A 60-year-old presents with sudden severe vertigo, nausea, and vomiting lasting 2-3 days, with no hearing loss or tinnitus. He can walk with support. Which diagnosis is MOST consistent?

• A Vestibular neuritis (labyrinthitis without auditory symptoms) ✓
• B Meniere's disease
• C Benign paroxysmal positional vertigo (BPPV)
• D Acoustic neuroma

Explanation

Vestibular neuritis presents with sudden onset severe prolonged vertigo (days), nausea/vomiting, absent hearing loss (distinguishing from labyrinthitis which has SNHL), and absence of neurological features. It is caused by viral inflammation of the superior vestibular nerve (most commonly), leaving inferior nerve/saccule spared. Caloric testing shows canal paresis on the affected side. BPPV is positional, brief (<1 min); Meniere's has auditory symptoms; acoustic neuroma is slowly progressive.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.