National Physical Therapy Examination NPTE Quiz
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A physical therapist is treating a patient for right posterior canal BPPV using the Epley maneuver. During the maneuver, as the patient is moved from long-sitting to the head-hanging right position, they experience the expected torsional upbeating nystagmus and vertigo. However, after 30 seconds, the nystagmus changes to a persistent, purely vertical downbeating nystagmus, and the patient reports feeling nauseous and 'unwell' in a way that is different from their typical vertigo.
The change in the type of nystagmus is MOST indicative of what type of problem?
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