DizzinessWhat does the patient mean by dizziness?
- Vertigo
- Impending feint
- Loss of balance
- Lightheadedness
Does the patient have falls?
- Stokes-Adams attacks
- Vertebrobasilar insufficiency
- Akinetic type of minor epilepsy
Causes of syncope
- Cardiac
- Stokes-Adams attacks
- Myocardial infarction
- Aortic stenosis
- Pulmonary stenosis
- Vasomotor
- Simple feint (vasovagal attack)
- Prolonged standing
- Hypotensive drugs
- Cough and micturition syncope
- Hypoglycaemia
- Subclavian steal syndrome
Causes of lightheadedness
- Cerebrovascular insufficiency
- Anaemia
- Post-tussive dizziness and syncope
- Anxiety
- Hyperventilation
Causes of vertigo
- Vertebrobasilar insufficiency/cervical spondylosis
- Meniere's disease (vertigo/tinnitus/deafness)
- Middle ear disease
- Vestibular neuronitis
- Benign positional vertigo
- Drug therapy
- Salicylates
- Phenytoin
- Quinine
- Gentamycin
10-minute consultation: Vertigo J Kanagalingam, D Hajioff, S Bennett http://bmj.com/cgi/content/full/330/7490/523?etoc
Rinne and Weber tests
| Disease | Weber | Rinne |
|---|---|---|
| Middle ear | Better affected side | Bone > air |
| Inner ear | Better on normal side | Air > bone (both reduced) |
![[dizziness]](dizzy3.gif)
Investigations?
Treatment?
Prevention?