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Other than eighth nerve dysfunction, the earliest neurologic sign in these patients is the loss of the corneal reflex.34 The diagnostic test of choice when the history or audiometric or other findings suggest this diagnosis would be a magnetic resonance imaging scan with gadolinium enhancement. Back to top from small cerebellar hemorrhage adjacent to the vermis looks just like BPPV except may have direction changing nystagmus Back to top Isolated dizziness was associated with only 0.7% (9 of 1297) rate of stroke/tia.

Medications, including vasodilator therapy and diuretics, are helpful for many patients.28 Patients are empirically placed on a low-sodium diet and asked to restrict caffeine and smoking.Because the only objective sign of vertigo is nystagmus, examination of the eyes is extremely important in evaluating the dizzy patient.The general physical examination is often unrewarding in the dizzy patient.The episodes may occur at irregular intervals for years, with periods of remission unpredictably intermixed.Eventually the syndrome reaches a phase, resulting in significant permanent hearing loss but a cessation of the vertigo. Multiple causes have been suspected, including allergy, an autoimmune disorder, viral infection, and hormonal effects.8 The pathologic correlate is an excessive accumulation of endolymph, resulting in hydrops.




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