Author: Joanna Lumb / Editor: Steve Corry-Bass / Reviewer: Joanna Lumb / Codes: EP7, GP9, NeuP9, SLO1, SuP7 / Published: 20/05/2022
A woman in her 50s presents to the Emergency Department (ED) after waking at 5am with nausea and vertigo – the room was spinning horizontally, and was worse with head movements and on standing. She had no headache or meningism, no symptoms of viral or bacterial infection, and had no other neurological symptoms apart from feeling off-balance and unsteady on her feet.
She has a past medical history of shoulder pain, and has no regular medications. She does not drink or smoke, lives alone, and is a shop-owner.
On examination, observations are normal and she has no neurological signs apart from diplopia at the extremes of eye movements. ENT examination is also normal. A HINTS examination is also performed.
Her ECG shows normal sinus rhythm, and her bloods are unremarkable.
12 responses
excellent revision
very simple and effective
A good case for review, but short
Good revision but not always easy to perform on patients with severe vertigo symptoms
quick refresher on vertigo case
Interesting module, very helpful. We diagnose more posterior strokes now that we are better skilled in recognising them
Interesting case; thanks.
Very useful case
Really useful test in the EM setting
Nice one
Informative post.
very relevant to common ED PRESENTATION