Friday, February 01, 2008

Evaluating dizzy patients-- historical pearls

Presyncope-- brief light headedness when standing with drop in BP
Benign positional vertigo-- lasts second, triggered with head movement especially in AM when getting out of bed or in pm when getting in . However, a few cases lack classical h/s and present with postural dizziness/falls
Vertiginous migraines-- last 10-30 minutes, are insensitive to position, may be followed by a HA
Meniere's related vertigo may last hours, be accompanied by tinnitus and hearing loss, and is not triggered by motion Vestibular neuritis may have a sudden onset and last days . Patients may describe a "floating sensation"
TIA's last a few minutes and are accompanied by other "brainstem" signs
Orthostatic intolerance-- light headed, dizzy, impulse of falling
Basilar occlusion-- rotational vertigo, nonvertiginous dizziness
psychiatric-- panic disorder-- dizzy/woozy, sudden veers
Hypoglycemia-- light headed, unsteady.

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