Of dizziness and nausea….

I saw a very interesting case today.

One of my patients could not attend physio due to a dizzy spell.
My supervisor, on further questioning, hypothesised that the patient could have positional vertigo (aka BPPV).

2/7 later, we had a tutorial with our supervisor on Ax and Rx for BPPV and it coincided with the day that patient was going to come in again for physio. I was excited as I knew I would be able to finally see a hall pike ax performed and possibly nystagmus (if the patient had it) and dx which semi circular canal was affected.

True enough, when the test was performed, the patient had nystagmus, but it was really subtle. And to see which direction the nystagmus is, its best to look at the veins in the eye to see which direction the eyeballs are really moving (ie: the veins will move too). I now know what it means to really “look into a person’s eye…”

We then proceeded to treat the patient, using the canalith repositioning manoeuvre and had a pretty successful outcome. It is important that post repositioning, patients remain sitting upright for 1-2 hrs. When we did the re-ax, he felt much better but, the vestib system got stimulated again and thus, his symptoms came on but was much less this time round.

Now that’s something you don’t see in the clinics often.

Have a gd weekend everyone! And enjoy the well deserved break….