QuestionSBA
QuestionChoice
This is a presentation of viral labyrinthitis (inflammation of the membranous labyrinth of the inner ear). Labyrinthitis may present with vertigo, sensorineural hearing loss, tinnitus, and nausea. Viral labyrinthitis is classically preceded by a recent history of a viral illness. Labyrinthitis can be differentiated from vestibular neuronitis as the latter does not feature hearing loss.
10000296
a
Labyrinthitis
QuestionChoice
Acoustic neuromas are benign tumours of the vestibular portion of the vestibulocochlear nerve and typically manifest in the cerebellopontine angle. They can present with vertigo, unilateral sensorineural hearing loss, tinnitus, and even facial palsy if the facial nerve is compressed. An acoustic neuroma is less likely here as these tumours typically present with gradual onset of symptoms and hearing loss is unilateral, whereas this patient suffers from bilateral symptoms.
10000298
c
Acoustic neuroma (vestibular schwannoma)
QuestionChoice
Another important vertigo differential, Meniere's disease is an idiopathic inner ear condition. It is characterized by repeat acute episodes of vertigo, hearing loss, tinnitus, and a sensation of ear fullness. This diagnosis cannot be made here as this is a single isolated episode of vertigo and hearing loss.
10000299
d
Meniere's disease
QuestionChoice
Although this is an important differential, it is not the case here. Vestibular neuronitis is an inflammation of the vestibular portion of the vestibulocochlear nerve and presents with vertigo but not hearing loss. It may also feature a recent history of viral illness.
10000297
b
Vestibular neuronitis
QuestionChoice
A common vestibular disorder but unlikely in this case. Benign paroxysmal positional vertigo (BPPV) is characterised by vertigo caused by head movement, however, does not feature hearing loss and is therefore unlikely to be involved here. Diagnosis can be confirmed by a positive Dix-Hallpike manoeuvre (recreation of symptoms and rotational nystagmus) and BPPV can be treated with the Epley manoeuvre.
10000300
e
Benign paroxysmal positional vertigo
Concept
Chapter
2693
3737
Vertigo & Dizziness
Topic
138
Ear, Nose & Throat
12606
A 40-year-old female presents to General Practice with a 1 week history of vertigo that is worse on movement. She also complains of hearing loss. Examination reveals bilateral sensorineural hearing loss. She has no relevant past medical history but does report recently recovering from an upper respiratory tract infection.

Which of the following is the most likely diagnosis?
a