The present paper reports a clinical case of local syphilitic meningoencephalitis known as Argyll-Robertson syndrome and manifested in the form of acute sensorineural loss of hearing. The patient was a 46 year old resident of the city of Irkutsk. He experienced the sharp impairment of hearing involving both ears with the accompanying feeling of dizziness, disturbed orientation of the locomotorbehaviour, the lurching gate, subfebrility, the loss of the ability to speak and write. The diagnosis was based on the presence of anisocoria, the absence of consensual pupillary reaction to the light, weak atropine action on the pupils, well expressed positive results of the VRDL (blood) and RW (liquor) tests, an enhanced signal from the left temporal region in the T-2 regime during MRI, positive hearing dynamics within 12 hours after the onset of anti-inflammatory, antibacterial and infusion therapy. The specific feature of the clinical case being considered is differential diagnostics was performed with the purpose of distinguishing it from otogenic brain abscess associated with chronic left-hand mesotympanitis.