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Sudden dizziness,vomiting,loss of balanc
Hello doc My dad is suffering from DM ,HTN,and CAD Recent 2 days back he was alright. Out of no where he started feeling dizzy and was unable to walk properly due to imbalance and he had 2 episodes of vomiting, and he was seeing things upside down at that moment. Later ecg and echo reports are normal. But there was mild lowering of electrolytes.(Na,K,Ca)and was given ig fluids for the same. Then the emergency doc asked us to take ct brain plain and CT pns plain and contrast. CT pns showed mild dns and doctors here diagnosed it was positional vertigo and prescribed tablets betavert ,gemavert,and stemtil. But still there is very little improvement. What next investigation can be done?? And what might be the DD of this case. I am attaching ct  pns film here .
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Vestibular exercise. Rule out cervical neck pain. Neurologist opinion. MRI brain helps to rule out any central pathalogy
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You need neurologist consultation.
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can be due to electrolyte imbalance and central cause
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get evaluation ASAP
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Upside down vision along with imbalance, nausea and vertigo is usually seen in reversal in vision metamorphopsia or RVM. Can be due to central or vestibular cause. Mild DNS wont usually cause such symptoms. Medications prescribed for controlling dizziness is okay but further evaluation is required to know the proper diagnosis.
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Get both ENT consultation for appropriate assessment of vestibular function and Neurology consultation for ruling out the central cause since your father is both diabetic and hypertensive.
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BP and sugar levels need to be monitored as well..for positional vertigo, medicines are fine but more details are required for accurate diagnosis
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.