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

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This case report describes the physical therapy differential diagnostic and clinical decisionmaking processes utilized in the management of a complex dizzy patient.

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.

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. This case report demonstrates the need for physical therapists to incorporate a comprehensive patient management approach in order to efficiently maximize patient outcomes.