Paient Case 1(Benign paroxysmal positional vertigo)

Man, 70s, dizziness, eye fatigue

Chief Complaint

• The patient experiences rotational vertigo when moving their head.
• Symptoms began 10 days ago, primarily upon waking in the morning.
• The patient has consulted an otolaryngologist, but there has been no improvement.

Other symptoms

• In addition to rotational vertigo, the patient also experiences a sensation of lightheadedness or floating dizziness.
• The patient was diagnosed with angina pectoris seven years ago.
• Leg cramps (calf muscle spasms)

Physical findings

• The patient experiences vertigo when turning their head to the right.
• The patient presents with generalized edema.
• A firm and forceful pulse (“Lao Mai”)
• There is increased tension in the sternocleidomastoid muscle.
• Muscle tension is noted in the left upper back.
• The patient complains of lower back pain.

Treatment Plan

• To relieve muscle tension along the spinal column from the cervical to the lumbar region.
• To stimulate the Kidney and Spleen meridians to promote fluid elimination.
• Since the condition appears to be benign paroxysmal positional vertigo (BPPV), we will perform physical therapy to reposition the dislodged ear crystals (otoconia) back to their original location.
• To relieve lumbar muscle tension associated with sciatica.

Progress

• The initial session of therapeutic exercise was effective, and the rotational vertigo subsided.
• At the second session, the rotational vertigo had resolved, but the patient still reported a sensation of floating dizziness.
• By the third session, both the rotational and floating vertigo had improved and subsided. However, the patient still experienced calf cramps and lower back pain.
• At the fourth session, the leg edema and muscle cramps had improved.
• At the fifth session, poor circulation was noted, so physical exercise was recommended, and treatment was concluded.