title: [Peripheral vestibular syndrome intricated pathogenic issues. A case report].
abstract: BACKGROUND
  Ménière's syndrome appears to be the final common pathway of the mechanisms the inner ear responds to almost any injury. Although the autoimmune disease seems to play a major role, exposure to intense noise can also be a trigger in the appearance and/or aggravation of the disease.
  
  
  METHODS
  The case of 41 years old musician with a history of ankylosing spondylitis, diagnosed with Ménière's syndrome 5 years ago, is presented. Recently the symptoms became more polymorphic, revealing the association between benign paroxysmal positional vertigo (BPPV), Ménière's syndrome and high frequency hearing loss in an autoimmune background. Besides general, neurological and ENT examination, the diagnostic workup comprised of tonal audiogram, brain stem auditory evoked potentials, computerized dynamic posturography and videonistagmography.
  
  
  RESULTS
  The final diagnosis was acute noise trauma, Ménière's syndrome, left horizontal semicircular canal BPPV, bilateral sensorineural sudden aggravated hearing loss in high frequencies (above 9 kHz) and allegedly autoimmune inner ear disease. Treatment with an association of corticosteroids, vasodilators and vitamins combined with Vannucchi's maneuver were followed by a significant relief of the symptoms.
  
  
  CONCLUSIONS
  Although no causal relationship was found between acoustic trauma and increased endolymphatic pressure, both literature data and the case presented show that intense and prolonged noise exposure may aggravate peripheral vestibular syndrome.
authors.affiliation: Clinica de Otorinolaringologie, Spitalul Clinic de Recuperare Iaşi.
authors.forename: Loreta
authors.initials: L
authors.lastname: Ungureanu
authors.forename: S
authors.initials: S
authors.lastname: Cozma
authors.forename: Luminiţa
authors.initials: L
authors.lastname: Rădulescu
authors.forename: Cornelia
authors.initials: C
authors.lastname: Tomescu
authors.forename: D
authors.initials: D
authors.lastname: Mârţu
mesh_terms: D000158:Acoustic Impedance Tests; D000328:Adult; D015551:Autoimmunity; D004359:Drug Therapy, Combination; D016057:Evoked Potentials, Auditory, Brain Stem; D015444:Exercise; D005938:Glucocorticoids / Q000627:therapeutic use; D006316:Hearing Loss, High-Frequency / Q000175:diagnosis* / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy; D006317:Hearing Loss, Noise-Induced / Q000175:diagnosis / Q000276:immunology; D006801:Humans; D007759:Labyrinth Diseases / Q000175:diagnosis / Q000276:immunology; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D009622:Noise / Q000009:adverse effects; D012307:Risk Factors; D013167:Spondylitis, Ankylosing / Q000150:complications; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D014665:Vasodilator Agents; D014815:Vitamins