Vertebral-Basilar Case 1: Suddenly Dizzy

The patient suddenly developed vertigo ("the room was spinning") while getting up out of his chair. He lost his balance, became nauseated, and vomited on the living room floor. He was able to call out for help, but when his wife came running in from the next room she immediately noticed that his speech was slurred and hard to understand. She immediately dialed 911. 

The EMTs arrived about 20 minutes later and took him to the local hospital. He began to improve in the ambulance. By the time he arrived in the emergency room, he was speaking clearly again and could sit up. An electrocardiogram revealed atrial fibrillation. He was observed closely for the next 18 hours, but there were no further events and his neurologic exam showed no lasting deficits. Anticoagulation therapy was initiated.