dizziness

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Introduction

Defined as a disturbed state of spatial awareness.

Etiology

* dizziness is most common symptom linked to a missed diagnosis of stroke presenting to the emergency department[3]

Epidemiology

Physical examination

Clinical manifestations

Laboratory

Diagnostic procedures

Radiology

Complications

Management

More general terms

More specific terms

Additional terms

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 1013-15
  2. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 649
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 Medical Knowledge Self Assessment Program (MKSAP) 11, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2009, 2012 2015, 2018, 2022.
  4. 4.0 4.1 Journal Watch 20(7):56, 2000
    Tinetti ME, Williams CS, Gill TM. Dizziness among older adults: a possible geriatric syndrome. Ann Inten Med 132:337, 2000 PMID: https://www.ncbi.nlm.nih.gov/pubmed/10691583
    Drachman DA Occam's razor, geriatric syndromes, and the dizzy patient. Ann Intern Med 132:403, 2000 PMID: https://www.ncbi.nlm.nih.gov/pubmed/10691591
  5. 5.0 5.1 5.2 Journal Watch 24(24):188, 2004
    Yardley L, Donovan-Hall M, Smith HE et al Effectiveness of primary care-based vestibular rehabilitation for chronic dizziness. Ann Intern Med. 2004 Oct 19;141(8):598-605. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15492339
    Zapanta PE and Meyers AD Medscape: eMedicine: Vestibular Rehabilitation http://emedicine.medscape.com/article/883878
  6. 6.0 6.1 6.2 Uneri A, Polat S. Vertigo, dizziness and imbalance in the elderly. J Laryngol Otol. 2008 May;122(5):466-9. Epub 2007 Sep 13. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17850686
  7. 7.0 7.1 Stanton VA et al, Overreliance on symptom quality in diagnosing dizziness: results of a multicenter survey of emergency physicians. Mayo Clin Proc 2007, 82:1319 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17976351
  8. 8.0 8.1 Kim AS et al. Risk of vascular events in emergency department patients discharged home with diagnosis of dizziness or vertigo. Ann Emerg Med 2011 Jan; 57:34 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20855127
  9. 9.00 9.01 9.02 9.03 9.04 9.05 9.06 9.07 9.08 9.09 9.10 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
    Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
    Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
    Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
    Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
    Geriatric Review Syllabus, 10th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
  10. 10.0 10.1 Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician. 2010 Aug 15;82(4):361-8, 369. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20704166
  11. Zapanta PE and Meyers AD Medscape: eMedicine: Vestibular Rehabilitation http://emedicine.medscape.com/article/883878
  12. 12.0 12.1 12.2 Lawhn-Heath C et al. Utility of head CT in the evaluation of vertigo/dizziness in the emergency department. Emerg Radiol 2013 Jan; 20:45. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22940762
  13. Sloane PD, Coeytaux RR, Beck RS, Dallara J. Dizziness: state of the science. Ann Intern Med. 2001 May 1;134(9 Pt 2):823-32. PMID: https://www.ncbi.nlm.nih.gov/pubmed/11346317
  14. Alrwaily M, Whitney SL Vestibular rehabilitation of older adults with dizziness. Otolaryngol Clin North Am. 2011 Apr;44(2):473-96 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21474018
  15. Barin K, Dodson EE. Dizziness in the elderly. Otolaryngol Clin North Am. 2011 Apr;44(2):437-54 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21474016
  16. 16.0 16.1 Kerber KA, Brown DL, Lisabeth LD, Smith MA, Morgenstern LB Stroke among patients with dizziness, vertigo, and imbalance in the emergency department: a population-based study. Stroke. 2006 Oct;37(10):2484-7. Epub 2006 Aug 31. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16946161
  17. Wetmore SJ, Eibling DE, Goebel JA et al Challenges and opportunities in managing the dizzy older adult. Otolaryngol Head Neck Surg. 2011 May;144(5):651-6 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21493351
  18. 18.0 18.1 Dros J, Maarsingh OR, Beem L, et al. Functional prognosis of dizziness in older adults in primary care: a prospective cohort study. J Am Geriatr Soc. 2012;60:2263-2269. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23231549
  19. Cianfrone G, Pentangelo D, Cianfrone E et al Pharmacological drugs inducing ototoxicity, vestibular symptoms and tinnitus: a reasoned and updated guide. Eur Rev Med Pharmacol Sci. 2011 Jun;15(6):601-36. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21796866
  20. Shoair OA, Nyandege AN, Slattum PW. Medication-related dizziness in the older adult. Otolaryngol Clin North Am. 2011 Apr;44(2):455-71, PMID: https://www.ncbi.nlm.nih.gov/pubmed/21474017
  21. Chan Y. Differential diagnosis of dizziness. Curr Opin Otolaryngol Head Neck Surg. 2009 Jun;17(3):200-3. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19365263
  22. Kentala E, Rauch SD. A practical assessment algorithm for diagnosis of dizziness. Otolaryngol Head Neck Surg. 2003 Jan;128(1):54-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12574760
  23. Zhao JG, Piccirillo JF, Spitznagel EL Jr et al Predictive capability of historical data for diagnosis of dizziness. Otol Neurotol. 2011 Feb;32(2):284-90. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21178804
  24. Huh YE, Kim JS. Bedside evaluation of dizzy patients. J Clin Neurol. 2013 Oct;9(4):203-13. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24285961 Free PMC Article
  25. 25.0 25.1 Geraghty AW, Essery R, Kirby S et al Internet-Based Vestibular Rehabilitation for Older Adults With Chronic Dizziness: A Randomized Controlled Trial in Primary Care. Ann Fam Med May/June 2017 vol. 15 no. 3 209-216 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28483885 Free Article <Internet> http://www.annfammed.org/content/15/3/209
    Balance retraining website https://balance.lifeguidehealth.org/player/play/balance
  26. van Vugt VA, Bas G, van der Wouden JC et al. Prognosis and survival of older patients with dizziness in primary care: a 10-year prospective cohort study. Ann Fam Med. 2020;18(2):100-109 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32152013 PMCID: PMC7062481 Free PMC article https://www.annfammed.org/content/18/2/100
  27. Gurley KL, Edlow JA. Acute Dizziness. Semin Neurol. 2019 Feb;39(1):27-40. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30743290 Review.
  28. 28.0 28.1 28.2 28.3 Das S, Annam CS, Bakshi SS, Seepana R. Persistent positional perceptual dizziness in clinical practice: a scoping review. Neurol Sci. 2023 Jan;44(1):129-135. Epub 2022 Aug 22. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35994134 Review.
  29. 29.0 29.1 29.2 29.3 Kaski D. Neurological update: dizziness. J Neurol. 2020 Jun;267(6):1864-1869. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32130499 PMCID: PMC7293664 Free PMC article. Review.
  30. 30.0 30.1 30.2 30.3 Staab JP Persistent Postural-Perceptual Dizziness. Semin Neurol. 2020 Feb;40(1):130-137. doi:http://dx.doi.org/ 10.1055/s-0039-3402736. Epub 2020 Jan 14. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31935771 Review.
  31. Vestibular test American Hearing Reseach Foundation http://american-hearing.org/disorders/vestibular-testing/
  32. NIDCD Balance, Dizziness and You http://www.nidcd.nih.gov/health/balance/baldizz.asp

Patient information

dizziness patient information