Benign Positional Paroxysmal Vertigo

Dizzy

Step 1: View clinicals

A 75 year old lady presents with dizziness and vomiting, which commenced when she sat up in bed today. The symptoms subsided completely after a few minutes. She describes the dizziness as "feeling like the room is spinning around her". Her medical history is only significant for well controlled hypertension.


Step 2: Order all relevant investigations

Dix-Hallpike test

L/S: negative R/S: vertigo and downbeating nystagmus after a small latent period. Spontaneous resolution after around a minute.

Audiometry

Her hearing on both sides is normal

EEG

No abnormalities are noted.

MRI Brain

No abnormalities are noted in the MRI.


Step 3: Select appropriate management

Epley's manoeuvre
Enoxaparin
Antibiotics
Steroids


Score: ★★☆