Tinnitus is common in acoustic neuroma, is usually unilateral, and confined to the affected ear. Vertigo is not common, occurring in only about 20 percent of acoustic neuroma cases and appears more often in patients with small tumors. Unsteadiness is much more prevalent than vertigo, and approximately 70 percent of patients with large tumors have this symptom. Headache occurs in about 40 percent of those with large tumors. Cerebellar symptoms, such as poor coordination, are unusual.
Facial weakness is uncommon.
Facial twitching occurs in about 10 percent of patients. Conventional pure-tone and speech audiometry are the most useful diagnostic tests. In patients with small tumors, there may be abnormal eye movements. In those with large tumors, there may be abnormal eye movements that are characteristic of central nervous system disease. Rotatory chair testing is less sensitive than caloric testing.