By Dr Angie Yong

I first met Celia, a lovely 68-year-old lady, when she was admitted to hospital following a fall resulting in a closed head injury with a small subdural haematoma. Her medical team noticed she had significant postural hypotension with a drop in systolic blood pressure from systolic 100 (units) to 60 on sitting for more than five minutes. She also had peripheral neuropathy with mild glove and stocking sensory loss on her feet and hands.

Ceilia told me she had lost weight and was suffering from dizziness which started eight months ago, and gradually worsened until she could not remain upright for an extended period. She used to work as a receptionist but had been unable to continue in that role due to her ailing health.

The following tests and results were performed as part of the workup for neuropathy.