<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 28-year-old woman presents with severe vertigo. She also reports multiple episodes of vomiting and difficulty walking. The vertigo is continuous, not related to the position, and not associated with tinnitus or hearing disturbances. She has a past history of acute vision loss in her right eye that resolved spontaneously several years ago. She also experienced left-sided body numbness 3 years ago that also resolved rapidly. She only recently purchased health insurance and could not fully evaluate the cause of her previous symptoms at the time they presented. The patient is afebrile and her vital signs are within normal limits. On physical examination, she is alert and oriented. An ophthalmic exam reveals horizontal strabismus. There is no facial asymmetry and her tongue is central on the protrusion. Gag and cough reflexes are intact. Muscle strength is 55 bilaterally. She has difficulty maintaining her balance while walking and is unable to perform repetitive alternating movements with her hands. Which of the following is the best course of treatment for this patients condition?? A: Acyclovir, B: Azathioprine, C: High doses of glucose, D: High-doses of corticosteroids, E: Plasma exchange,  <response>: This is a clinical case scenario describing a 28-year-old woman with severe vertigo, vomiting, difficulty walking, and a history of acute vision loss and left-sided numbness years ago that spontaneously resolved. The key findings on exam are horizontal strabismus, difficulty with balance and coordination. Based on the acute onset of vertigo, vomiting, and difficulty walking, along with the neurological findings, this presentation is most consistent with acute disseminated encephalomyelitis ADEM. ADEM is an immune-mediated inflammatory disorder of the central nervous system characterized by acute onset of multifocal neurological deficits including ataxia, vertigo, vision changes and motor and sensory deficits. The patients history of prior episodes of acute neurological deficits that spontaneously resolved also supports this diagnosis.The treatment of choice for ADEM is high-dose intravenous corticosteroids to decrease inflammation and suppress the immune response. Plasma exchange is another option, but corticosteroids are first-line. The other answer choices of acyclovir, azathioprine and high-dose glucose would not be appropriate treatments.In summary, this patients presentation is most consistent with ADEM given the acute neurological deficits on exam and history of similar prior episodes. High-dose corticosteroids would be the best treatment choice.D: High-doses of corticosteroids 