The Potential Significance of Reversed Stapes Reflex in Clinical Practice in Idiopathic Intracranial Hypertension

Abstract

Background: Stapes reflex test is a method of evaluating the involuntary muscle contraction of the stapedius muscle in response to a high-intensity sound stimulus. The formation of this reflex involves the intact function of the 7 th nerve, brain stem, 8 th nerve, and middle ear. Due to ease of administration and information yielded, the stapedial reflex is considered one of the most powerful differential diagnostic audiological procedures. Numerous studies have remarked on the fluid communication between the intracochlear and intracranial spaces through the cochlear aqueduct. Currently, the potential significance of a noninvasive audiological technique in the discrimination of raised intracranial pressure constitutes a crucial topic of interest. Methods: We have performed the pre-LP and post-LP detailed otorhinolaryngological investigations, including the detailed inspection, audiometric testing, tympanometry, and stapedial reflex in a total of four consecutive patients with IIH. Results: We found that the stapedial reflex was bilateral absent initially in two of the patients. However, the second stapedial reflex investigations after LP showed reversal of the reflex responses in both of the patients. Conclusions: We suggest some hypotheses and propose some clinical applications. Future studies focusing on the potential utility of this reflex in the monitorization of IIH may provide crucial perspectives.

Idiopathic Intracranial Hypertension- The Eyes and Beyond

“…The present article attempts to discuss the role of the stapedial reflex in IIH. [ 20 ] The series has a very small number of patients with mixed results, which certainly needs to be reproduced in a much larger number to be credible. Additionally, the role of the stapedial reflex in the prediction of the intracranial pressures is not well established, as the same can occur due to many causes of the ear as well.…”

Utility of Stapedial Reflex in Idiopathic Intracranial Hypertension

“…In this issue of the journal, the authors report a case series of the patients with IIH. [ 4 ] The authors recorded stapedial reflex in four patients with IIH and noted abnormal stapedial reflexes in two of the patients. This abnormal stapedial or acoustic reflex reversed to normal after therapy.…”