A directed history and physical examination are usually sufficient to rule out the few serious causes of dizziness. Key information in the history: the patient's description of the dizziness in his or her own words and details about the effects of position. Duration of a dizzy spell is also a useful diagnostic criterion; brief spells are more common in vestibular disorders. Take the blood pressure and pulse while the patient is supine and upright to detect orthostatic changes, perform the Hallpike maneuver, auscultate the heart, and watch the patient walk and turn (looking for unsteadiness in gait). A screen with the patient holding a gaze to the left, right, up, and down can elicit nystagmus, as can head shaking for 10 seconds; this finding suggests a vestibulopathy. Therapeutic options are limited; however, in at least two thirds of patients, symptoms resolve without intervention over weeks to months.
|Original language||English (US)|
|Number of pages||7|
|State||Published - Aug 1 1996|
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