A 37-year-old woman comes to her primary care PA for evaluation of dizziness and hearing loss. The patient has had multiple episodes of dizziness lasting between 20 minutes to several hours. These episodes are associated with ringing in the left ear. The patient states, “These episodes are so debilitating I have to lie in bed until they are over. Sometimes the spinning sensation is so intense that I vomit.” Past medical history is noncontributory. She has not had any recent bacterial or viral infections. Vital signs are within normal limits, and physical examination reveals no significant findings. Audiometric testing demonstrates low-mid frequency hearing loss in the left ear. Hearing in the right ear is normal. Which of the following is the most likely diagnosis?

Benign paroxysmal positional vertigo

Meniere disease

Foundational SciencesPathologyNervous system and special sensesDisorders of the earDisorders of balance and spatial orientation

Organ SystemsNervous system and special sensesPathologyDisorders of the earDisorders of balance and spatial orientation

Definitions & Key takeaways

Ménière disease is a disorder of the inner ear that causes episodes of vertigo, tinnitus, and hearing loss. These episodes can last for minutes or hours, and may occur several times a week. The cause of Ménière disease is unknown, but it may be related to problems with the balance organ in the inner ear.

Meniere disease

Definitions & Key takeaways

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