Updated 19 June 2015

What's your diagnosis? – Case 15: the world is spinning

Mrs P, a 35-year-old secretary, is feeeling very unsteady on her feet. This has never happen to her before. Grab your otoscopes and help solve this week’s case.


Mrs P has been feeling very dizzy for the last few days. Initially she thought it might be due to abnormal blood pressure, but she's never had blood pressure problems before. She decides to visit her GP.

The following is a summary of the GP’s notes:


Sudden onset vertigo sensation – patient denies that she feels lightheaded, but describes the sensation: “It feels like everything around me is spinning out of control”. The spinning sensation is not brought on by any specific position of her head, but appears randomly and last for minutes at a time. 

After asking her, the patient admits that she's been experiencing a ringing sound in her left ear for approximately the past week. Occasionally it feels as if her hearing is not as good in her left ear.

No discharges from patient’s ears. She does not experience any pain in her ears.

She reports no medical or surgical history.

Flu-like symptoms about a week ago – cleared after taking over-the-counter medication. Mrs P is a regular smoker.

On Examination:

- Normal system examination: normal heart, lungs and abdominal exams.

Throat: slightly red – appearance similar to a persistent post-nasal drip

Ears: normal examination.

Based on the information above, what is the most likely diagnosis?

Hint:  The timing and duration of Mrs P's symptoms is vital for differentiating between possible causes.

What’s your diagnosis? Join the guesswork on our Facebook page, or comment below. 

NOTE: Health24's on-site GP Dr Owen Wiese will reveal new cases on Thursdays. We'll post the answer with the story on Mondays, or you can get it via the Daily Tip – sign up here.

Previously on What's Your Diagnosis?

What's your diagnosis? -  Case 1: vomiting and weight loss

What's your diagnosis? -  Case 2: eye pain

What's your diagnosis? -  Case 3: strange behaviour and a bullet in the back

What's your diagnosis? -  Case 4: seeing odd things

What's your diagnosis? - Case 5: mysterious lungs

What's your diagnosis? - Case 6: runner with seizures

What's your diagnosis? - Case 7: swollen knee

What's your diagnosis? - Case 8: bloody semen

What's your diagnosis? - Case 9: confusing neurological signs

What's your diagnosis? - Case 10: diabetic teenager with unusual signs and symptoms

What's your diagnosis? - Case 11: bruising with no apparent reason

What's your diagnosis? - Case 12: severe tummy pain

What's your diagnosis? - Case 13: severe sore throat

What's your diagnosis? - Case 14: abdominal pain and swelling

Dr. Owen J. Wiese is Health24's resident doctor. After graduating from Stellenbosch University with additional qualifications in biochemistry and physiology he developed a keen interest in providing medical information through the media.


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