DIAGNOSES AND DISCUSSION OF CHALLENGING CLINICAL CASE NO. 08/2001
Menier’s disease
| The
symptoms and signs described in the question are most consistent with
Menier’s disease. In this disorder, paroxysmal vertigo due to
labyrinthine lesions is associated
with nausea, vomiting, rotatory nystagmus, tinnitus, hig-tone
hearing loss with recruitment, and most characteristically, fullness in
the ear. Labyrinthitis would be an unlikely diagnosis in the case
presented because of the hearing loss and multiple episodes.
Vertebral-basilar insufficiency and multiple sclerosis typically are
associated with brainstem signs. Acoustic neuroma only rarely causes
vertigo as its initial symptom, and the vertigo it causes is mild and
intermittent. |