Question

Which of the following historical or physical examination

details would most effectively argue against benign paroxysmal
positional vertigo as a cause of dizziness?
a. Brief episodes of dizziness accompanied by nausea
b. A negative result on Romberg's test
c. Failure to reproduce the dizziness with Dix-Hallpike
maneuver
d. Episodes lasting 4 to 6 hours, with progressive unilateral
hearing loss
e. Multiple similar episodes over many years

Answer 1

The historical or physical examination detail most indicative of not having benign paroxysmal positional vertigo is having dizzy episodes lasting 4 to 6 hours that come with progressive unilateral hearing loss, as these longer and hearing loss-related symptoms indicate conditions like Ménière's disease rather than BPPV.

Step-by-step explanation:

The historical or physical examination detail that would most effectively argue against benign paroxysmal positional vertigo (BPPV) as a cause of dizziness is d. Episodes lasting 4 to 6 hours, with progressive unilateral hearing loss. BPPV is characterized by brief episodes of dizziness that are typically triggered by changes in head position, and the dizziness usually lasts less than a minute. The Dix-Hallpike maneuver is used to diagnose BPPV by reproducing the symptoms when the patient's head is turned in certain directions while lying down.

A Romberg's test result is used to assess balance and proprioception, but a negative result does not specifically argue against BPPV. Persistence of dizziness for several hours and associated auditory symptoms such as hearing loss suggests a condition like Ménière's disease, where there is an overproduction or accumulation of fluid in the inner ear, rather than BPPV which is not associated with long-duration episodes or progressive hearing loss.