This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: ENT
In a patient with acoustic neuroma, all are seen except - 
Select and explain. 
A. Facial nerve may be involved, B. Reduced corneal reflex, C. Cerebellar signs, D. Acute episode of vertigo
D: Acute episode of vertigo
Answer: D: Acute episode of vertigo 
Explanation: Lets see Each Option Separately

Option a – Facial nerve may be involved –

This is correct as we have discussed in previous Questions,. facial nerve may be involved but complete palsy doesnot occur

Option b – Reduced corneal reflex –

This is correct reduced corneal reflex is the first sign of Trigeminal nerve involvement

Option c – Cerebellar signs – This is correct
Option d – Acute episodes of vertigo

“Vestibular symptoms seen in acoustic neuroma are imbalance or unsteadiness. True vertigo is seldom seen”

Acute episode of vertigo is a rare presenting feature in acoustic neuroma since it is a slow growing tumor so there is adequate time for compensation.