Vertigo

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Vertigo

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Questions

USMLE® Step 1 style questions USMLE

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A 30-year-old woman comes to the clinic due to spinning sensation and feeling unstable. This sensation started 1 month ago and since then has gotten gradually worse. She also describes constant fatigue and tingling sensation in both of her upper extremities. She states that several months ago, she went to the emergency department for an episode of intense right eye pain with movement and the loss of color vision; this gradually improved over 2 weeks. Vital signs are within normal limits. Physical examination shows ataxia and nystagmus. A head MRI shows multiple hyperintense periventricular and cerebellar ovoid lesions. Which of the following is the most likely additional finding in this patient?    

External References

First Aid

2024

2023

2022

2021

Central vertigo p. 548

Peripheral vertigo p. 548

Vertigo p. 548

Meniere disease as cause p. 725

posterior circulation stroke p. 526

streptomycin p. 194

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Summary

Vertigo is a type of dizziness characterized by the illusion of motion or spinning. A person with vertigo feels as if they or the objects around them are moving when they are not. Vertigo may be associated with nausea, vomiting, sweating, or difficulty walking. It is typically worsened when the head is moved.

Vertigo can be caused by various conditions affecting the inner ear, brain, or sensory pathways, such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, Meniere's disease, or migraines. Diagnosis requires a thorough medical history, physical examination, and vestibular testing Treatment depends on the underlying causes and may include medications like antiemetics and benzodiazepines, or even surgery.