Mrs P suffered a sudden onset of vertigo in our latest case. Read the full case study here.
In Mrs P’s history, it is very important to note that she feels as if “the world is spinning”, but not “lightheaded” (where it feels as if the person is walking on a cloud, but the surroundings are not spinning). This is important to note because lightheadedness is usually persistent (as long as the cause is still present) while vertigo involves transient, but recurrent episodes.
With labyrinthitis the nerves in your inner ear that control your sense of position become inflamed. This can be caused by an infection of the upper respiratory tract like flu or ear infections.
Making the case more complicated is the fact that Mrs P also reported a ringing sound in her left ear and occasional reduced hearing in the same ear. This is in keeping with Meniere’s disease – a condition where the fluid volume in the inner ear is high, due to, for example, abnormal drainage or virus infections.
The exact details of how this disease is caused are still unknown. With Meniere’s disease it is important to remember that it can become a chronic condition that can last for weeks or even months. Labyrinthinits usually clears within about a week.
With middle ear infections, patients can also experience a feeling of being off-balance, but in Mrs P’s case a middle ear infection is unlikely as this is usually accompanied by pain.
Making a definite diagnosis in this case is not straight forward, as there are many factors involved. Based on her history and examination findings, an exact diagnosis cannot be made as the timeframe of her symptoms is too short to exclude a potentially chronic condition like Meniere’s.
The viral illness, that Mrs P experienced a week or so before the onset of her vertigo episodes, makes labyrinthitis the more likely diagnosis.
Vertigo is unpredictable
Conditions associated with vertigo should not be taken lightly as the onset of a vertigo episode can’t be predicted and can happen while driving or working at a height.
Treatment depends on the cause, but with Miniere’s disease and labyrinthitis there are no known cures. Doctors will often treat the symptoms and prescribe medicines to ease the nausea and vomiting. Medicines like meclizine, used in treating motion sickness, may ease the vertigo symptoms. In very severe cases surgical options are available.
NOTE: Health24's on-site GP Dr Owen Wiese reveals new cases on Thursdays. The answer is posted with the story on Mondays, or you can get it in our Daily Tip – sign up here.
Previously on What's Your Diagnosis?
What's your diagnosis? – Case 1: vomiting and weight loss
What's your diagnosis? – Case 2: eye pain
What's your diagnosis - Case 3: strange behaviour and a bullet in the back
What's your diagnosis - Case 4: seeing odd things
What's your diagnosis - Case 5: mysterious lungs
What's your diagnosis - Case 6: runner with seizures
What's your diagnosis - Case 7: swollen knee
What's your diagnosis - Case 8: bloody semen
What's your diagnosis - Case 9: confusing neurological signs
What's your diagnosis - Case 10:diabetic teenager with unusual signs and symptoms
What's your diagnosis - Case 11:bruising with no apparent cause
What's your diagnosis - Case 12: severe tummy pain
What's your diagnosis - Case 13: severe sore throat
Image: woman suffering from vertigo from Shutterstock
Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.