A 30-year-old woman has presented to her family doctor complaining of three distressing episodes over the last several months during which she got extremely dizzy, had loud ringing in her ears, and felt like her ears were full of fluid
She states that her hearing diminishes, and she feels nauseous during these episodes. What diagnosis is the physician most likely to first suspect?
A)
Acute otitis media
B)
Acute vestibular neuronitis
C)
Benign paroxysmal positional vertigo (BPPV)
D)
Ménière disease
Ans:
D
Feedback:
Ménière disease is characterized by fluctuating episodes of tinnitus, feelings of ear fullness, and violent rotary vertigo that often renders the person unable to sit or walk. There is a need to lie quietly with the head fixed in a comfortable position, avoiding all head movements that aggravate the vertigo. Symptoms referable to the autonomic nervous system, including pallor, sweating, nausea, and vomiting, usually are present. The more severe the attack, the more prominent are the autonomic manifestations. A fluctuating hearing loss occurs with a return to normal after the episode subsides. Her symptomatology is not characteristic of AOM, acute vestibular neuronitis, or BPPV.
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