A 75-year-old right-handed male presents with dizziness that started 1 hour ago

Discussion in 'Plab 1 and 2 forum' started by Santosh Jadhav, Oct 23, 2013.

  1. Santosh Jadhav

    Santosh Jadhav Active Member

    A 75-year-old right-handed male presents with dizziness that started 1 hour ago. His dizziness consists of a spinning sensation and he feels off balance as he walks. He reports coughing when trying to drink water earlier, but otherwise notes no symptoms. He has an unremarkable past medical history and is taking no medications. On exam, he is found to have left-sided ptosis and left facial numbness to pinprick. Gag reflex is absent. Motor examination is otherwise unremarkable.
    Sensory examination revealed decreased pinprick
    sensation of the right arm and leg. He is unsteady while walking, tending to lean leftward.

    What is the most likely diagnosis in this patient?

    A) Acute vestibulitis/labyrinthitis.
    B) Benign paroxysmal positional vertigo (BPPV).
    C) Cerebellar stroke.
    D) Brainstem stroke.
    E) Ménière attack.

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