Spontaneous, unidirectional, horizontal nystagmus
There is NO impaired hearing
There is no tinnitus
There are no focal neurological symptoms
Vestibular neuritis /neuronitis.
40 year old man
4 day history of vertigo after a viral URTI last week.
Nausea and fine horizontal nystagmus
No hearing loss or tinnitus
Vestibular neuronitis
Vertigo + hearing loss + tinnitus + absent corneal reflex
Vestibular schwannoma / Acoustic neuroma