Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • vertigo
  • hearing loss
  • tinnitus
  • aural fullness
  • drop attacks

Other diagnostic factors

  • positive Romberg's test
  • Fukuda's stepping test
  • bilateral symptoms
  • nystagmus
  • tandem walk

Risk factors

  • recent viral infection
  • genetic predisposition
  • autoimmune disease

Diagnostic investigations

1st investigations to order

  • pure-tone air and bone conduction with masking
  • speech audiometry
  • tympanometry/immitance/stapedial reflex levels
  • oto-acoustic emissions (OAE)
Full details

Investigations to consider

  • electrocochleography
  • electronystagmography
  • rotary chair test
  • vestibular-evoked myogenic potential (VEMP)
  • MRI of internal auditory canals
  • TFT
  • Lyme disease and syphilis serology
  • ANA
  • anti-neutrophil cytoplasmic antibody
  • rheumatoid factor
Full details

Emerging tests

  • 3-dimensional MRI
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Soha N. Ghossaini

Otology-Neurotology

Ear Nose and Throat Associates of New York

New York

NY

Disclosures

SNG declares that she has no competing interests.

Maurice H. Miller

Professor Emeritus of Audiology

Department of Communication Sciences and Disorders

Steinhardt School of Culture, Education, and Human Development

New York University

Specialist in Forensic and Occupational Audiology

New York

NY

Disclosures

MHM declares that he has no competing interests.

Peer reviewers VIEW ALL

Associate Professor of Otology and Laryngology

Harvard Medical School

Boston

MA

Disclosures

SDR declares that he has no competing interests.

Professor

Otolaryngology/Head and Neck Surgery

The New York Eye and Ear Infirmary

Surgeon Director

New York

NY

Disclosures

CJL declares that he has no competing interests.

Consultant ENT Surgeon

Leicester Royal Infirmary

Leicester

UK

Disclosures

PR declares that he has no competing interests.

Clinical Senior Lecturer & Consultant in Audiovestibular Medicine

Ear Institute

University College London

London

UK

Disclosures

DEB declares that she has no competing interests.

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