Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- vertigem
- tontura
- náuseas e vômitos
- perda auditiva
- otorreia
Other diagnostic factors
- nistagmo
- zumbido
- movimentos rápidos da cabeça ou do corpo relacionados à vertigem
- sintomas tipo influenza
- otalgia
Risk factors
- infecções virais
- otite média crônica supurativa
- otite média aguda
- colesteatoma
- meningite
- malformações da orelha interna
- doenças autoimunes da orelha
- sífilis
Diagnostic investigations
1st investigations to order
- audiograma
- teste de Weber
- teste de Rinne
Investigations to consider
- tomografia computadorizada (TC) ou ressonância nuclear magnética (RNM) cranioencefálica
- eletronistagmografia
- teste da cadeira rotatória
- potenciais evocados miogênicos vestibulares
- sorologia para sífilis
- coloração de Gram e cultura do líquido cefalorraquidiano
- teste rápido para sorologia de HIV
- perfil metabólico básico (incluindo ureia e creatinina)
Treatment algorithm
viral: não HIV
bacteriana: após otite média
bacteriana: após meningite
bacteriana: sifilítica
associada ao vírus da imunodeficiência humana (HIV)
autoimune
com sintomas vestibulares persistentes pós-tratamento
Contributors
Authors
Brandon Isaacson, MD, FACS
Professor
Department of Otolaryngology-Head & Neck Surgery
University of Texas Southwestern Medical Center
Dallas
TX
Disclosures
BI is an author of a reference cited in this topic.
Peer reviewers
Marc Bennett, MD
Associate Professor
The Otology Group of Vanderbilt
Nashville
TN
Disclosures
MB declares that he has no competing interests.
Joni K. Doherty, MD, PhD
Assistant Professor
Neurotology Otolaryngology-Head & Neck Surgery
USC Keck School of Medicine
San Diego
CA
Disclosures
JKD declares that she has no competing interests.
Iain Swan, MD, FRCS
Senior Lecturer in Otolaryngology
Honorary Consultant Otolaryngologist
Glasgow Royal Infirmary
Glasgow
UK
Disclosures
IS declares that he has no competing interests.
References
Key articles
Lindeman RC. Acute labyrinthine disorders. Otolaryngol Clin North Am. 1979 May;12(2):375-87. Abstract
Goldstein NA, Casselbrant ML, Bluestone CD, et al. Intratemporal complications of acute otitis media in infants and children. Otolaryngol Head Neck Surg. 1998 Nov;119(5):444-54. Abstract
Davis LE, Johnsson LG. Viral infections of the inner ear: clinical, virologic, and pathologic studies in humans and animals. Am J Otolaryngol. 1983 Sep-Oct;4(5):347-62. Abstract
Voetsch B, Sehgal S. Acute dizziness, vertigo, and unsteadiness. Neurol Clin. 2021 May;39(2):373-89. Abstract
Rubin AM, Zafar SS. The assessment and management of the dizzy patient. Otolaryngol Clin North Am. 2002 Apr;35(2):255-73. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Neurite vestibular
- Vertigem posicional paroxística benigna
- Doença de Ménière
More DifferentialsGuidelines
- Hearing loss in adults: assessment and management
- Suspected neurological conditions: recognition and referral
More GuidelinesPatient information
Infecção da orelha média
Infecção da orelha externa
More Patient information
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