This male patient, 74 years old, reports that his dizziness is a lightheadedness, and that he has unsteadiness and imbalance, but  not true vertigo.  He believes the dizziness is related to his blood pressure medication, as his symptoms have improved since this medication’s dosage was reduced.  He was unable to ambulate without the assistance of a cane when on the higher dosage medication.  HIs problems have occurred for the last 4 to 6 months.  He reports that he tends to veer to the right.

He had a stroke 15 years ago.  He has type 2 diabetes.  He has an aggressively growing benign brain tumor, treated with gamma knife radiation. Recent MRI results indicate the tumor’s size is stable.

• If his dizziness is related to medication, what VNG findings would you expect?
• If the dizziness is related to his brain tumor, what VNG findings would you expect?
• Could a stroke, 15 years prior, be implicated in the present dizziness? Could it affect the VNG results?

Case credits: with thanks to Tricia Sheehan, AuD, and Hillary Snapp, AuD, University of Miami