A 38-Year-Old Woman with a Feeling of Dizziness and Imbalanc | Figure 1
A 38-Year-Old Woman with a Feeling of Dizziness and Imbalance
A 38-year-old woman comes to your office with a 1-year history of episodic dizziness, ringing in both ears, a feeling of aural fullness, and hearing loss. The symptoms come on every 1 or 2 weeks and usually last for 12 hours. Nausea and vomiting are present. When asked to describe the dizziness, the patient says, "The world is spinning around me."
On physical examination, the patient has horizontal nystagmus. The slow phase of the nystagmus is to the left, and the rapid phase is to the right. Audiograms reveal bilateral sensorineural hearing loss in the low frequencies.
What is the most likely diagnosis in this patient?
- a. vestibular neuronitis
- b. acute labyrinthitis
- c. positional paroxysmal vertigo
- d. orthostatic hypotension
- e. Ménière disease
Question from Swanson’s Family Medicine Review, 8th edition. ISBN: 9780323356329. Copyright ©2017 Elsevier, Inc.
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