Practice Cases
Patient 1: Joanna—I’m back on the ship Tap the arrow to view the case.A 51-year-old professor returns from a 2-week cruise to Alaska. The next morning, she calls your office to schedule a telemedicine visit. She tells you that she woke up, got out of bed, and then became “dizzy” and fell backward onto the […]
Case Study 4: My World Is Spinning
Case study 4: Min—My world is spinning Tap the image to view the case. A 62-year-old woman comes to see you about repeated episodes of spinning vertigo over five days, which gradually improved. Today (day 7), she gets 15–45 seconds of vertigo brought on by movement such as rolling over in bed. She denies tinnitus, […]
Case Study 3: I Passed Out
Case study 3: Frank—I passed out Tap the image to view the case. A 62-year-old man with a history of cluster headaches and MI comes to the office because he has increasing dizziness. He passed out yesterday while walking. Past smoker, quit 5 years ago. Brother had an MI at 55. Question Check your answer […]
Case Study 2: Dizzy Doing Dishes
Case study 2: Opal—Dizzy doing dishes Tap the image to view the case. A 72-year-old woman passed out when she turned her head to answer a question from her son while reaching to get dishes from a high cupboard. She felt dizzy for a few seconds before she lost consciousness. No chest pain. No known […]
Case Study 1: Bug Bite While Swimming
Case study 1: Jeremy—Bug bite while swimming Tap the arrow to view the case.A previously healthy, athletic 40-year-old man is brought in by ambulance. He is hypotensive after collapsing. While he was swimming, he was bitten by a large fly or bee on the forehead and bled from the bite. He suddenly felt unwell and […]
7. Dizziness/Syncope
Author Dawn DeWitt, MD In this module Overview “Dizziness” (“feeling faint,” pre-syncope) is experienced by almost everyone. Temporary loss of consciousness due to decreased blood flow to the brain (fainting). 1 of every 30 ED visits. Differentiate from vertigo—a feeling of movement, spinning, motion sickness Main causes: BPV, Meniere’s, 8th nerve tumour, posterior circulation stroke. […]
References
Adanabikusm D.P. Peripheral Nerve Pathology. Neuropathology. Updated February 2011. Peripheral Neuropathy Fact Sheet. National Institute of Neurological Disorders and Stroke. Accessed April 26, 2022. Agamanolis D.P. Peripheral Nerve Pathology. Neuropathology. Updated February 2011. Chronic Inflammatory Demyelinating Polyneuropathy. National Organization for Rare Disorders. Accessed April 26, 2022. Poncelet AN. An algorithm for the evaluation of peripheral […]
Knowledge Check
This quiz deliberately has both peripheral neuropathy items and central neurological lesion items to help you test your knowledge in distinguishing between the two. question Which of the following are associated with the patients below? (Not all items will be associated with a patient.) Median nerve/Carpal tunnel Ulnar neuropathy Mononeuritis multiplex Radiculopathy Vitamin B12 deficiency […]
Neuropathy: Practice Cases
Patient 1: Clay—Pins and needles Tap the arrow to view the case.A 35-year-old rancher who breeds cattle presents to your clinic a week after being hospitalized for upper and lower extremity sensory changes and weakness. His symptoms began about three months ago, initially as numbness and “pins and needles” tingling in both of his feet, […]
Charcot-Marie-Tooth Disease: Hereditary Motor and Sensory Neuropathy
Author Blake Cohoe, MD editor Dawn DeWitt, MC, MSc, MACP, FRACP Hereditary motor and sensory neuropathy Question Hereditary motor-sensory neuropathy (HMSN) primarily affects the peripheral nervous system. Which of the following are features of the most common type of HMSN? Other answers ALS: Death of both upper and lower motor neurons in the motor cortex […]