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Radiology Quiz Case 2
Mark Aferzon, MD;
Carl L. Reams, MD
Geisinger Medical Center, Danville, Pa
Arch Otolaryngol Head Neck Surg. 2002;128:1104-1107.
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A PREVIOUSLY healthy 38-year-old woman presented for evaluation of dizziness.
She had been well until she had an episode of disorientation and disequilibrium
while at work. Since then, she has had daily intermittent episodes of disorientation,
lasting minutes and characterized by bilateral aural fullness and bilateral
tinnitus. She has also had daily headaches ("whole head") and fatigue. She
denied otalgia, otorrhea, hearing loss, vision change, nausea/vomiting, numbness,
and weakness, as well as precipitating factors, alleviating factors, migraines,
and trauma.
Her medical history and physical examination revealed no abnormalities
(normal findings on ear examination and Romberg and Hallpike tests; normal
gait; and extraocular movements intact without nystagmus). An audiogram revealed
symmetrical, essentially normal hearing (30-dB notch at 6 kHz bilaterally;
100% discrimination bilaterally). Electronystagmographic testing revealed
good caloric response bilaterally with borderline right caloric weakness (24%)
and a spontaneous right-beating nystagmus in all positions, . . . [Full Text of this Article]
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