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Question
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Which of the following suggests that a patients vertigo is from a brainstem or cerebellar lesion, as opposed to a peripheral cause?
Explanation
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Differentiating peripheral from central causes of vertigo is an important, albeit challenging, component to caring for the vertiginous patient. Peripherally associated vertigo may have other signs indicating ear involvement, including tinnitus, hearing loss, or ear pain. Vertigo can be acute onset with either peripheral or central lesions. Nystagmus can be present in either central or peripheral lesions, but tends to improve with visual fixation in peripheral lesions, and worsen with visual fixation in brainstem or cerebellar lesions
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Reference
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Bradleys NiCP, 7th edn, Ch. 46.
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Option 1
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Is Correct (Option 1):
Nystagmus worse with visual fixation
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Option 2
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Is Correct (Option 2):
Decreased hearing in one ear
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Option 3
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Is Correct (Option 3):
Ear pain
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Option 4
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Is Correct (Option 4):
Tinnitus in one ear
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