ENT
In cooperative patients, the Weber and Rinne tests can help differentiate between
conductive and sensorineural hearing loss.

The most common reason for conductive deafness is middle ear effusion related to acute
otitis media.

Sensorineural deafness is most common due to meningitis. . If due to labyrinthis then will
have vertigo and positive Rhomberg’s test.

Hearing loss associated with focal neurologic findings should prompt radiographic
evaluation of the middle ear, as well as evaluation for retrocochlear masses.
Patients with vestibular neuritis typically experience a single episode of sudden-onset
rotary vertigo, imbalance, and nausea that lasts for several days.

Labyrinthitis is a similar syndrome to vestibular neuritis, but with the addition of hearing
symptoms (sensory type hearing loss or tinnitus).

Benign paroxysmal positional vertigo (BPPV) manifests as recurrent episodes of vertigo
that last 1 min or less and is associated with head movements occurring without warning,
maximal at onset and resolving spontaneously after minutes to hours without loss of
consciousness, there is associated Nystagmus, Ataxia, Vomiting, Pallor, fearfulness and
normal neurological examination and audiometric / vestibular functions between attacks, not
attributed to another disorder.

Vestibular migraine A current or past history of migraine,  Vestibular symptoms of moderate
or severe intensity lasting between 5 min and 72 hours, Headache with Unilateral location,
Pulsating quality, Moderate or severe intensity, Aggravation by routine physical activity,
Photophobia and phonophobia, Visual aura, not attributed to another disorder. Acute attacks
are managed with triptans, ergotamine, benzodiazepine, antiemetics (promethazine),
antihistamines, and anticholinergic agents (scopolamine)
Unilateral hearing Loss
Vertigo
Occurs in Adolescents

Pharyngitis followed by lateral neck pain then respiratory distress and sepsis. When the
peritonsillar abscess wall ruptures internally, the drainage carrying bacteria seeps through
the soft tissue and infects the nearby structures. Spread of infection to the nearby internal
jugular vein provides a gateway for the spread of bacteria through the bloodstream.

Ultrasonography with Doppler or computed tomographic neck angiography

Fusobacterium necrophorum

Rx - Broad spectrum antibiotics and anti-thrombotics
Postanginal sepsis (Lemierre syndrome)