Vestibular Migraine Disease and Horizontal Canal Benign Paroxysmal Positional Vertigo in an Adult Patient
JA is a 27-year-old female referred to our office for an evaluation of dizziness. JA reported waking in the middle of the night with vertigo approximately 6 weeks prior to the visit. She reported severe spinning each time she would lay down and was evaluated by her primary care physician who diagnosed her with bilateral ear infections and prescribed antibiotics. JA reported persistent “bobbing” sensations between episodes of vertigo and stated the vertigo was provoked by changes in head and body position. She also complained of symptoms of photophobia (sensitivity to light) and headaches and was evaluated by a neurologist for migraines. At the point of her visit, JA reported consistent dizziness that lasted for days. She noted no particular direction for her spinning sensation. She noted that the spinning is present whenever she lies down so she had been sleeping upright in a chair for several weeks. She also noted spinning whenever she turns her head. She could not identify the direction of her spinning. Medical history was also positive for bilateral tinnitus of 1-week duration, ear pain (otalgia) and fullness that began 6 weeks prior to the visit, and anxiety.