Videonystagmography in a geriatric patient with paroxysmal positional vertigo

The purpose of this article is to familiarize a wide range of practicing physicians (otorhinolaryngologists/audiologists, vestibulologists/otoneurologists, neurologists/neurovascular specialists, therapists/cardiologists, geriatricians) with diagnostic approaches when consulting patients with complaints of episodes of impaired balance, which are regularly triggered by changes in the position of the head and body. The main aspects of the propaedeutics of vestibular system diseases are illustrated by the example of an elderly patient who was diagnosed with central subacute remitting vestibulopathy of vascular origin based on comprehensive vestibulometry. The high diagnostic capabilities of correct and consistent performance of postural tests during computerized videonystagmography are demonstrated. The main objective symptom confirming the involvement of the central parts of the vestibular system is the registration of positional and positioning nystagmus when gaze fixation is eliminated (in the dark with eyes open). The detection of objective videonystagmographic symptoms confirming the patient’s complaints of paroxysmal positional vertigo requires (on the part of the therapist/geriatrician and neurologist/neurovascular specialist) correction of drug therapy for arterial hypertension complicated by central subacute remitting vestibulopathy.
Keywords: paroxysmal positional vertigo, videonystagmography, positioning nystagmus, positional nystagmus
Conflict of interest. The authors declare that there is no conflict of interest.
Funding. The study has not received any funding.