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Vertigo, rapid heart rate, Labyrinthitis. Doctor say's labryinthitis, but could it be meiniere's?

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Doctor say's labryinthitis, but could it be meiniere's?
Tuesday night I was taken to the hospital via EMS due to a violent case of vertigo, nausea, and rapid heart rate. These attacks happened in waves and lasted around an hour or so. I was discharged from the ER that night.

It’s been two days and I still have a generally disoriented feeling along with very mild fatigue. I went to see my neurologist who diagnosed me with Labyrinthitis. When I saw the doctor I had no hearing loss, or tinnitus. I explained that I do not remember any ringing but wasn’t sure. He mentioned that if I had tinnitus, due to Meniere’s, I’d remember it, because it's pronounced. The attack came in waves and inbetween them I was able to seek advice from my mom (a nurse) on the phone, as well as talk to a professor, security, EMS, and the ER staff. I remember hearing them fine and being responsive enough to answer questions. The doctor said this was evidence it was Labyrinthitis and not Meniere’s. He checked my ears and eyes, saying they looked perfect.
My questions are: 1) Does his diagnosis sound like Labyrinthitis, and not Meneire’s? 2) I have to fly to California (from NYC) in a week-the doctor said it will not be an issue. Does this seem correct? 3) Last night I started getting a strange feeling in my left ear. Almost like a mild form of when you're in an airplane & the ear needs to "pop." Maybe a fullness. When I woke up the next morning It felt as though there was an odd pulsation going on in my ears. However, the sound is not pronounced at all. I can only hear it if the room is ultra quiet. Once the tv, radio, or background noise is present the feeling is gone. Sometimes I think I cannot even hear it anymore, like I forget about it. Would this be tinnitus or is it an actual ringing like a bell? I am so paranoid over meneire's, I might be amplifying normal noise. This is all coming about 2.5 days after my attack. Would these symptoms and earache occur after the attack or mostly preceding and during one?

The last sentence should read, "Would these symptoms and earache occur after the attack or mostly preceding and during one-if it were meniere's?"
Posted Tue, 22 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 9 hours later

Thank you for your query.

1. Meniere's disease is diagnosed on the following criteria:
a. Vertigo
b. Fluctuating hearing loss
c. Tinnitus
d. Fullness in the ear
There is usually nausea and vomiting, the hearing usually worsens during an attack and the tinnitus also worsens. Earache is not a usual symptom.

2. Labyrinthitis involves both the cochlea and the vestibular labyrinth. Since you do not have hearing loss, your diagnosis cannot be labyrinthitis. It may be vestibular neuritis alone. You should get a PTA (Pure Tone Audiogram) to document any hearing loss. Meniere's disease usually causes low frequency hearing loss initially ( Audiogram sloping to left).

3. Get a Tympanogram done to check middle ear pressures. If this Impedance Audiogram is normal, it may be Meniere's as it does not affect the middle ear. A normal tympanogram also means that flying is not a problem.

4. The symptoms of Meniere's preceed the vertigo.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

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