SOLVED862

Mr. W, aged 57 years, presented to your practice complaining of severe dizziness. The man reported that the disequilibrium was with him when he woke up two days ago and was accompanied by vomiting. Mr. W thought the feeling of unsteadiness would go away, but it had not abated. Moving his head or opening his eyes made the dizziness worse. Mr. W denies taking any medications. During your intake Mr. W notes that recently he has been battling sinus congestion and an accompanying headache behind his left eye. He had used a Netti pot for relief. No recent fever, ear problem or tinnitus was reported, and Mr. W had no history of dizziness or head or neck trauma. There was no family history of heart attack, stroke, or diabetes. Objective Mr. W was afebrile, and his BP was normotensive (117/71 mm Hg). Pulse was 60 beats per minute and respiration 16 breaths per minute. Mr. W was alert and oriented. Ear, nose and throat all appeared normal. Cranial nerves II through XII were all intact. Horizontal nystagmus to the left was noted, and the Dix-Hallpike test was mildly positive. Finger-to-nose and heel-to-shin movements were normal. Mr. W had no pronator
SCIENCE
HEALTH SCIENCE
NURSING

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