Neurodegenerative Diseases USMLE Step 1 Practice Question
A 48-year-old man presents with recurrent episodes of vertigo lasting 4-6 hours accompanied by left-sided tinnitus and progressive sensorineural hearing loss. Vital signs show BP 138/82, HR 94, RR 16, temp 37.2°C, SpO₂ 98%. During attacks, he exhibits horizontal-torsional nystagmus that improves with visual fixation. Audiometry confirms low-frequency sensorineural hearing loss on the left. Neurologic examination reveals no cranial nerve deficits otherwise. Recent brain MRI shows no acute findings. Which of the following is the most likely diagnosis?
Answer choices
- ABenign paroxysmal positional vertigo
- BCentral vertigo from cerebellar stroke
- CMeniere diseaseCorrect answer
- DAcoustic trauma
- EVestibular schwannoma
- FSudden sensorineural hearing loss from viral labyrinthitis
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