Investigating Auditory Function and Balance Tutorial

Question 1

81M - sudden, intermittent vertigo crisis starting 2 days ago

Very strong room spinning sensation with nausea. Sitting improves spinning. Lasts few minutes. Feels unstable and is very anxious. When still, he does not feel dizzy and does not experience any major symptom. Hearing less from about 10 years, and that it could be worse. No new hearing symptoms accompanying the dizziness.

What is a suitable diagnosis for this case?

Answer 1

Benign paroxysmal positional vertigo (BPPV)

The otoliths (crystals) embedded in the gel that sit on the hair cells in the utricle and saccule normally bend the hair cells to signal movement
But in this disease, the crystals fall off and end up in the semicircular canals instead, causing the hair cells in the semicircular canals to move at a greater rate during head movement = vertigo

When a person moves from one position to another, otoliths (crystals) move = vertigo
Staying still = crystals stop moving = no vertigo

Question 2

Select and explain three elements of the story that support your hypothesis

Answer 2

Intermittent – fades away when patient stays still
Feels dizzy when moving head and changing position
Acute onset of symptoms

Question 3

Could the hearing problem and the dizziness be related? Explain

Answer 3

Probably not related because hearing loss happened over 10yrs ago getting progressively worse. His BPPV started 2 days ago