Vertigo history and symptoms: Difference between revisions
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==History and Symptoms== | ==History and Symptoms== | ||
'''Important factors in history:''' | '''Important factors in history:''' | ||
*'''Confirm true vertigo''': | *'''Confirm true vertigo''': | ||
**True vertigo is described as the room spinning around the patient.<ref name="pmid16445269">{{cite journal| author=Labuguen RH| title=Initial evaluation of vertigo. | journal=Am Fam Physician | year= 2006 | volume= 73 | issue= 2 | pages= 244-51 | pmid=16445269 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16445269 }} </ref> | **True vertigo is described as the room spinning around the patient.<ref name="pmid16445269">{{cite journal| author=Labuguen RH| title=Initial evaluation of vertigo. | journal=Am Fam Physician | year= 2006 | volume= 73 | issue= 2 | pages= 244-51 | pmid=16445269 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16445269 }} </ref> | ||
**Once true vertigo is established next step is to identify if the origin of dysfunction is central or peripheral.<ref name="Baloh2016">{{cite journal|last1=Baloh|first1=Robert W.|title=Differentiating between peripheral and central causes of vertigo|journal=Otolaryngology–Head and Neck Surgery|volume=119|issue=1|year=2016|pages=55–59|issn=0194-5998|doi=10.1016/S0194-5998(98)70173-1}}</ref> | **Once true vertigo is established next step is to identify if the origin of dysfunction is central or peripheral.<ref name="Baloh2016">{{cite journal|last1=Baloh|first1=Robert W.|title=Differentiating between peripheral and central causes of vertigo|journal=Otolaryngology–Head and Neck Surgery|volume=119|issue=1|year=2016|pages=55–59|issn=0194-5998|doi=10.1016/S0194-5998(98)70173-1}}</ref> | ||
{| class="wikitable" style="margin: 1em auto 1em auto" | {| class="wikitable" style="margin: 1em auto 1em auto" | ||
|+ | |+ | ||
! Distinguishing Feature || Peripheral Vertigo || Central Vertigo | !Distinguishing Feature||Peripheral Vertigo||Central Vertigo | ||
|- | |- | ||
| [[Nausea]] | |[[Nausea]]||Could be severe||Variable | ||
|- | |- | ||
| [[Vomiting]] | |[[Vomiting]]||Could be severe||Variable | ||
|- | |- | ||
|[[Hearing loss]] || Common || Rare | |[[Hearing loss]]||Common||Rare | ||
|- | |- | ||
|[[Tinnitus]] || Common || Rare | |[[Tinnitus]]||Common||Rare | ||
|- | |- | ||
|Other [[Neurological]] [[Symptoms]] || Rare || Common | |Other [[Neurological]] [[Symptoms]]||Rare||Common | ||
|} | |} | ||
*'''Time course''':<ref name="Derebery1999">{{cite journal|last1=Derebery|first1=M. Jennifer|title=THE DIAGNOSIS AND TREATMENT OF DIZZINESS|journal=Medical Clinics of North America|volume=83|issue=1|year=1999|pages=163–177|issn=00257125|doi=10.1016/S0025-7125(05)70095-X}}</ref><ref name="Solomon2000">{{cite journal|last1=Solomon|first1=David|title=DISTINGUISHING AND TREATING CAUSES OF CENTRAL VERTIGO|journal=Otolaryngologic Clinics of North America|volume=33|issue=3|year=2000|pages=579–601|issn=00306665|doi=10.1016/S0030-6665(05)70228-0}}</ref><ref name="RosenbergGizzi2000">{{cite journal|last1=Rosenberg|first1=Michael L.|last2=Gizzi|first2=Martin|title=NEURO-OTOLOGIC HISTORY|journal=Otolaryngologic Clinics of North America|volume=33|issue=3|year=2000|pages=471–482|issn=00306665|doi=10.1016/S0030-6665(05)70221-8}}</ref> | *'''Time course''':<ref name="Derebery1999">{{cite journal|last1=Derebery|first1=M. Jennifer|title=THE DIAGNOSIS AND TREATMENT OF DIZZINESS|journal=Medical Clinics of North America|volume=83|issue=1|year=1999|pages=163–177|issn=00257125|doi=10.1016/S0025-7125(05)70095-X}}</ref><ref name="Solomon2000">{{cite journal|last1=Solomon|first1=David|title=DISTINGUISHING AND TREATING CAUSES OF CENTRAL VERTIGO|journal=Otolaryngologic Clinics of North America|volume=33|issue=3|year=2000|pages=579–601|issn=00306665|doi=10.1016/S0030-6665(05)70228-0}}</ref><ref name="RosenbergGizzi2000">{{cite journal|last1=Rosenberg|first1=Michael L.|last2=Gizzi|first2=Martin|title=NEURO-OTOLOGIC HISTORY|journal=Otolaryngologic Clinics of North America|volume=33|issue=3|year=2000|pages=471–482|issn=00306665|doi=10.1016/S0030-6665(05)70221-8}}</ref> | ||
**Lasting a Day or Longer: [[Vestibular neuronitis]], vertebrobasilar [[ischemia]] with [[labyrinth]] infarct, [[Brainstem stroke]], Inferior [[cerebellar]] [[infarct]]/bleed | **Lasting a Day or Longer: [[Vestibular neuronitis]], vertebrobasilar [[ischemia]] with [[labyrinth]] infarct, [[Brainstem stroke]], Inferior [[cerebellar]] [[infarct]]/bleed | ||
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**[[Acoustic neuroma]]: [[tinnitus]], ear pain, [[aural fullness]], [[headache]], facial weakness. | **[[Acoustic neuroma]]: [[tinnitus]], ear pain, [[aural fullness]], [[headache]], facial weakness. | ||
**[[Vestibular Migraine]]: [[headache]], [[photophobia]], visual aura. | **[[Vestibular Migraine]]: [[headache]], [[photophobia]], visual aura. | ||
**[[Ménière disease]]: hearing loss, [[tinnitus]] | **[[Ménière disease]]: hearing loss, [[tinnitus]] | ||
**Acute [[labyrinthitis]] or [[vestibular neuritis]]: recent viral infection | **Acute [[labyrinthitis]] or [[vestibular neuritis]]: recent viral infection | ||
**Medication induced: [[aminoglycosides]], [[anticonvulsants]] ([[phenytoin]]), [[anti-depressants]] ([[tricyclic antidepressants]], [[monoamine oxidase]]), [[antihypertensives]], [[diuretics]] ([[furosemide]]), [[barbiturates]], [[cocaine]], [[nitroglycerin]], [[salicylates]] | **Medication induced: [[aminoglycosides]], [[anticonvulsants]] ([[phenytoin]]), [[anti-depressants]] ([[tricyclic antidepressants]], [[monoamine oxidase]]), [[antihypertensives]], [[diuretics]] ([[furosemide]]), [[barbiturates]], [[cocaine]], [[nitroglycerin]], [[salicylates]] | ||
== References == | |||
<br /> | |||
* The majority of patients with [disease name] are asymptomatic. | |||
OR | |||
* The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. | |||
* Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. | |||
=== History === | |||
Patients with vertigo may have a positive history of: | |||
* described as the room spinning around the patient.<ref name="pmid16445269" /> | |||
* [History finding 2] | |||
* [History finding 3] | |||
=== Common Symptoms === | |||
Common symptoms of [disease] include: | |||
* [Symptom 1] | |||
* [Symptom 2] | |||
* [Symptom 3] | |||
=== Less Common Symptoms === | |||
Less common symptoms of [disease name] include | |||
* [Symptom 1] | |||
* [Symptom 2] | |||
* [Symptom 3] | |||
==References== | |||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | {{WH}} |
Revision as of 00:12, 21 January 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]
Overview
In order to reach the underlying cause of vertigo, it is important to first confirm the presence of true vertigo which is usually described as 'room spinning around'. Once that is established next step is to differentiate between the central and peripheral causes of vertigo. Time duration and associated signs and symptoms help in identifying the underlying cause.
History and Symptoms
Important factors in history:
- Confirm true vertigo:
Distinguishing Feature | Peripheral Vertigo | Central Vertigo |
---|---|---|
Nausea | Could be severe | Variable |
Vomiting | Could be severe | Variable |
Hearing loss | Common | Rare |
Tinnitus | Common | Rare |
Other Neurological Symptoms | Rare | Common |
- Time course:[3][4][5]
- Lasting a Day or Longer: Vestibular neuronitis, vertebrobasilar ischemia with labyrinth infarct, Brainstem stroke, Inferior cerebellar infarct/bleed
- Lasting Minutes to Hours: Meniere’s disease, vertebrobasilar transient ischemic attack (TIA), Migraine headache, Perilymph fistula.
- Lasting Seconds: Benign paroxysmal positional vertigo
- Associated Signs and symptoms:[6][4][5]
- Benign paroxysmal positional vertigo: Triggered by a change in head position.
- Vertebrobasilar stroke: diplopia, dysphagia, dysarthria, and numbness or weakness.
- Acoustic neuroma: tinnitus, ear pain, aural fullness, headache, facial weakness.
- Vestibular Migraine: headache, photophobia, visual aura.
- Ménière disease: hearing loss, tinnitus
- Acute labyrinthitis or vestibular neuritis: recent viral infection
- Medication induced: aminoglycosides, anticonvulsants (phenytoin), anti-depressants (tricyclic antidepressants, monoamine oxidase), antihypertensives, diuretics (furosemide), barbiturates, cocaine, nitroglycerin, salicylates
- The majority of patients with [disease name] are asymptomatic.
OR
- The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
- Symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
History
Patients with vertigo may have a positive history of:
- described as the room spinning around the patient.[1]
- [History finding 2]
- [History finding 3]
Common Symptoms
Common symptoms of [disease] include:
- [Symptom 1]
- [Symptom 2]
- [Symptom 3]
Less Common Symptoms
Less common symptoms of [disease name] include
- [Symptom 1]
- [Symptom 2]
- [Symptom 3]
References
- ↑ 1.0 1.1 Labuguen RH (2006). "Initial evaluation of vertigo". Am Fam Physician. 73 (2): 244–51. PMID 16445269.
- ↑ Baloh, Robert W. (2016). "Differentiating between peripheral and central causes of vertigo". Otolaryngology–Head and Neck Surgery. 119 (1): 55–59. doi:10.1016/S0194-5998(98)70173-1. ISSN 0194-5998.
- ↑ Derebery, M. Jennifer (1999). "THE DIAGNOSIS AND TREATMENT OF DIZZINESS". Medical Clinics of North America. 83 (1): 163–177. doi:10.1016/S0025-7125(05)70095-X. ISSN 0025-7125.
- ↑ 4.0 4.1 Solomon, David (2000). "DISTINGUISHING AND TREATING CAUSES OF CENTRAL VERTIGO". Otolaryngologic Clinics of North America. 33 (3): 579–601. doi:10.1016/S0030-6665(05)70228-0. ISSN 0030-6665.
- ↑ 5.0 5.1 Rosenberg, Michael L.; Gizzi, Martin (2000). "NEURO-OTOLOGIC HISTORY". Otolaryngologic Clinics of North America. 33 (3): 471–482. doi:10.1016/S0030-6665(05)70221-8. ISSN 0030-6665.
- ↑ Hanley K, O'Dowd T, Considine N (2001). "A systematic review of vertigo in primary care". Br J Gen Pract. 51 (469): 666–71. PMC 1314080. PMID 11510399.