Patient is seen for vestibular evaluation. Primary complaint…
Patient is seen for vestibular evaluation. Primary complaint is persistent imbalance the past 6 months. She stated she had one attack of severe true rotational vertigo six months ago, and since then has feared another will occur. She has limited her activities, as quick head movements exacerbate her imbalance. She takes meclizine daily. VNG shows normal pursuit, OPK/OKN, and saccades. She has a left beating nystagmus on gaze testing without fixation. HFHS yielded a left beating nystagmus. No positional symptoms or nystagmus. Bithermal bilateral calorics yielded a 50% right weakness with no directional preponderance.
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