The Instant Diagnosis 4






A 37-year-old woman has had episodes of intense vertigo lasting several hours in the last 4 weeks. Each episode is associated with tinnitus and a sense of fullness in her right ear; during the attacks, she prefers to fie on her left side. Examination during an attack shows that she has tine rotary nystagmus, which is maximal on gaze to the left. There are no ocular palsies, cranialnerve signs, or long-tract signs. An audiogram shows a high-tone hearing loss in the right ear, with recruitment but no tone decay. The most likely diagnosis in the case described is:

(A) labyrinthitis
(B) Méniére's disease
(C) vertebral-basilar insufficiency
(D) acoustic neuroma
(E) multiple sclerosis
See the diagnosis and a little discussion

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