Differential Diagnosis for Sudden Hearing Loss
- Single most likely diagnosis:
- Sudden Sensorineural Hearing Loss (SSNHL) in the right ear, given the patient's history of similar symptoms in the left ear. The description of sudden onset, feeling of ear congestion, and loss of hearing, especially for low-frequency sounds, supports this diagnosis. The previous episode in the left ear and the current symptoms in the right ear suggest a possible recurrent condition.
- Other Likely diagnoses:
- Meniere's Disease: Given the patient's history of vertigo, vomiting, and progressive hearing loss, Meniere's disease is a plausible diagnosis. The feeling of ear fullness and the fluctuating hearing loss, especially the recent decrease in hearing low-frequency sounds, could be indicative of this condition.
- Acoustic Neuroma: Although less likely given the sudden onset, an acoustic neuroma (a type of tumor) could cause unilateral hearing loss, vertigo, and tinnitus. The fact that the patient had a similar episode in the other ear does not rule out this possibility, as it could be a new development.
- Do Not Miss diagnoses:
- Stroke or Transient Ischemic Attack (TIA): It is crucial to rule out a stroke or TIA, as these conditions can present with sudden hearing loss, especially if accompanied by other neurological symptoms. The sudden onset of symptoms warrants immediate evaluation to exclude a cerebrovascular event.
- Multiple Sclerosis: This condition can cause a wide range of neurological symptoms, including hearing loss, vertigo, and balance problems. Although less common, multiple sclerosis should be considered, especially if other neurological symptoms are present.
- Rare diagnoses:
- Cogan Syndrome: A rare disorder that can cause sudden hearing loss, vertigo, and eye inflammation. The patient's symptoms could fit this diagnosis, but it is much less common than other conditions listed.
- Autoimmune Inner Ear Disease: This condition involves the immune system attacking the inner ear, leading to hearing loss, vertigo, and tinnitus. It is a rare cause of sudden hearing loss but should be considered if other diagnoses are ruled out and the patient has a history of autoimmune disorders.