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Old 10-05-2012
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Arrow Gyrus Daily Questions; Internal Medicine #46

A 34-year-old man complains of 1 week of dizziness, vertigo, tinnitus, and right-sided gait ataxia. Electronys-tagmography (calorics) with sequential administration of warm and cold water into the ear canal is performed. On the left, cold water causes right-beating nystagmus and warm water causes left-beating nystagmus. On the right ear, there is no response to the cold caloric. What is the cause of this patient’s dizziness and vertigo?

A. Acoustic neuroma
B. Aminoglycoside antibiotics
C. Cerebellar ischemia
D. Otoconia (ear otoliths)
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A. Acoustic neuroma since there is no response to the cold caloric on the right ear.

Quote:
One mnemonic used to remember the FAST direction of nystagmus is COWS.[8]
COWS: Cold Opposite, Warm Same.
Cold water = FAST phase of nystagmus to the side Opposite from the cold water filled ear
Warm water = FAST phase of nystagmus to the Same side as the warm water filled ear
In other words: Contralateral when cold is applied and ipsilateral when warm is applied
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Last edited by Novobiocin; 10-05-2012 at 08:42 AM.
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Old 10-08-2012
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Quote:
Originally Posted by Novobiocin View Post
A. Acoustic neuroma since there is no response to the cold caloric on the right ear.
Well explained u r correct ..

Answer is A
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