Question

A 62 year old woman comes to ER cuz dissy. When she looked up at a high shelf the patient experienced a spinning sensation and nausea. She closed her eyes and sat down and the sx resolved. No headache, earache, tinnitus, or hearing impairment. Sx recurred 30 min later when she bent down to get into her car. Which of the following will reveal the underlying cause?

-Provocative head positioning maneuvers*
--Dix Hallpike maneuver can provoke the sx = rotate pt head 45 as they lay down from a seated position

Answer 1

The 62-year-old woman's symptoms are consistent with Benign Paroxysmal Positional Vertigo (BPPV), which occurs when calcium carbonate crystals in the inner ear become dislodged. A provocative head positioning maneuver such as the Dix Hallpike maneuver can be used to confirm the diagnosis.

Step-by-step explanation:

The symptoms described by the patient, including a spinning sensation and nausea triggered by certain head movements, are consistent with a condition called Benign Paroxysmal Positional Vertigo (BPPV). BPPV occurs when calcium carbonate crystals in the inner ear become dislodged and migrate into the semicircular canals. This disrupts the normal movement of fluid in the canals, leading to dizziness and other balance problems.

The patient's symptoms are typical of BPPV, as they occur when the patient changes head position. To confirm the diagnosis and identify the underlying cause, a provocative head positioning maneuver such as the Dix Hallpike maneuver can be performed. This maneuver involves rotating the patient's head 45 degrees as they lie down from a seated position, which can provoke the symptoms of BPPV if present.

It is important to note that BPPV is a relatively common and treatable condition. Treatment typically involves specific head positioning exercises (repositioning maneuvers) that can help to reposition the dislodged crystals and alleviate symptoms.