Chapter

The History of the Dizzy Patient

Robert W. Baloh, Vicente Honrubia and Kevin A. Kerber

in Baloh and Honrubia's Clinical Neurophysiology of the Vestibular System, Fourth Edition

Fourth edition

Published on behalf of Oxford University Press

Published in print December 2011 | ISBN: 9780195387834
Published online April 2013 | e-ISBN: 9780199322787 | DOI: http://dx.doi.org/10.1093/med/9780195387834.003.0005

Series: Contemporary Neurology Series

The History of the Dizzy Patient

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Vertigo is an episodic phenomenon, whereas nonvestibular dizziness is often continuous. An exception would be presyncopal light-headedness caused by postural hypotension or cardiac arrhythmia. Patients with psychophysiologic dizziness often report being dizzy from morning to night without changes for months to years at a time. Vertigo is typically aggravated by head movements, whereas nonvestibular dizziness is often aggravated by movement of visual targets. Episodes of dizziness induced by position change suggest a vestibular lesion if postural hypotension has been ruled out. Although stress can aggravate both vestibular and nonvestibular dizziness, dizziness that is reliably precipitated by stress suggests a nonvestibular cause. Finally, episodes of dizziness occurring only in specific situations (e.g., driving on the freeway, entering a crowded room, or shopping in a busy supermarket) suggest a nonvestibular cause.

Chapter.  11939 words.  Illustrated.

Subjects: Neurology

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