Tinnitus, aural fullness, and hearing loss typically precede an acute vertigo attack.
Most patients experience nausea, vomiting, and ataxia with vertigo attacks.
Most episodes last less than 2 hours. In early stages the classic presentation may not be described by the patient. In early stages patients are generally asymptomatic between episodes. Investigations History Most important part of the diagnosis Pattern of symptoms Association between hearing loss, tinnitus, and vertigo Physical Examination Spontaneous nystagmus directed toward affected ear is typical during an acute attack. Later disease often is associated with a flat sensorineural loss.