tinnitus - messy2004

[ArchivalUser]

A 34 yo man comes with episodes of dizziness and right sided tinnitus. In addition, he describes fluctuating hearing loss on the right side. He reports that the episodes of dizziness occur several times per week, usually lasting from 30 mins up to several hours. He describes the tinnitus as an intermittent roaring type sound. At the moment, he is without any symptoms. He is otherwise healthy. He takes no medications and has no known drug allergies. He denies a history of headaches, fever, weight loss, or other focal neurologic deficits. A complete review of systems is also negative. He is afebrile with stable vital signs. Head and neck exam ia normal bilaterally; the patient has no vertigo or cranial nerve deficits. A Dix-Hallpike maneuver doesnot reproduce his symptoms. An audiogram reveals normal hearing bilaterally. The patient's symptoms of dizziness, hearing loss and tinnitus are the typical findings in which of the following conditions

A. Benign paroxysmal positional vertigo
B. Labyrinthitis
C. Meniere disease
D. Migraine-associate dizziness
E. Vestibular schwannoma

[ArchivalUser]

Labyrinthitis( flutuating hearing loss and dizziness)
It cant be Meniere coz it doent have vertigo( definite hearing loss should be there...isnt it?)
not v.schwannoma coz no b/l hearing loss
not migraine,coz no headaches
not BPPvertigo- Dix- Hall maneuver is negative

[ArchivalUser]

no abnormal hearing audio dizzinesintermittent hearloss d answer

[ArchivalUser]

Meniere disease

[ArchivalUser]

Episodes of dizziness lasting 30mins-several hours + unilateral tinnitus + fluctual hearing loss : Classical triad of symptoms seen in Meniere disease. ©

Because the patient denies any history of headache, the diagnostic of migraine is unlikely (D)

Labirynthitis: sudden onset of intense vertigo that can last several days or weeks, so it is unlikely (B)

Schwannoma can cause unilateral hearing loss, dizziness and tinnitus, however, these symptoms are constant and slowly progressive (E)