- Email: [email protected]
Reversible hearing loss in temporal association with chemoprophylactic mefloquine use
ARTICLE IN PRESS Travel Medicine and Infectious Disease (2007) 5, 385–388
Available at www.sciencedirect.com
journal homepage: www.elsevierhealth.com/journals/tmid
Reversible hearing loss in temporal association with chemoprophylactic mefloquine use Mark Wise, Stephen Toovey Burggartenstrassse 32, CH-4103 Bottmingen, Switzerland Received 9 July 2007; received in revised form 26 August 2007; accepted 30 August 2007
KEYWORDS Mefloquine; Prophylaxis; Malaria; Tinnitus; Hearing loss; Deafness
Summary A 67 year old Caucasian lady received pre-travel immunizations against tetanus, diphtheria, typhoid fever, hepatitis A, and mefloquine chemoprophylaxis. Left sided hearing loss consequent upon tympanic rupture was present since childhood; she was otherwise in good health and without history of recent upper respiratory tract infection. After 1 dose of mefloquine right sided tinnitus and hearing loss developed; audiometry revealed mixed left sided loss and right sided sensorineural loss ( 90 db at 1 kHz; 70 dB at 4 kHz). Prednisone, aspirin and omeprazole were prescribed; mefloquine chemoprophylaxis was discontinued. On day 9 of her hearing loss the tinnitus suddenly disappeared, and right sided hearing improved. Audiometry on day 93 revealed normal right sided hearing ( 10 dB at 1 kHz; 10 dB at 4 kHz). Causality remains undetermined, but it may be prudent to avoid mefloquine chemoprophylaxis in individuals with known hearing impairment. & 2007 Elsevier Ltd. All rights reserved.
Introduction
Case report
Mefloquine is prescribed widely for the chemoprophylaxis of malaria in travelers. We describe a case of reversible hearing loss that occurred in a patient shortly after she took mefloquine for chemoprophylaxis. The possible etiology of the hearing loss is discussed, as are implications for the prescription of mefloquine.
A 67 year old Caucasian lady presented at a travel clinic in Toronto in November 2005 for travel health advice and immunizations prior to a planned 3 week trip to India. She was a retired school teacher in good general health. There was no recent history of upper respiratory tract infection. During childhood she had undergone a tonsillectomy, as well as a left tympanoplasty following rupture of the left tympanic membrane. Left sided hearing loss consequent upon the tympanic rupture had been present since childhood. Aside from counseling regarding food, water and insect precautions, the patient was vaccinated against tetanus, diphtheria, typhoid fever and hepatitis A. Mefloquine (Lariams) at a dose of 250 mg weekly was prescribed for malaria prophylaxis.
Corresponding author. Tel.: +41 61 421 7872;
fax: +41 61 421 7063. E-mail address: [email protected] (S. Toovey). 1477-8939/$ - see front matter & 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.tmaid.2007.08.006
ARTICLE IN PRESS 386
M. Wise, S. Toovey
Pre-departure, on the day following ingestion of the first mefloquine dose, the patient noticed ringing in the right ear and difficulty hearing the telephone when placed against that ear. Over the next 24 h, this progressed to a much more severe hearing loss. An otorhinolaryngologist’s opinion was obtained 48 h later. Examination at that time revealed significant left tympanosclerois, compatible with the history of perforation. The right ear canal was clean and the right tympanic membrane appeared normal. Rinne’s test was positive bilaterally and Weber’s test lateralized to the left ear. An audiogram revealed a mixed loss on the left and moderately severe to profound sensorineural loss on the right (Figure 1). Treatment was commenced with prednisone, 40 mg daily for 3 days, tapered off by 5 mg daily; aspirin 325 mg daily, and omeprazole 20 mg daily were also prescribed. Mefloquine chemoprophylaxis was discontinued and substituted with daily atovaquone-proguanil (Malarones). Despite the hearing loss, the patient left for India 3 days later (day 5 of her hearing loss). On day 9 of her hearing loss, while traveling by road, the patient suddenly became aware that her tinnitus had disappeared, and that she was able to hear a dial tone with her right ear. The improvement in hearing was maintained. Upon return to Canada a follow up audiogram was taken in February 2006, on day 93 of the illness. This confirmed the recovery of hearing on the right, showing normal hearing; this has remained normal since; audiometric findings in the left ear were essentially unchanged from those found in the initial (day 2) audiogram (Figure 2).
Discussion Mefloquine is known to be neurotoxic, with numerous reports in the literature documenting a range of neuropsy-
chiatric effects from sleep disturbances to psychosis.1–17 Recently, a plausible biochemical mechanism has been demonstrated for this neurotoxicity.18,19 Additionally, ototoxicity is a known adverse effect of quinine,20–22 a chemical relative of mefloquine. Fusetti et al. reported 3 cases of hearing loss associated with mefloquine chemoprophylaxis.23 Of these 3 cases, 1 subject suffered irreversible bilateral hearing loss, 1 irreversible unilateral loss, while the third enjoyed partial recovery from bilateral loss. While reports of vaccine associated hearing loss exist, these are generally in association with hepatitis B, smallpox, mumps, measles, and rubella vaccines.24–33 Only one report gives an association with a vaccine, diphtheria–tetanus, received by our subject, detailing hearing loss in association with vertigo;34 although our subject did not experience vertigo, an association with diphtheria–tetanus vaccination cannot be excluded. The switch of chemoprophylaxis to atovaqoneproguanil was motivated by the absence of literature reports associating the combination with ototoxicity. The case we describe is compatible with Fusetti’s report of mefloquine associated ototoxicity, although it is also compatible with the clinical entity known as ‘sudden sensorineural hearing loss’.35 This condition is one of the unsolved mysteries of otorhinolaryngology, and is characterized by unilateral sensorineural hearing loss that develops within 24 h, with a mean pure tone audiogram loss of X30 dB at 3 adjacent frequencies in the absence of marked vestibular symptoms, and lacking a discernible etiology.36 Various etiologies have been proposed for sudden sensorineural hearing loss, including viruses, auto-immunity, vascular disorders, and drug toxicity. None of these have been conclusively shown as being causative; in all likelihood, there may be a number of causes, some of which may operate together. Treatment usually comprises high dose intravenous corticosteroids, which are not always successful.37,38
Pure tone frequency (Hz) 250
500
1000
2000
4000
6000
8000
0 Left air unmasked Right air unmasked
10
Threshold shift (dB)
20 30 40 50 60 70 80 90 100
Figure 1 Audiogram day 2.
ARTICLE IN PRESS Reversible hearing loss in temporal association with chemoprophylactic mefloquine use
387
Pure tone frequency (Hz) 250
500
1000
2000
4000
6000
8000
0 Left air unmaksed Right air unmasked
10 20
Threshold shift (dB)
30 40 50 60 70 80 90 100
Figure 2
Audiogram day 93.
A confounding factor in our case is the pre-existing hearing loss in the left ear, which precluded a definite determination of whether the effect was uni- or bi-lateral. The recovery of hearing also does not clearly differentiate between mefloquine toxicity and sudden sensorineural hearing loss, given that reversibility is associated with both. Given that the responsiveness of sudden sensorineural hearing loss to corticosteroids remains controversial, and the relatively low total dose of corticosteroid employed in this case, response to treatment cannot be used as a determinant of etiology. This case had a ‘happy ending’, in that the patient regained her hearing. Had the hearing loss not reversed, she would have been left with bilateral hearing loss. It is clearly not possible to determine with certainty the cause of the hearing loss reported in this case. Nevertheless, the case may provide a lesson regarding contraindications to mefloquine use. Given the known neurotoxicity of mefloquine, and the reported cases of hearing loss associated with mefloquine, it may be prudent to avoid, where possible, mefloquine usage in individuals with impaired hearing.
References 1. Ajana F, Fortier B, Martinot A, Rouveix B, Camus D. Mefloquine prophylaxis and neurotoxicity-report of A case. Sem Hop 1990;66(17):918–9. 2. Bem JL, Kerr L, Stuerchler D. Mefloquine prophylaxis: an overview of spontaneous reports of severe psychiatric reactions and convulsions. J Trop Med Hyg 1992;95(3):167–79. 3. Bernard J, Le CJ, Sarrouy J, Renaudineau J, Geffray L, Dufour P, et al. Toxic encephalopathy caused by mefloquine? Presse Med 1987;16(33):1654–5. 4. Berninger E, Karlsson KK, Alvan G. Quinine reduces the dynamic range of the human auditory system. Acta Otolaryngol 1998;118(1):46–51.
5. Cruikshank SJ, Hopperstad M, Younger M, Connors BW, Spray DC, Srinivas M. Potent block of Cx36 and Cx50 gap junction channels by mefloquine. Proc Natl Acad Sci USA 2004;101(33): 12364–9. 6. Garg MR, Gopinathan N, Kshirsagar NA. Mefloquine induced grand mal seizure in a case of uncomplicated falciparum malaria. J Assoc Physicians India 1996;44(10):750. 7. Meier CR, Wilcock K, Jick SS. The risk of severe depression, psychosis or panic attacks with prophylactic antimalarials. Drug Saf 2004;27(3):203–13. 8. Meyer P, Combes N, Corne P, Jonquet O. Convulsions and shock during antimalarial chemoprophylaxis with mefloquine. Presse Med 2003;32(9):408. 9. Patchen LC, Campbell CC, Williams SB. Neurologic reactions after a therapeutic dose of mefloquine. N Engl J Med 1989;321(20):1415–6. 10. Pous E, Gascon J, Obach J, Corachan M. Mefloquine-induced grand mal seizure during malaria chemoprophylaxis in a nonepileptic subject. Trans R Soc Trop Med Hyg 1995;89(4):434. 11. Rouveix B, Bricaire F, Michon C, Franssen G, Lebras J, Bernard J, et al. Mefloquine and an acute brain syndrome. Ann Intern Med 1989;110(7):577–8. 12. Ruff TA, Sherwen SJ, Donnan GA. Seizure associated with mefloquine for malaria prophylaxis. Med J Aust 1994;161(7):453. 13. Sowunmi A, Adio RA, Oduola AM, Ogundahunsi OA, Salako LA. Acute psychosis after mefloquine. Report of six cases. Trop Geogr Med 1995;47(4):179–80. 14. Stuiver PC, Ligthelm RJ, Goud TJ. Acute psychosis after mefloquine. Lancet 1989;2(8657):282. 15. van Riemsdijk MM, Sturkenboom MC, Ditters JM, Ligthelm RJ, Overbosch D, Stricker BH. Atovaquone plus chloroguanide versus mefloquine for malaria prophylaxis: a focus on neuropsychiatric adverse events. Clin Pharmacol Ther 2002;72(3):294–301. 16. van Riemsdijk MM, Ditters JM, Sturkenboom MC, Tulen JH, Ligthelm RJ, Overbosch D, et al. Neuropsychiatric events during prophylactic use of mefloquine before travelling. Eur J Clin Pharmacol 2002;58(6):441–5.
ARTICLE IN PRESS 388 17. Weinke T, Trautmann M, Held T, Weber G, Eichenlaub D, Fleischer K, et al. Neuropsychiatric side effects after the use of mefloquine. Am J Trop Med Hyg 1991;45(1):86–91. 18. Dow GS, Hudson TH, Vahey M, Koenig ML. The acute neurotoxicity of mefloquine may be mediated through a disruption of calcium homeostasis and ER function in vitro. Malar J 2003;2:14. 19. Toovey S. Mechanisms of artemisinin combination therapy neurotoxicity Ghent. Belgium: University of Ghent; 2006. 20. Claessen FAP, van Boxtel CJ, Perenboom RM, Tange RA, Wetsteijn JCFM, Kager PA. Quinine pharmacokinetics: ototoxic and cardiotoxic effects in healthy Caucasian subjects and in patients with falciparum malaria. Trop Med Int Health 1998;3(6):482–9. 21. Karlsson KK, Berninger E, Alvan G. The effect of quinine on psychoacoustic tuning curves, stapedius reflexes and evoked otoacoustic emissions in healthy volunteers. Scand Audiol 1991;20(2):83–90. 22. Tange RA, Dreschler WA, Claessen FA, Perenboom RM. Ototoxic reactions of quinine in healthy persons and patients with Plasmodium falciparum infection. Auris Nasus Larynx 1997;24(2):131–6. 23. Fusetti M, Eibenstein A, Corridore V, Hueck S, Chiti-Batelli S. Mefloquine and ototoxicity: a report of 3 cases. Clin Ter 1999;150(5):379–82. 24. Biacabe B, Erminy M, Bonfils P. A case report of fluctuant sensorineural hearing loss after hepatitis B vaccination. Auris Nasus Larynx 1997;24(4):357–60. 25. Bonfils P, Biacabe B, Potard G, Aidan D. Fluctuant perception hearing loss after hepatitis B vaccine. Ann Otolaryngol Chir Cervicofac 1996;113(6):359–61. 26. Brodsky L, Stanievich J. Sensorineural hearing loss following live measles virus vaccination. Int J Pediatr Otorhinolaryngol 1985;10(2):159–63.
M. Wise, S. Toovey 27. DeJonckere PH, de Surgeres GG. Acute tinnitus and permanent audiovestibular damage after hepatitis B vaccination. Int Tinnitus J 2001;7(1):59–61. 28. Garcia Callejo FJ, Costa A, I de PV, Marco AJ. Sudden bilateral deafness after measles, mumps and rubella vaccination. An Pediatr (Barc ) 2005;62(5):482–3. 29. Hulbert TV, Larsen RA, Davis CL, Holtom PD. Bilateral hearing loss after measles and rubella vaccination in an adult. N Engl J Med 1991;325(2):134. 30. Jayarajan V, Sedler PA. Hearing loss following measles vaccination. J Infect 1995;30(2):184–5. 31. Nabe-Nielsen J, Walter B. Unilateral total deafness as a complication of the measles–mumps–rubella vaccination. Scand Audiol Suppl 1988;30:69–70. 32. Stewart BJ, Prabhu PU. Reports of sensorineural deafness after measles, mumps, and rubella immunisation. Arch Dis Child 1993;69(1):153–4. 33. Watson JG. A child of 3 years who developed an encephalitic reaction to MMR (mumps, measles, rubella) immunisation at age 15 months. Int J Pediatr Otorhinolaryngol 1990;19(2):189–90. 34. Mair IW, Elverland HH. Sudden deafness and vaccination. J Laryngol Otol 1977;91(4):323–9. 35. Xenellis J, Karapatsas I, Papadimitriou N, Nikolopoulos T, Maragoudakis P, Tzagkaroulakis M, et al. Idiopathic sudden sensorineural hearing loss: prognostic factors. J Laryngol Otol 2006:1–7. 36. Charrier JB, Tran Ba HP. Idiopathic sudden sensorineural hearing loss: a review. Ann Otolaryngol Chir Cervicofac 2005;122(1):3–17. 37. Hughes GB, Freedman MA, Haberkamp TJ, Guay ME. Sudden sensorineural hearing loss. Otolaryngol Clin North Am 1996;29(3):393–405. 38. Thurmond M, Amedee RG. Sudden sensorineural hearing loss: etiologies and treatments. J La State Med Soc 1998;150(5):200–3.
Available at www.sciencedirect.com
journal homepage: www.elsevierhealth.com/journals/tmid
Reversible hearing loss in temporal association with chemoprophylactic mefloquine use Mark Wise, Stephen Toovey Burggartenstrassse 32, CH-4103 Bottmingen, Switzerland Received 9 July 2007; received in revised form 26 August 2007; accepted 30 August 2007
KEYWORDS Mefloquine; Prophylaxis; Malaria; Tinnitus; Hearing loss; Deafness
Summary A 67 year old Caucasian lady received pre-travel immunizations against tetanus, diphtheria, typhoid fever, hepatitis A, and mefloquine chemoprophylaxis. Left sided hearing loss consequent upon tympanic rupture was present since childhood; she was otherwise in good health and without history of recent upper respiratory tract infection. After 1 dose of mefloquine right sided tinnitus and hearing loss developed; audiometry revealed mixed left sided loss and right sided sensorineural loss ( 90 db at 1 kHz; 70 dB at 4 kHz). Prednisone, aspirin and omeprazole were prescribed; mefloquine chemoprophylaxis was discontinued. On day 9 of her hearing loss the tinnitus suddenly disappeared, and right sided hearing improved. Audiometry on day 93 revealed normal right sided hearing ( 10 dB at 1 kHz; 10 dB at 4 kHz). Causality remains undetermined, but it may be prudent to avoid mefloquine chemoprophylaxis in individuals with known hearing impairment. & 2007 Elsevier Ltd. All rights reserved.
Introduction
Case report
Mefloquine is prescribed widely for the chemoprophylaxis of malaria in travelers. We describe a case of reversible hearing loss that occurred in a patient shortly after she took mefloquine for chemoprophylaxis. The possible etiology of the hearing loss is discussed, as are implications for the prescription of mefloquine.
A 67 year old Caucasian lady presented at a travel clinic in Toronto in November 2005 for travel health advice and immunizations prior to a planned 3 week trip to India. She was a retired school teacher in good general health. There was no recent history of upper respiratory tract infection. During childhood she had undergone a tonsillectomy, as well as a left tympanoplasty following rupture of the left tympanic membrane. Left sided hearing loss consequent upon the tympanic rupture had been present since childhood. Aside from counseling regarding food, water and insect precautions, the patient was vaccinated against tetanus, diphtheria, typhoid fever and hepatitis A. Mefloquine (Lariams) at a dose of 250 mg weekly was prescribed for malaria prophylaxis.
Corresponding author. Tel.: +41 61 421 7872;
fax: +41 61 421 7063. E-mail address: [email protected] (S. Toovey). 1477-8939/$ - see front matter & 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.tmaid.2007.08.006
ARTICLE IN PRESS 386
M. Wise, S. Toovey
Pre-departure, on the day following ingestion of the first mefloquine dose, the patient noticed ringing in the right ear and difficulty hearing the telephone when placed against that ear. Over the next 24 h, this progressed to a much more severe hearing loss. An otorhinolaryngologist’s opinion was obtained 48 h later. Examination at that time revealed significant left tympanosclerois, compatible with the history of perforation. The right ear canal was clean and the right tympanic membrane appeared normal. Rinne’s test was positive bilaterally and Weber’s test lateralized to the left ear. An audiogram revealed a mixed loss on the left and moderately severe to profound sensorineural loss on the right (Figure 1). Treatment was commenced with prednisone, 40 mg daily for 3 days, tapered off by 5 mg daily; aspirin 325 mg daily, and omeprazole 20 mg daily were also prescribed. Mefloquine chemoprophylaxis was discontinued and substituted with daily atovaquone-proguanil (Malarones). Despite the hearing loss, the patient left for India 3 days later (day 5 of her hearing loss). On day 9 of her hearing loss, while traveling by road, the patient suddenly became aware that her tinnitus had disappeared, and that she was able to hear a dial tone with her right ear. The improvement in hearing was maintained. Upon return to Canada a follow up audiogram was taken in February 2006, on day 93 of the illness. This confirmed the recovery of hearing on the right, showing normal hearing; this has remained normal since; audiometric findings in the left ear were essentially unchanged from those found in the initial (day 2) audiogram (Figure 2).
Discussion Mefloquine is known to be neurotoxic, with numerous reports in the literature documenting a range of neuropsy-
chiatric effects from sleep disturbances to psychosis.1–17 Recently, a plausible biochemical mechanism has been demonstrated for this neurotoxicity.18,19 Additionally, ototoxicity is a known adverse effect of quinine,20–22 a chemical relative of mefloquine. Fusetti et al. reported 3 cases of hearing loss associated with mefloquine chemoprophylaxis.23 Of these 3 cases, 1 subject suffered irreversible bilateral hearing loss, 1 irreversible unilateral loss, while the third enjoyed partial recovery from bilateral loss. While reports of vaccine associated hearing loss exist, these are generally in association with hepatitis B, smallpox, mumps, measles, and rubella vaccines.24–33 Only one report gives an association with a vaccine, diphtheria–tetanus, received by our subject, detailing hearing loss in association with vertigo;34 although our subject did not experience vertigo, an association with diphtheria–tetanus vaccination cannot be excluded. The switch of chemoprophylaxis to atovaqoneproguanil was motivated by the absence of literature reports associating the combination with ototoxicity. The case we describe is compatible with Fusetti’s report of mefloquine associated ototoxicity, although it is also compatible with the clinical entity known as ‘sudden sensorineural hearing loss’.35 This condition is one of the unsolved mysteries of otorhinolaryngology, and is characterized by unilateral sensorineural hearing loss that develops within 24 h, with a mean pure tone audiogram loss of X30 dB at 3 adjacent frequencies in the absence of marked vestibular symptoms, and lacking a discernible etiology.36 Various etiologies have been proposed for sudden sensorineural hearing loss, including viruses, auto-immunity, vascular disorders, and drug toxicity. None of these have been conclusively shown as being causative; in all likelihood, there may be a number of causes, some of which may operate together. Treatment usually comprises high dose intravenous corticosteroids, which are not always successful.37,38
Pure tone frequency (Hz) 250
500
1000
2000
4000
6000
8000
0 Left air unmasked Right air unmasked
10
Threshold shift (dB)
20 30 40 50 60 70 80 90 100
Figure 1 Audiogram day 2.
ARTICLE IN PRESS Reversible hearing loss in temporal association with chemoprophylactic mefloquine use
387
Pure tone frequency (Hz) 250
500
1000
2000
4000
6000
8000
0 Left air unmaksed Right air unmasked
10 20
Threshold shift (dB)
30 40 50 60 70 80 90 100
Figure 2
Audiogram day 93.
A confounding factor in our case is the pre-existing hearing loss in the left ear, which precluded a definite determination of whether the effect was uni- or bi-lateral. The recovery of hearing also does not clearly differentiate between mefloquine toxicity and sudden sensorineural hearing loss, given that reversibility is associated with both. Given that the responsiveness of sudden sensorineural hearing loss to corticosteroids remains controversial, and the relatively low total dose of corticosteroid employed in this case, response to treatment cannot be used as a determinant of etiology. This case had a ‘happy ending’, in that the patient regained her hearing. Had the hearing loss not reversed, she would have been left with bilateral hearing loss. It is clearly not possible to determine with certainty the cause of the hearing loss reported in this case. Nevertheless, the case may provide a lesson regarding contraindications to mefloquine use. Given the known neurotoxicity of mefloquine, and the reported cases of hearing loss associated with mefloquine, it may be prudent to avoid, where possible, mefloquine usage in individuals with impaired hearing.
References 1. Ajana F, Fortier B, Martinot A, Rouveix B, Camus D. Mefloquine prophylaxis and neurotoxicity-report of A case. Sem Hop 1990;66(17):918–9. 2. Bem JL, Kerr L, Stuerchler D. Mefloquine prophylaxis: an overview of spontaneous reports of severe psychiatric reactions and convulsions. J Trop Med Hyg 1992;95(3):167–79. 3. Bernard J, Le CJ, Sarrouy J, Renaudineau J, Geffray L, Dufour P, et al. Toxic encephalopathy caused by mefloquine? Presse Med 1987;16(33):1654–5. 4. Berninger E, Karlsson KK, Alvan G. Quinine reduces the dynamic range of the human auditory system. Acta Otolaryngol 1998;118(1):46–51.
5. Cruikshank SJ, Hopperstad M, Younger M, Connors BW, Spray DC, Srinivas M. Potent block of Cx36 and Cx50 gap junction channels by mefloquine. Proc Natl Acad Sci USA 2004;101(33): 12364–9. 6. Garg MR, Gopinathan N, Kshirsagar NA. Mefloquine induced grand mal seizure in a case of uncomplicated falciparum malaria. J Assoc Physicians India 1996;44(10):750. 7. Meier CR, Wilcock K, Jick SS. The risk of severe depression, psychosis or panic attacks with prophylactic antimalarials. Drug Saf 2004;27(3):203–13. 8. Meyer P, Combes N, Corne P, Jonquet O. Convulsions and shock during antimalarial chemoprophylaxis with mefloquine. Presse Med 2003;32(9):408. 9. Patchen LC, Campbell CC, Williams SB. Neurologic reactions after a therapeutic dose of mefloquine. N Engl J Med 1989;321(20):1415–6. 10. Pous E, Gascon J, Obach J, Corachan M. Mefloquine-induced grand mal seizure during malaria chemoprophylaxis in a nonepileptic subject. Trans R Soc Trop Med Hyg 1995;89(4):434. 11. Rouveix B, Bricaire F, Michon C, Franssen G, Lebras J, Bernard J, et al. Mefloquine and an acute brain syndrome. Ann Intern Med 1989;110(7):577–8. 12. Ruff TA, Sherwen SJ, Donnan GA. Seizure associated with mefloquine for malaria prophylaxis. Med J Aust 1994;161(7):453. 13. Sowunmi A, Adio RA, Oduola AM, Ogundahunsi OA, Salako LA. Acute psychosis after mefloquine. Report of six cases. Trop Geogr Med 1995;47(4):179–80. 14. Stuiver PC, Ligthelm RJ, Goud TJ. Acute psychosis after mefloquine. Lancet 1989;2(8657):282. 15. van Riemsdijk MM, Sturkenboom MC, Ditters JM, Ligthelm RJ, Overbosch D, Stricker BH. Atovaquone plus chloroguanide versus mefloquine for malaria prophylaxis: a focus on neuropsychiatric adverse events. Clin Pharmacol Ther 2002;72(3):294–301. 16. van Riemsdijk MM, Ditters JM, Sturkenboom MC, Tulen JH, Ligthelm RJ, Overbosch D, et al. Neuropsychiatric events during prophylactic use of mefloquine before travelling. Eur J Clin Pharmacol 2002;58(6):441–5.
ARTICLE IN PRESS 388 17. Weinke T, Trautmann M, Held T, Weber G, Eichenlaub D, Fleischer K, et al. Neuropsychiatric side effects after the use of mefloquine. Am J Trop Med Hyg 1991;45(1):86–91. 18. Dow GS, Hudson TH, Vahey M, Koenig ML. The acute neurotoxicity of mefloquine may be mediated through a disruption of calcium homeostasis and ER function in vitro. Malar J 2003;2:14. 19. Toovey S. Mechanisms of artemisinin combination therapy neurotoxicity Ghent. Belgium: University of Ghent; 2006. 20. Claessen FAP, van Boxtel CJ, Perenboom RM, Tange RA, Wetsteijn JCFM, Kager PA. Quinine pharmacokinetics: ototoxic and cardiotoxic effects in healthy Caucasian subjects and in patients with falciparum malaria. Trop Med Int Health 1998;3(6):482–9. 21. Karlsson KK, Berninger E, Alvan G. The effect of quinine on psychoacoustic tuning curves, stapedius reflexes and evoked otoacoustic emissions in healthy volunteers. Scand Audiol 1991;20(2):83–90. 22. Tange RA, Dreschler WA, Claessen FA, Perenboom RM. Ototoxic reactions of quinine in healthy persons and patients with Plasmodium falciparum infection. Auris Nasus Larynx 1997;24(2):131–6. 23. Fusetti M, Eibenstein A, Corridore V, Hueck S, Chiti-Batelli S. Mefloquine and ototoxicity: a report of 3 cases. Clin Ter 1999;150(5):379–82. 24. Biacabe B, Erminy M, Bonfils P. A case report of fluctuant sensorineural hearing loss after hepatitis B vaccination. Auris Nasus Larynx 1997;24(4):357–60. 25. Bonfils P, Biacabe B, Potard G, Aidan D. Fluctuant perception hearing loss after hepatitis B vaccine. Ann Otolaryngol Chir Cervicofac 1996;113(6):359–61. 26. Brodsky L, Stanievich J. Sensorineural hearing loss following live measles virus vaccination. Int J Pediatr Otorhinolaryngol 1985;10(2):159–63.
M. Wise, S. Toovey 27. DeJonckere PH, de Surgeres GG. Acute tinnitus and permanent audiovestibular damage after hepatitis B vaccination. Int Tinnitus J 2001;7(1):59–61. 28. Garcia Callejo FJ, Costa A, I de PV, Marco AJ. Sudden bilateral deafness after measles, mumps and rubella vaccination. An Pediatr (Barc ) 2005;62(5):482–3. 29. Hulbert TV, Larsen RA, Davis CL, Holtom PD. Bilateral hearing loss after measles and rubella vaccination in an adult. N Engl J Med 1991;325(2):134. 30. Jayarajan V, Sedler PA. Hearing loss following measles vaccination. J Infect 1995;30(2):184–5. 31. Nabe-Nielsen J, Walter B. Unilateral total deafness as a complication of the measles–mumps–rubella vaccination. Scand Audiol Suppl 1988;30:69–70. 32. Stewart BJ, Prabhu PU. Reports of sensorineural deafness after measles, mumps, and rubella immunisation. Arch Dis Child 1993;69(1):153–4. 33. Watson JG. A child of 3 years who developed an encephalitic reaction to MMR (mumps, measles, rubella) immunisation at age 15 months. Int J Pediatr Otorhinolaryngol 1990;19(2):189–90. 34. Mair IW, Elverland HH. Sudden deafness and vaccination. J Laryngol Otol 1977;91(4):323–9. 35. Xenellis J, Karapatsas I, Papadimitriou N, Nikolopoulos T, Maragoudakis P, Tzagkaroulakis M, et al. Idiopathic sudden sensorineural hearing loss: prognostic factors. J Laryngol Otol 2006:1–7. 36. Charrier JB, Tran Ba HP. Idiopathic sudden sensorineural hearing loss: a review. Ann Otolaryngol Chir Cervicofac 2005;122(1):3–17. 37. Hughes GB, Freedman MA, Haberkamp TJ, Guay ME. Sudden sensorineural hearing loss. Otolaryngol Clin North Am 1996;29(3):393–405. 38. Thurmond M, Amedee RG. Sudden sensorineural hearing loss: etiologies and treatments. J La State Med Soc 1998;150(5):200–3.