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Vertigo evaluaton and VNG Report anup patel

The vertigo evaluation report for Anup Patel, a 48-year-old male, indicates recurrent episodes of rotatory vertigo triggered by position changes, with a history of similar episodes two years prior. Examination and video nystagmography tests suggest right-sided anterior semicircular canal BPPV and a possibility of apogeotropic posterior semicircular canal BPPV. Treatment includes Yakovino Maneuver and medications, with a follow-up review scheduled in one month.

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AnupKumarPatel
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22 views

Vertigo evaluaton and VNG Report anup patel

The vertigo evaluation report for Anup Patel, a 48-year-old male, indicates recurrent episodes of rotatory vertigo triggered by position changes, with a history of similar episodes two years prior. Examination and video nystagmography tests suggest right-sided anterior semicircular canal BPPV and a possibility of apogeotropic posterior semicircular canal BPPV. Treatment includes Yakovino Maneuver and medications, with a follow-up review scheduled in one month.

Uploaded by

AnupKumarPatel
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Dr.

Amol Acharya ENT and Vertigo Clinic


DR AMOL ACHARYA
MBBS DLO DNB (Gold Medalist) Email – [email protected]
Consultant ENT Surgeon Address – Chhatrapati clinics, Chhatrapati square
MMC Regn. No. 91526 Nagpur

Vertigo evaluation Report


Name – Anup Patel Age / Sex. 48 yrs/ male

Date of examination – 18/01/2025

History -
- Recurrent episodes of rotatory vertigo lasting for seconds to a minute since 2 days . episodes are
triggered by position change in bed, getting into bed , bending over . there is a sensation of rotation of
surroundings. History of similar episodes 2 years back which subsided subsequent to some
medications.
- No history of episodic headaches with migrainous character in past or present
- No history of nausea vomitting
No history of photophobia or phonophobia
No history of otorrhoea/ otalgia / ear fullness/fluctuating deafness/tinnitus
No diplopia / dysarthria / dysphagia / dysphonia

No history of visual vertigo or supermarket syndrome


No history of hyperacusis or sound intolerance
ENT Examination
Ears -- Bilateral Tympanic membrane intact and normal
TFT - NAD
Nose - normal
Throat - normal
Neck - normal
Voice - normal

Respiration - normal
Speech - normal
Memory- normal

Neurological
No Neck stiffness
Romberg test- normal

Tandem walking with vision – normal


Tandem walking without vision – normal
Finger nose test – normal , no incoordination , no pastpointing
No Dysdiadokokinesia

No cerebellar signs
No Skew Deviation of eyes
NEUROTOLOGICAL EXAMN.
Neck posture normal / no head tilt / no Ptosis
Range of eye movements – monocular / binocular – normal

Cover/ Uncover Test – normal


Alternating cover test – normal
Head Impulse test – normal , no catch up saccades
No Spontaneous Nystagmus

No Gaze evoked Nystagmus


Smooth Pursuit movements – normal
Dix halpike test – left – no nystagmus or vertigo
Dix halpike test- Right – downbeat nystagmus +

Mclure pagnini test – no nystagmus or vertigo

Video Nystagmography

Patient Name – Anup Patel Age – 48 yrs/ male Dated- 18/01/2024

SACCADES – Both Vertical & Horizontal saccades are normal w.r.t latency, velocity & accuracy

SMOOTH PURSUIT TEST- Both vertical and horizontal smooth pursuit movements are normal.

OPTOKINETIC NYSTAGMUS TEST – Normal gains.

GAZE TEST – There is no Gaze evoked Nystagmus

NYSTAGMUS TEST – SPONTANEOUS IN LIGHT - No nystagmus or vertigo

- SPONTANEOUS IN DARK - No nystagmus or vertigo or other eye movement disorder

- HIGH FREQ. HEAD SHAKE TEST - There was very minimal downbeat and right beating
nystagmus with SPV of approx. 3 deg/sec. with no associated vertigo.
- Valsalva nose and mouth -No nystagmus or vertigo

- TULLIO PHENOMENON- - No nystagmus or vertigo

- FISTULA TEST - No nystagmus or vertigo

- HYPERVENTILATION TEST - very minimal SPV of approx. 2 deg/sec downbeat


nystagmus with no associated vertigo

POSITIONAL TESTS – DIX-HALPIKE – RIGHT - Downbeat geotropic rotatory nystagmus + with associated
vertigo lasting for 1 min. There was no nystagmus reversal on getting up.

- DIX HALPIKE – LEFT - downbeat nystagmus + with mild vertigo

- MCLURE PAGNINI TEST RIGHT - on getting into supine position there was downbeat
nystagmus which lasted for a minute. On right lateral position the downbeat nystagmus
continued . On left lateral position there was downbeat nystagmus with reduced intensity.
But in all these position there was no vertiginous sensation.

IMPRESSION –VNG Test is suggestive of 1) Right sided anterior semicircular canal BPPV 2) There is a possibility of
apogeotropic posterior semicircular canal BPPV

Clinical impression

- Recurrent positional vertigo


- Right sided Anterior semicircular canal Benign paroxysmal positional vertigo
- Possibility of apogeotropic posterior semicircular canal BPPV
Treatment
- Yakovino Manoeuvre done , repeated twice
- Tab Flunarizine 10 mg once daily in morning for 3 weeks
- Tab Stugeron 25 mg twice daily for 3 days
- To keep a diary of future vertigo episodes if any.

Review
- After 1 month or sos if needed.

Further Investigations
- MRI Brain sos depending upon response to the above manoeuvres.

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