D.K. is a 65 year old female with brief episodic vertigo (lasting seconds, triggered by position changes) and light headedenss, which began a month ago and is improving gradually. The last episode was a few days prior to the VNG evaluation.

She describes true vertigo, triggered by lying down and turning and by either rolling left or right.  She says she has “a certain feeling” just before the episodes. Looking down or bending her head down will also provoke the episodes. She reports that she veers right when walking and tends to fall backwards.  She denies nausea or vomiting.

She has had headaches “forever” with some migraine headaches.

She has an intermittent clicking tinnitus; she is not sure how long that has been present.

She had knee surgery 11 years ago.  She is negative for history of middle ear surgery.

She reports that she is easily upset, she is on a prescription “mood stabilizer” (tegretol) and takes Abilify for “irritability”.  She is treated for hypothyroidism and high cholesterol levels.  She has NOT stopped any of her medications.

Case credits:Julia Andrews, AuD, South Florida ENT Associates