Case 02 · trainee
Vertigo with hoarseness in a 67-year-old smoker
Vignette
A 67-year-old hypertensive smoker presents with sudden onset vertigo, dysphagia, and hoarseness for 6 hours. Examination shows left Horner's syndrome, left palatal weakness, decreased pain and temperature on the left face and right body, and a wide-based gait with falls to the left. Head impulse test is normal. Bucket SVV reads −11° (tilted to the patient's left) with a complete ocular tilt reaction.
SVV trace
Large ipsilesional tilt with complete OTR, normal HIT