NeuroMed Hospital F/U

Neurologist Hospital Follow Up Notes for: Mrs. Eleanor Vance 1 November 2024 Clinical: Mrs. Vance, a 68-year-old female, presents for follow-up regarding her recent hospitalisation for acute onset vertigo and nystagmus. She reports significant improvement in her symptoms since discharge, with only occasional mild dizziness when changing positions rapidly. No further episodes of severe vertigo have occurred. She denies headache, tinnitus, or focal neurological deficits. Her balance feels much more stable compared to her admission. She continues to adhere to the prescribed vestibular rehabilitation exercises. Results: * MRI Brain (28/10/2024): No acute intracranial pathology, specifically no evidence of stroke or new demyelinating lesions. Old lacunar infarcts noted in the bilateral basal ganglia, consistent with her medical history. * Audiometry (29/10/2024): Mild bilateral high-frequency sensorineural hearing loss, stable compared to previous studies, not contributing to current vertigo. Conclusion: Resolved acute vestibular syndrome, likely viral labyrinthitis, with ongoing mild post-viral vestibulopathy. No evidence of central nervous system involvement contributing to current symptoms. Plan: - Continue vestibular rehabilitation exercises twice daily. - Prescribe Prochlorperazine 5mg PRN for residual mild dizziness (max 3 days). - Follow-up with vestibular physiotherapist in 2 weeks. - Reassess in neurology clinic in 3 months or sooner if symptoms worsen significantly. Follow-up Note 10 November 2024 Clinical Mrs. Vance returns today reporting continued improvement in her dizziness. She now experiences only very brief, mild episodes of unsteadiness, primarily with quick head movements. She has not required Prochlorperazine since the last visit. Her balance is significantly better, and she reports being able to perform most daily activities without issue. Vestibular rehabilitation exercises are being performed consistently. Neurological examination remains unremarkable, with no nystagmus noted on gaze or head impulse testing. Gait is steady and tandem walking is well-performed. Conclusion: Progressing well with recovery from acute vestibular syndrome. Residual symptoms are minimal and consistent with expected post-viral resolution. No new concerns. Plan: - Continue current vestibular rehabilitation programme. - Gradually increase activity levels as tolerated. - Return to clinic for PRN review if symptoms unexpectedly return or worsen. Otherwise, discharged from neurology follow-up with advice to continue with GP for general care.