QuestionSBA
QuestionChoice
While the description of vertigo would fit with acute labyrinthitis, the fact there is no hearing loss or tinnitus makes this less likely.
10027727
b
Acute Labyrinthitis
QuestionChoice
This is a classical description of BPPV; the otoconia in the inner ear become dislodged by head movements such as getting out of bed. This stimulates the hair cells which causes the vertigo or the sensation of the room spinning.
10027726
a
Benign paroxysmal positional vertigo (BPPV)
QuestionChoice
This is an important differential for vertigo as there may be ischaemia in the cerebellum causing her symptoms. However, this is less likely in this case. In particular, the fact there are no neurological findings mentioned makes BPPV most likely.
10027730
e
Transient ischaemic attack (TIA)
QuestionChoice
This is a reactivation of the varicella-zoster virus along the facial nerve (CN VII). Whilst some vertigo may be associated, the presenting complaint is likely to be facial droop due to facial nerve palsy.
10027729
d
Ramsay-Hunt syndrome
QuestionChoice
Typically vestibular schwannomas cause unilateral sensorineural hearing loss and progressive tinnitus. This is because they affect the conductivity of the vestibulocochlear nerve (CN VIII).
10027728
c
Vestibular schwannoma
Concept
Chapter
2693
3999
Benign Paroxysmal Positional Vertigo (BPPV)
Topic
186
Ear, Nose and Throat
17943
A 45-year-old woman presents to her GP complaining of recurrent episodes of dizziness. Upon further questioning, she describes episodes of "the room spinning" which lasts 30-60 seconds at a time. She has noticed that getting out of bed can be a trigger. There is no tinnitus or hearing loss associated with this episode, however, she does state that she often feels very nauseous and has vomited on one occasion.

What is the most likely diagnosis?
a