QuestionSBA
QuestionChoice
This is a classic description of benign paroxysmal positional vertigo (BPPV), with short episodes of vertigo triggered by head movement. It can be treated by carrying out the Epley manoeuvre after diagnosing it using the Dix-Hallpike manoeuvre.
10035032
a
Epley manoeuvre
QuestionChoice
Whilst a posterior circulation stroke is an important differential for sudden-onset vertigo, it would typically come on acutely and be severe and persistent.
10035036
e
Advise the patient to attend A&E for an urgent CT head
QuestionChoice
There are no concerning features to suggest a referral to ENT is required. If her vertigo remained persistent after the Epley manoeuvre, or if the patient developed hearing loss/tinnitus, a referral to ENT may be warranted.
10035034
c
Referral to ENT
QuestionChoice
As the patient is not complaining of nausea, an anti-emetic is unlikely to be helpful.
10035033
b
Ondansetron
QuestionChoice
The patient’s symptoms are not consistent with excessive ear wax and therefore prescribing olive oil drops is unlikely to be beneficial.
10035035
d
Prescribe olive oil drops
Concept
Chapter
2693
6121
Vertigo and Dizziness
Topic
186
Ear, Nose and Throat
19410
Benign paroxysmal positional vertigo (BPPV) causes brief dizziness with head movements. The Epley maneuver, a series of head movements, helps reposition displaced otoliths in the inner ear to relieve symptoms.
A 36-year-old female complains of dizziness.

She states it occurs mostly when she wakes up in the morning and turns her head to look at her phone. It has been occurring for the past 10 months.

It lasts for around 30 seconds at a time and she has no associated tinnitus or hearing loss.

Given the most likely diagnosis, what is the most appropriate management option?
a