Bilateral posterior canal Benign Paroxysmal Positional Vertigo co-existing with cranial nerves schwannoma and Meniere Disease: Case report

Abstract

Benign Paroxysmal Positional Vertigo (BPPV) is a common peripheral vestibular problem with a right ear and posterior canal predisposition. BPPV afflicts older adults beyond the age of 50 with a high prevalence between 71 and 80 years of age. Although most cases of BPPV are unilateral, bilateral BPPV is not uncommonly seen in patients with a history of head trauma, ototoxicity, falls or vesitbulopathy. However, bilateral BPPV coexisting with bilateral vestibulopathy has not been reported. We describe a case of bilateral posterior canal BPPV with definite Menieres Disease (MD), schwannoma of the cochlea-vestibular nerves secondary to a schwannoma arising from the Jugular Foramen (JF) with mass effect and an incidental schwannoma of the right orbital optic nerve. Diagnosis and management was a challenging process, serving as a reminder for clinicians to have both conceptual and procedural knowledge in order to plan the most efficacious rehabilitation strategies.

Keywords

• Benign paroxysmal positional vertigo (BPPV)
• Vestibulopathy
• Cranial nerves schwannoma
• Bilateral