Vestibular disorders: central features in positional vertigo: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Vestibular disorders: central features in positional vertigo

Sample item

A patient with positional vertigo on Dix-Hallpike testing shows pure downbeating nystagmus without latency that does not fatigue and persists while the head position is held. What does this indicate?

ATypical posterior canal BPPVBLateral canal BPPVCMeniere diseaseDA central cause such as a posterior fossa lesion

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. A central cause such as a posterior fossa lesion

Typical posterior canal BPPV gives an upbeating torsional nystagmus with a latent period, lasting less than a minute and fatiguing on repetition. Pure vertical downbeat nystagmus with no latency or fatigue is a central sign needing MRI.

Option by option

A. Typical posterior canal BPPV
Posterior canal BPPV is upbeating torsional with latency and fatigue.
B. Lateral canal BPPV
Lateral canal BPPV causes horizontal nystagmus on the supine roll test.
C. Meniere disease
Meniere disease is not positional.
D. A central cause such as a posterior fossa lesion (correct)
Correct. Central positional nystagmus is non-fatiguing without latency.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, A central cause such as a posterior fossa lesion. Typical posterior canal BPPV gives an upbeating torsional nystagmus with a latent period, lasting less than a minute and fatiguing on repetition.

Why is "Typical posterior canal BPPV" not the answer?

Posterior canal BPPV is upbeating torsional with latency and fatigue.

Why is "Lateral canal BPPV" not the answer?

Lateral canal BPPV causes horizontal nystagmus on the supine roll test.

Why is "Meniere disease" not the answer?

Meniere disease is not positional.

What concept does this question test?

It tests Vestibular disorders: central features in positional vertigo in ENT. Pure vertical downbeat nystagmus with no latency or fatigue is a central sign needing MRI.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Vestibular disorders: central features in positional vertigo?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.