A 62-year-old man presents with episodic vertigo lasting seconds triggered by rolling in bed. Neurologic examination is normal; Dix-Hallpike manoeuvre...

Question

A 62-year-old man presents with episodic vertigo lasting seconds triggered by rolling in bed. Neurologic examination is normal; Dix-Hallpike manoeuvre reproduces symptoms with torsional up-beating nystagmus on the right. What is the most appropriate treatment?

Accepted Answer

Perform Epley canalith repositioning manoeuvre

Answer

Prescribe meclizine chronically

Answer

Order emergent MRI brain

Answer

Start high-dose corticosteroids

Answer

Refer urgently for neurosurgical decompression

ca-mccqe1 MCQ (SBA): Benign paroxysmal positional vertigo

A 62-year-old man presents with episodic vertigo lasting seconds triggered by rolling in bed. Neurologic examination is normal; Dix-Hallpike manoeuvre reproduces symptoms with torsional up-beating nystagmus on the right. What is the most appropriate treatment?