Dizziness classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2] Norina Usman, M.B.B.S[3]

Overview

Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

Classification

Dizziness may be classified into subtypes based on the symptoms[1]:

Classification of Dizziness[2]
Type of Dizziness Description Origin of Disorder
Type I Dizziness

(Vertigo)

  • Rotational/spinning sensation
  • Often instantaneous
  • Oscillopsia may occur
  • Often accompanied by nausea, vomiting, and a staggering gait
Vestibular system disorder

(Peripheral OR Central)

Type II Dizziness

(Impending faint/Presyncope)

  • Sensation of impending faint/loss of consciousness
  • Pallor, dimness of vision, roaring in the ears, and diaphoresis may occur
  • Recovery upon assuming the recumbent position is common
Non Vestibular system disorder
Type III Dizziness (Disequilibrium)
  • Loss of balance without an abnormal sensation in the head occurs
  • Occurs when walking and disappears upon sitting down.
  • Occurs as a result of a disorder of motor system control
Type IV Dizziness
  • Vague lightheadedness occurs
  • It includes dizziness that cannot be identified with certainty as any of the other types

Classification

Another way to classify is based on the timing and trigger as follows:[3]

1. New episodic:

  - With triggers:
    --Triggered episodic vestibular syndrome (e.g., positional vertigo from BPPV)
  - Without triggers:
    --Spontaneous episodic vestibular syndrome (e.g., arrhythmia from cardiac causes)

2. New continuous:

  - Post-exposure acute vestibular syndrome (e.g., after gentamicin)
  - Spontaneous acute vestibular syndrome (e.g., stroke of posterior fossa)

3. Chronic, persistent:

  - Chronic vestibular syndrome (unilateral vestibular loss, present with head movement)
  - Spontaneous chronic vestibular syndrome (associated with degeneration of cerebellum)

References

  1. Walker HK, Hall WD, Hurst JW (1990). "Clinical Methods: The History, Physical, and Laboratory Examinations". PMID 21250167.
  2. Mukherjee A, Chatterjee SK, Chakravarty A (2003). "Vertigo and dizziness--a clinical approach". J Assoc Physicians India. 51: 1095–101. PMID 15260396.
  3. Newman-Toker DE, Edlow JA (August 2015). "TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo". Neurol Clin. 33 (3): 577–99, viii. doi:10.1016/j.ncl.2015.04.011. PMC 4522574. PMID 26231273.

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