A sudden hearing loss occurs in about 25 percent of patients with acoustic neuroma. Tinnitus is very common in acoustic neuroma, is usually unilateral and confined to the affected ear. Vertigo is more common with smaller tumors. 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.