Dizziness Flashcards
What should you ask about when someone presents with dizziness?
Loss of consciousness
What are the four main types of dizziness?
Pre-syncope
Vertigo
Disequilibrium
Non-specific dizziness
What is pre-syncope caused by?
Reduced blood flow to the brain
What will a person with pre-syncope describe?
Feeling faint
Like passing out
Don’t lose consciousness
What is pre-syncope the same as?
Prodromal phase of syncope
What are the symptoms of pre-syncope the same as?
Those for syncope
Do you have to have syncope after pre-syncope?
No
What is vertigo?
Illusion of motion
What does a person with vertigo feel like?
They/their environment spinning around
What is physiological vertigo?
Vertigo after spinning around fast multiple times
No underlying disease process
What is pathological vertigo usually due to?
Disturbance of vestibular system
What are the parts of the vestibular system?
Labyrinth in inner ear - 3 fluid-filled semicircular canals - Otolith organs: utricle and saccule Vestibular nerve Central vestibular structures in brain
What do the vestibular nuclei project to?
Ophthalmic nuclei in brainstem
Spinal cord
Cerebellum
Cortex
What other sensory inputs are important for maintaining balance?
Eyes
Skin
Muscles
Joints
How many people presenting with dizziness will have vertigo?
50%
What do the causes of vertigo include?
Viral infection
Stroke
Benign paroxysmal positional vertigo (BPPV)
What is the most common cause of vertigo?
BPPV
What happens in BPPV?
Ca crystals from otolith organs become dislodged
Settle in posterior semicircular canal
Spinning sensation whenever head moves suddenly
What is disequilibrium?
Dizziness due to gait disturbance
What can cause disequilibrium?
Loss of balance because of diseases of
- Nerves
- Muscles
- Cerebellum
How might a patient with disequilibrium describe it?
Wobbliness of feet
Feel like leaning to one side when they walk
Doesn’t happen when not walking
How is non-specific dizziness described?
Light headedness
Woozy
Foggy in head
What causes non-specific dizziness?
Not clear Sometimes related to - Hyperventilation - Psychological problems - Anxiety - Depression
Can more than one type of dizziness be present at once?
Yes, especially in older patients who have multiple medical problems
What can you ask about the quality of dizziness?
Spinning
Loss of balance
Foggy
What can you ask about the severity of dizziness?
Disruption of normal activity
Causing falls
What can you ask about the time course of dizziness?
Acute/chronic
Periodicity
Change over time
What can you ask about the context of dizziness?
Viral illness
New medication
Headache
What can you ask about the relieving factors of dizziness?
Keeping still
Medication
What can you ask about the aggravating factors of dizziness?
Movement
Changing position
What are the associated features of dizziness?
Nausea Vomiting Headache Hearing loss Tinnitus Visual changes Other neurological symptoms
