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186483 Medicine

A 48-year-old man complains of recurrent episodes of sudden-onset dizziness. He notices an abrupt onset of a “spinning” sensation when sitting up or lying down in bed. The symptoms last for 30 seconds and then resolve completely. He has no hearing change or other neurologic symptoms, and his physical examination is completely normal. A Dix-Hallpike maneuver reproduces his symptoms. Which of the following is the most likely mechanism for his vertigo symptoms?

Abasilar migraine
Bbrain stem ischemic events
Cbenign cerebellar tumors
Dcalcium debris (calcium carbonate crystals) in the semicircular canals
Medicine
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