Patient History and Presentation
A 45-year-old female presented to the clinic with sudden onset of severe vertigo, nausea, and difficulty maintaining balance. She reported no prior history of migraines or ear infections. The patient described a sensation of the room spinning, especially when turning her head. She also experienced tinnitus and a feeling of fullness in her right ear.
Clinical Examination and Diagnosis
On examination, nystagmus (involuntary eye movements) was noted when looking to the right. A head impulse test was positive for the right ear. The patient's hearing was slightly reduced on the right side based on a pure-tone audiometry test. Based on these findings, a diagnosis of labyrinthitis was made. Labyrinthitis is an inflammation of the inner ear labyrinth, often caused by a viral infection.
Treatment and Management
The patient was prescribed vestibular suppressants (e.g., meclizine) and antiemetics to manage acute symptoms. She was advised to rest in a dark, quiet room and avoid sudden head movements. Corticosteroids were considered to reduce inflammation. A course of vestibular rehabilitation exercises was initiated after the acute phase to promote central compensation.
Outcomes and Recovery
Over the following two weeks, the vertigo gradually decreased. The patient reported significant improvement in balance by week three. Full recovery of hearing was noted at a one-month follow-up. She was advised to continue vestibular exercises at home. The case underscores the importance of early diagnosis and symptomatic management to prevent chronic imbalance.
Keywords
- labyrinthitis
- vertigo
- nystagmus
- vestibular neuritis
- inner ear inflammation
- balance disorder
- tinnitus
- vestibular rehabilitation
- viral infection
- hearing loss