Dizziness resident survival guide: Difference between revisions

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==Overview==
==Overview==
Dizziness is a complex and subjective complaint that encompasses a wide spectrum of symptomatology.<ref name="pmid19365263">{{cite journal| author=Chan Y| title=Differential diagnosis of dizziness. | journal=Curr Opin Otolaryngol Head Neck Surg | year= 2009 | volume= 17 | issue= 3 | pages= 200-3 | pmid=19365263 | doi=10.1097/MOO.0b013e32832b2594 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19365263  }} </ref> It is one of the most common presenting symptom among patients seen by emergency medical physicians, primary care physicians, neurologists, and otolaryngologists.<ref name="pmid19365263">{{cite journal| author=Chan Y| title=Differential diagnosis of dizziness. | journal=Curr Opin Otolaryngol Head Neck Surg | year= 2009 | volume= 17 | issue= 3 | pages= 200-3 | pmid=19365263 | doi=10.1097/MOO.0b013e32832b2594 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19365263  }} </ref>
[[Dizziness]] is a complex and subjective complaint that encompasses a wide [[spectrum]] of [[symptomatology]].<ref name="pmid19365263">{{cite journal| author=Chan Y| title=Differential diagnosis of dizziness. | journal=Curr Opin Otolaryngol Head Neck Surg | year= 2009 | volume= 17 | issue= 3 | pages= 200-3 | pmid=19365263 | doi=10.1097/MOO.0b013e32832b2594 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19365263  }} </ref> It is one of the most common presenting [[symptoms]] among patients seen by emergency medical [[physicians]], [[primary care]] physicians, [[neurologists]], and [[otolaryngologists]].<ref name="pmid19365263">{{cite journal| author=Chan Y| title=Differential diagnosis of dizziness. | journal=Curr Opin Otolaryngol Head Neck Surg | year= 2009 | volume= 17 | issue= 3 | pages= 200-3 | pmid=19365263 | doi=10.1097/MOO.0b013e32832b2594 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19365263  }} </ref>
==Causes==
==Causes==
===Life Threatening Causes===
===Life Threatening Causes===
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
Life-threatening causes include conditions that may result in death or permanent [[disability]] within 24 hours if left untreated.


*Electrolyte imbalance
*[[Electrolyte imbalance]]
*Traumatic brain injury
*[[Traumatic brain injury]]
*Heat stroke
*[[Heatstroke]]


===Common Causes===
===Common Causes===


*Hypotension
*[[Hypotension]]
*Dehydration
*[[Dehydration]]
*Hypoglycemia
*[[Hypoglycemia]]
*Arrhythmias
*[[Arrhythmias]]
*Stroke
*[[Stroke]]
*Labyrinthitis
*[[Labyrinthitis]]
*Meniere's disease
*[[Meniere's disease]]
*BPV
*[[BPV]]
*Medication effects
*[[Medication effects]]




==Diagnosis==
==Diagnosis==
Shown below is an algorithm summarizing the diagnosis of dizziness according to the American Academy of Neurology guidelines.
Shown below is an [[algorithm]] summarizing the [[diagnosis]] of [[dizziness]] according to the American Academy of Neurology guidelines.


{{familytree/start |summary=PE diagnosis Algorithm.}}  
{{familytree/start |summary=PE diagnosis Algorithm.}}  
{{familytree | | | | | | | | | | | | | | | | | | | | | | | A01 |A01= Patient with dizziness}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | A01 |A01= Patient with [[dizzines]]s}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | A01 |A01= Presentation periodical or sustained?}}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | A01 |A01= Presentation periodical or sustained?}}
Line 34: Line 34:
{{familytree | | | | | | | | | F01 | | | | | | | | | | | | | | | | | | | | | | | | | | F02 |F01= Periodical|F02= Sustained}}
{{familytree | | | | | | | | | F01 | | | | | | | | | | | | | | | | | | | | | | | | | | F02 |F01= Periodical|F02= Sustained}}
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | F01 | | | | | | | | | | | | | | | | | | | | | | | | | | F02 |F01= Provoked or unprovoked?|F02= History of intoxication or trauma, or unknown?}}
{{familytree | | | | | | | | | F01 | | | | | | | | | | | | | | | | | | | | | | | | | | F02 |F01= Provoked or unprovoked?|F02= History of [[intoxication]] or [[trauma]], or unknown?}}
{{familytree | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | | | | | | | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | | | | }}
{{familytree | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | | | | | | | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | | | | }}
{{familytree | | | F01 | | | | | | | | | | F02 | | | | | | | | | | | | | | F03 | | | | | | | | | | F04 | | |F01= Provoked |F02= Unprovoked |F03= History of intoxication |F04= Unknown }}
{{familytree | | | F01 | | | | | | | | | | F02 | | | | | | | | | | | | | | F03 | | | | | | | | | | F04 | | |F01= Provoked |F02= Unprovoked |F03= History of [[intoxication]] |F04= Unknown }}
{{familytree | | | |!| | | | | | | | | | | |!| | | | | | | | | | | | | | | |!| | | | | | | | | | | |!| | | | }}
{{familytree | | | |!| | | | | | | | | | | |!| | | | | | | | | | | | | | | |!| | | | | | | | | | | |!| | | | }}
{{familytree | | | F01 | | | | | | | | | | |!| | | | | | | | | | | | | | | |!| | | | | | | | | | | F02 | | |F01= Apply Dix-Hallpike maneuver |F02= Physical examination }}
{{familytree | | | F01 | | | | | | | | | | |!| | | | | | | | | | | | | | | |!| | | | | | | | | | | F02 | | |F01= Apply [[Dix-Hallpike maneuver]] |F02= [[Physical examination]] }}
{{familytree/end}}  
{{familytree/end}}  
==Do's==
==Do's==

Revision as of 14:54, 19 August 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo M.D.

Overview

Dizziness is a complex and subjective complaint that encompasses a wide spectrum of symptomatology.[1] It is one of the most common presenting symptoms among patients seen by emergency medical physicians, primary care physicians, neurologists, and otolaryngologists.[1]

Causes

Life Threatening Causes

Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.

Common Causes


Diagnosis

Shown below is an algorithm summarizing the diagnosis of dizziness according to the American Academy of Neurology guidelines.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Patient with dizziness
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Presentation periodical or sustained?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Periodical
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Sustained
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Provoked or unprovoked?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
History of intoxication or trauma, or unknown?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Provoked
 
 
 
 
 
 
 
 
 
Unprovoked
 
 
 
 
 
 
 
 
 
 
 
 
 
History of intoxication
 
 
 
 
 
 
 
 
 
Unknown
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Apply Dix-Hallpike maneuver
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Physical examination
 
 

Do's

  • The content in this section is in bullet points.

Don'ts

  • The content in this section is in bullet points.

References

  1. 1.0 1.1 Chan Y (2009). "Differential diagnosis of dizziness". Curr Opin Otolaryngol Head Neck Surg. 17 (3): 200–3. doi:10.1097/MOO.0b013e32832b2594. PMID 19365263.

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