60yr old female with dizziness from 4 months presented to general medicine department

This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.

This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.

A 60 yr old female who is an housewife belonging to nalgona presented to the hospital.

Chief complaint : -dizziness from past 4                                    months

                   - pain all over face from 10 days

 

 HOPI:

The patient presented with dizziness which was of sudden onset and intermittent and fell unconscious 3 times in the past 4 months.The sensation of dizziness aggrevated during sudden change of postures like sudden sitting from supine position which was relieved on medication.

-she even complained of a headblow 10days back because of which she had ear pain which was electric shock type, radiating from her frontal lobe to mandible and then to a tooth.The pain was even dragging type ,intermittent, progressively increasing and radiating from her left side of face to all over her face which is aggrevated on chewing and relieved on some unknown medication.

-associated with no generalized weakness,no cold,no cough,no fever,and no burning micturation.

PAST HISTORY:

The patient was asymptomatic till the day she fell unconscious 4 months back.She went to many other hospitals for treatment and took some unknown medication because of which pain relieved temporarily and it returned back.

- She has a H/O Eye surgery on both of her eyes 3 yrs back

-H/O HTN from past 30 years.

-No H/O DM,Tb,and asthma.

PERSONAL HISTORY:

Diet : mixed 

App : normal 

Sleep :normal

Medications : daily 2 tablets (1 for HTN, 1 for DM )

Non alcoholic ,non smoker 

MENOPAUSE: When she was around 18 yrs old. She has undergone hysterectomy because they were suspecting uterine cancer.

FAMILY HISTORY:

no family History 

GENERAL EXAMINATION:

No pallor, no icterus, no cyanosis, no clubbing ,no edema , no lymphadenopathy.

NOTE:

She even had a surgery to both of her knee caps 30 yrs back.

DIAGNOSIS: 

BPPV- Benign Paroximal                                            Positional Vertigo.

TREATMENT:

Epleys Maneuver.