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interesting 'BPPV' case

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Hi Docs,

62yo female recently presented w/hx frequent fainting + severe vertigo w/nausea + vomiting 1-5x/day (no h/a) since 2004 (no trauma reported). In 2005 she had complete scan of tests (CT-brain, MRI-brain, lab panels) which supposedly were wnl (MD left area w/all pt records). The severe s/s necessitated her quitting her job and she has been "trying to live with the s/s". Recent C-spine films (1/11) indicate mod C4-5 facet arthrosis, mild DJD C3-C6 + mild reversed cerv lordosis. Pt also c/o "very stiff neck". Neuro/ortho: severely restricted C-spine rom + cranium. I'm concerned about the severity of the pt's s/s - suggestions for further eval? Would Epley maneuver be appropriate in this case??

Many thanks.

Lily Roselyn, DC

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