Case history
Case history
A 40-year-old woman presents with a 1-year history of recurrent episodes of vertigo. The vertigo spells are described as a sensation of the room spinning that lasts from 20 minutes to a few hours and may be associated with nausea and vomiting. The spells are incapacitating and are accompanied by dizziness, vertigo, and disequilibrium, which may last for days. No loss of consciousness is reported. The patient also reports aural fullness, tinnitus, and hearing loss in the right ear that is more pronounced around the time of her vertigo spells. Physical exam of the head and neck is normal. A horizontal nystagmus is noted. She is unable to maintain her position during Romberg testing or Fukuda stepping test. She turns toward the right side and is unable to walk tandem. Her cerebellar function tests are normal.
Other presentations
Patients may present with any combination of hearing loss, tinnitus, vertigo, or aural fullness.
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