We report on two patients with biopsy proven audiovestibular sarcoidosis. Their presentations included that of hearing impairment, vertigo and gait unsteadiness. On examination there was evidence of sensorineural hearing loss, a positive head impulse test and gait ataxia. The clinical findings were confirmed by formal oto-neurology testing, the results of which included sensorineural hearing loss with poor speech discrimination, semi-circular canal hypofunction and abnormal auditory brainstem responses. MRI of the brain revealed enhancement of the vestibular nerves.
Both patients responded to high dose oral corticosteroid treatment, which reinforces the importance of thorough investigation should the possibility of a reversible cause of audiovestibular dysfunction exist. A review of the pertinent literature was undertaken.