Dizziness

What 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 faint (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 Bennetthttp://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]

Vertigo (2009)

An approach to the evaluation and management of syncope in adults (2010)

Syncope

Investigations?

Treatment?

Prevention?

 

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