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Curing a 96-year-old patient afflicted with benign paroxysmal positional vertigo on a motorized turntable

Authors Bockisch CJ, Straumann D, Weber KP

Received 6 December 2013

Accepted for publication 20 January 2014

Published 8 April 2014 Volume 2014:9 Pages 589—591

DOI https://doi.org/10.2147/CIA.S58785

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

The eye movements of the patient during the treatment.

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Christopher J Bockisch,1–3 Dominik Straumann,1,4 Konrad P Weber1,2

1Department of Neurology, University Hospital Zurich, 2Department of Ophthalmology, University Hospital Zurich, 3Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 4Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland

Background: Dizziness in the elderly is a serious health concern due to the increased morbidity caused by falling. The most common cause of dizziness in the elderly, benign paroxysmal positional vertigo (BPPV), is frequently undiagnosed, and bedside treatment of these patients can be difficult due to neck and back stiffness, which makes repeated and accurate repositioning maneuvers difficult.
Case presentation: After a fall, a 96-year-old woman was referred by a resident neurologist for intractable BPPV. The patient was placed on a motorized turntable and repositioned to remove the calcite particles from the affected posterior semicircular canal. Video monitoring of the eyes allowed confirmation of the diagnosis, as well as an immediate evaluation of the effectiveness of the maneuver.
Conclusion: Every patient with dizziness or imbalance, even in the absence of typical complaints of BPPV, should be tested with provocation maneuvers, because the clinical picture of BPPV is not always typical. Even if elderly patients with dizziness are very frail, the completion of provocation maneuvers is imperative, since the therapeutic maneuvers are extremely effective. A motorized turntable is very helpful to perform the repositioning accurately and safely.

Keywords: vestibulo ocular reflex, nystagmus, vertigo

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