Margaret

A 76-year-old woman presents with 3 days of positional vertigo. The dizziness occurs when sitting up in bed or turning her head suddenly. Take a focused history, perform a thorough neurological examination including the Dix-Hallpike manoeuvre, exclude red flags suggesting central causes, and provide an appropriate management plan.

1. 1Take a focused history of the dizziness using SOCRATES
2. 2Identify red flags suggesting central causes
3. 3Explore relevant past medical history including HTN and anti-hypertensive use
4. 4Perform a neurological examination including Dix-Hallpike and orthostatic BP
5. 5Order targeted investigations to exclude organic causes
6. 6Provide a working diagnosis with relevant differentials
7. 7Initiate treatment (Epley manoeuvre) and falls-prevention advice
8. 8Arrange follow-up and safety-net advice