Unsteadiness is much more prevalent than vertigo, and approximately 70 percent of patients with large tumors have this symptom. The facial sensory disturbance may respond to carbamazepine medication for neuralgia . Facial weakness is uncommon. Facial twitching, also known as facial synkinesis or hemifacial spasm, occurs in about 10 percent of patients. Headache prior to surgery occurs in roughly 40 percent of those with large tumors.
Conventional audiometry is the most useful diagnostic test for acoustic neuroma.
The most common abnormality is an asymmetrical high-frequency sensorineural hearing loss. However, recall that only about 1 in 1000 patients with hearing asymmetry have acoustics. ABR testing is less sensitive than MRI, but it is considerably less expensive. Nevertheless, ENG is not a reasonable diagnostic test because it is not specific. Rotatory chair testing is less sensitive than caloric testing.