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EM@3AM: Suppurative Labyrinthitis

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A 58-year-old male presents with 1 day of severe vertigo associated with nausea and vomiting, tinnitus, and sudden-onset hearing loss. He reports several days of left-sided ear pain and discharge from his left ear. Vital signs reveal T 38.9C, HR 120, BP 138/96, RR 18, SpO2 99% on room air. He...

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em@3am

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Underdiagnosed and associated with significant morbidity/mortality

Major risk factor is convulsive status/history of seizure

Look at eyes, face, fingers, feet for subtle movements -> If present, patient seizing

Be concerned if patient remains post ictal/does not improve for significant time

Treatment: Benzos + anti-seizure meds