Vertigo with upbeat nystagmus shortly after exposure to a small amount of organic solvent

Vertigo is a symptom with several possible etiologies. In this case, a 53-year-old woman presented with a 1-month history of vertigo. She had smelled an unpleasant organic solvent for three hours while working at a desk before the onset of vertigo. Physical examination revealed upbeat nystagmus and a wide-based gait but was otherwise unremarkable; no problems with coordination were observed. Further diagnostic tests, including MRI, inner ear function tests, blood sample analysis assessment of Vitamin B12 levels, and urinalysis, were performed. Vestibular rehabilitation and prevention of exposure to organic solvent were recommended to the patient. The upbeat nystagmus gradually subsided, then the nystagmus and gait disturbance resolved after six months. Patient history and past reports show that such a small amount of organic solvent can cause vertigo. This case highlights a diagnostic approach to vertigo and emphasizes the importance of obtaining a comprehensive history from the patient.

Automated summary

A 53-year-old woman presented with a 1-month history of vertigo. Physical examination revealed upbeat nystagmus and a wide-based gait. Further diagnostic tests suggested that the vertigo may have been caused by exposure to an organic solvent. This case highlights the importance of a diagnostic approach to vertigo and obtaining a comprehensive patient history.