29th September 2021

A 58 year old male presents to A&E concerned by sudden onset “dizziness” that started 2 hours ago

A 58 year old male presents to A&E concerned by sudden onset “dizziness” that started 2 hours ago. He has no previous medical conditions and takes no medications. On questioning what he means by dizziness, he says, “everything is spinning around him” and that the vertigo does not worsen with head movement. He also complains of some slight ringing in his left ear but is not sure when it started. He has not had a fall due to this, but he believes it is only a matter of time as he feels very off-balance. He is also concerned as he took time off work last week for a sore throat and fever and does not want to take any more time off work. Otoscopy of his ear is unremarkable and there is no mastoid tenderness. A focused cranial nerves examination reveals mild horizontal nystagmus and mild sensorineural hearing loss of the left ear.

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