title: Curing a 96-year-old patient afflicted with benign paroxysmal positional vertigo on a motorized turntable.
abstract: BACKGROUND
  Dizziness in the elderly is a serious health concern due to the increased morbidity caused by falling. The most common cause of dizziness in the elderly, benign paroxysmal positional vertigo (BPPV), is frequently undiagnosed, and bedside treatment of these patients can be difficult due to neck and back stiffness, which makes repeated and accurate repositioning maneuvers difficult.
  
  
  METHODS
  After a fall, a 96-year-old woman was referred by a resident neurologist for intractable BPPV. The patient was placed on a motorized turntable and repositioned to remove the calcite particles from the affected posterior semicircular canal. Video monitoring of the eyes allowed confirmation of the diagnosis, as well as an immediate evaluation of the effectiveness of the maneuver.
  
  
  CONCLUSIONS
  Every patient with dizziness or imbalance, even in the absence of typical complaints of BPPV, should be tested with provocation maneuvers, because the clinical picture of BPPV is not always typical. Even if elderly patients with dizziness are very frail, the completion of provocation maneuvers is imperative, since the therapeutic maneuvers are extremely effective. A motorized turntable is very helpful to perform the repositioning accurately and safely.
authors.affiliation: Department of Neurology, University Hospital Zurich ; Department of Ophthalmology, University Hospital Zurich ; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Bockisch
authors.affiliation: Department of Neurology, University Hospital Zurich ; Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
authors.forename: Dominik
authors.initials: D
authors.lastname: Straumann
authors.affiliation: Department of Neurology, University Hospital Zurich ; Department of Ophthalmology, University Hospital Zurich.
authors.forename: Konrad P
authors.initials: KP
authors.lastname: Weber
mesh_terms: D000058:Accidental Falls; D000369:Aged, 80 and over; D065635:Benign Paroxysmal Positional Vertigo / Q000628:therapy*; D053483:Eye Movement Measurements; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D012074:Remission Induction / Q000379:methods; D012399:Rotation
keywords: nystagmus; vertigo; vestibulo ocular reflex
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