Snapshot A 34-year-old woman presents to the emergency department with acute onset and sustained vertigo. She said her symptoms occured "out of the blue" and is accompanied by severe nausea and gait instability. She feels the room is spinning and denies experiencing lightheadedness or palpitations. One week prior to presentation she developed a viral upper respiratory infection. She has no past medical history and her family history is unremarkable. On physical examination, she has horizontal nystagmus that is suppressed with visual fixation. She also has a positive head-thrust test. There is no hearing loss. She is started on prednisone and given ondansetron and meclizine for symptom improvement. Introduction Overview login to view 1 more bullet Epidemiology Demographics login to view 2 more bullets Risk factors login to view 2 more bullets ETIOLOGY Pathophysiology login to view 2 more bullets Anatomy Organ login to view 1 more bullet Presentation Symptom login to view 3 more bullets Physical exam login to view 6 more bullets Imaging MRI brain with diffusion-weighted images login to view 2 more bullets Differential Cerebellar vascular event (infarction or hemorrhage) login to view 4 more bullets Wallenberg syndrome login to view 4 more bullets Meniere disease login to view 2 more bullets Treatment Conservative & Lifestyle login to view 3 more bullets Medical & pharmacologic login to view 10 more bullets Complications Head injury from falls Prognosis Typically self-limiting