Case 1 · Foundation
Sudden vertigo with horizontal nystagmus
A 42-year-old wakes with severe rotational vertigo, nausea, and unsteadiness that has persisted for two days. There is no hearing loss and no tinnitus. Symptoms are worse on head movement but never fully remit at rest.
Findings
- Spontaneous horizontal nystagmus beating away from one side
- Abnormal head impulse test towards the affected side
- Normal hearing on bedside testing
- No focal neurological signs