-associated acute hearing loss are reported in the medical literature. Three of the cases are well described, and feature abrupt bilateral hearing loss after a heroin overdose. Two additional cases are briefly discussed in abstracts. A comparison of available details suggests that a period of opiate abstinence followed by a potentially life threatening overdose immediately precedes the hearing loss. The deafness was of variable duration, lasting 3 days in two cases, 3 weeks in one case, and was permanent in two. Vertigo and tinnitus were not universal. Audiometric data, available in 3 cases, revealed high-frequency hearing loss, and suggested cochlear injury. Propoxyphene and hydrocodone induced hearing loss have also been described. Permanent high-frequency hearing loss was a common finding in these cases, which outnumber the heroin cases. Conclusion: Transient hearing loss is a rarely reported sequela of heroin overdose. Similar features among heroin, propoxyphene, and hydrocodone associated hearing loss cases suggest a common pathophysiology.
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Details
- Title
- Reversible Bilateral Hearing Loss after Heroin Overdose
- Creators
- S SimpsonC MurphyD Mullin
- Resource Type
- Book
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute
- Identifiers
- 991019170378504721