A 45-year-old patient with progressive unilateral sensorineural hearing loss undergoes VNG. Hyperventilation for 30 seconds elicits horizontal nystagmus with the fast phase beating to the RIGHT. This finding is most suggestive of:
- A Meniere's disease on the right
- B Vestibular schwannoma on the right side
- C Vestibular schwannoma on the left side ✓
- D Vestibular migraine
Correct answer: C. Vestibular schwannoma on the left side
Explanation
Hyperventilation-induced nystagmus occurs due to Central compensation mechanisms overcoming a peripheral vestibular deficit. The intact side's central tone dominates, producing nystagmus beating AWAY from the lesion. Right-beating nystagmus after hyperventilation indicates a left-sided peripheral lesion, most commonly vestibular schwannoma in the context of progressive unilateral SNHL.
Reference: Cummings Otolaryngology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.