Benign positional vertigo

This is a 73-year-old male patient, who presents to the center today complaining of numbness and tingling in his lower extremities. He is having numbness and tingling to his knees down to his toes bilaterally and symmetrically. He has burning pain intermittently associated with this. Symptoms began in 2001 after he underwent chromotherapy for non-Hodgkin’s lymphoma. He had two bone marrow transplants associated with this. He also has dizziness when he goes from a lying position to upright position and has trouble walking because of the dizziness. He rates his symptoms as 9/10. Symptoms are constant and alleviating with going to sleep. He has had no aggravating factors. He has had acupuncture in the past without relief. He has been on Neurontin, which did not help. He had two to three injections by podiatrist a year ago with no relief.

DIAGNOSES:
Peripheral neuropathy.
Benign positional vertigo.

RECOMMENDATIONS:
Dr. came and spoke with the patient and examined the patient. Clinical findings, assessment, diagnosis, and treatment recommendations were discussed with the patient. We will recommend EMG studies of the lower extremities to further evaluate his neuropathy. Recommend VMG study to further assess his dizziness. He may benefit from undergoing vestibular rehabilitation. He may benefit from physical therapy and improve his flexibility in the lower extremities and his gait. The patient has benefited from peripheral nerve blocks for his neuropathy. The patient will undergo testing evaluation first and then will consider treatments.

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