Approach to the evaluation of the dizzy patient

Baloh, R.W.

Otolaryngology--Head and Neck Surgery Official Journal of American Academy of Otolaryngology-Head and Neck Surgery 112(1): 3-7


ISSN/ISBN: 0194-5998
PMID: 7816456
DOI: 10.1016/s0194-5998(95)70299-7
Accession: 008183934

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Dizziness is a nonspecific symptom caused by many different pathophysiologic mechanisms. Vertigo, an illusion of movement, indicates a lesion within the vestibular system. The duration of attacks and associated symptoms helps to determine the site of lesion and likely diagnosis. Examination of the dizzy patient should Include a careful assessment of gait and balance and a search for spontaneous and positional nystagmus. The vestibulo-ocular reflex can be evaluated qualitatively at the bedside with the doll's eye, dynamic visual acuity, and ice water caloric tests. Each test provides different information about vestibular function.