Differential diagnosis and clinical decision-making in physical therapy: Case report of a complex dizzy patient

Abstract

Background: This case report describes the physical therapy differential diagnostic and clinical decisionmaking processes utilized in the management of a complex dizzy patient. Case presentation: A 55 year-old female patient with a congenital eye defect was initially diagnosed with left horizontal cupulolithiasis that was converted to horizontal canalithiasis using a modified liberatory maneuver. After resolving the left horizontal canalithiasis, the patient was diagnosed with left unilateral vestibular hypofunction, which was successfully treated by the physical therapist. Discussion: Over a period of 23 days and 5 physical therapy sessions, the patient management approach included examination (subjective and physical), evaluation of findings, physical therapy diagnosis, prognosis, plan of care, intervention, and evaluation of outcomes. Conclusion: This case report demonstrates the need for physical therapists to incorporate a comprehensive patient management approach in order to efficiently maximize patient outcomes.