Dizziness differential diagnosis: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Dizziness}} | {{Dizziness}} | ||
{{CMG}} | {{CMG}} '''Associate Editor-In-Chief:''' {{Norina Usman}} | ||
==Overview== | ==Overview== | ||
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==Differentiating Dizziness From Other Symptoms== | ==Differentiating Dizziness From Other Symptoms== | ||
[[Dizziness]] must be differentiated from [[vertigo]], [[presyncope]], and [[disequilibrium]]<ref name="pmid19893191">{{cite journal| author=Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE| title=Classification of vestibular symptoms: towards an international classification of vestibular disorders. | journal=J Vestib Res | year= 2009 | volume= 19 | issue= 1-2 | pages= 1-13 | pmid=19893191 | doi=10.3233/VES-2009-0343 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19893191 }} </ref><ref name="pmid4401538">{{cite journal| author=Drachman DA, Hart CW| title=An approach to the dizzy patient. | journal=Neurology | year= 1972 | volume= 22 | issue= 4 | pages= 323-34 | pmid=4401538 | doi=10.1212/wnl.22.4.323 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4401538 }} </ref><ref name="pmid17976352">{{cite journal| author=Newman-Toker DE, Cannon LM, Stofferahn ME, Rothman RE, Hsieh YH, Zee DS| title=Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting. | journal=Mayo Clin Proc | year= 2007 | volume= 82 | issue= 11 | pages= 1329-40 | pmid=17976352 | doi=10.4065/82.11.1329 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17976352 }} </ref><ref name="pmid21576300">{{cite journal| author=Tarnutzer AA, Berkowitz AL, Robinson KA, Hsieh YH, Newman-Toker DE| title=Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. | journal=CMAJ | year= 2011 | volume= 183 | issue= 9 | pages= E571-92 | pmid=21576300 | doi=10.1503/cmaj.100174 | pmc=3114934 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21576300 }} </ref><ref name="pmid26231272">{{cite journal| author=Kerber KA, Newman-Toker DE| title=Misdiagnosing Dizzy Patients: Common Pitfalls in Clinical Practice. | journal=Neurol Clin | year= 2015 | volume= 33 | issue= 3 | pages= 565-75, viii | pmid=26231272 | doi=10.1016/j.ncl.2015.04.009 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26231272 }} </ref>. | |||
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| '''[[Vertigo]]''' | | '''[[Vertigo]]''' | ||
| [[Vertigo]] is a transient and episodic [[perception of false sensation]] of motion characterized by a spinning sensation of either the surrounding environment or | | [[Vertigo]] is a transient and episodic [[perception of false sensation]] of motion characterized by a spinning sensation of either the surrounding environment or self-motion. | ||
| [[Disorientation]]<br>[[Moving]]<br>[[Spinning]]<br>[[Swaying]]<br>[[Tilting]]<br>[[Vague dizziness]]<br>[[Whirling]] | | [[Disorientation]]<br>[[Moving]]<br>[[Spinning]]<br>[[Swaying]]<br>[[Tilting]]<br>[[Vague dizziness]]<br>[[Whirling]] | ||
| [[Diaphoresis]]<br>[[Imbalance]]<br>[[Nausea]]<br>[[Pallor]]<br>[[Tachycardia]]<br>[[Vomiting]] | | [[Diaphoresis]]<br>[[Imbalance]]<br>[[Nausea]]<br>[[Pallor]]<br>[[Tachycardia]]<br>[[Vomiting]] | ||
|- | |- | ||
|'''[[Presyncope]]''' | |'''[[Presyncope]]''' | ||
| | | Presyncope is a state of [[lightheadedness]],<ref name="urlChapter 14: Evaluation of the Dizzy Patient">{{cite web|url=http://www.dartmouth.edu/~dons/part_2/chapter_14.html#chpt_14_presyncope| work=Disorders of the nervous system: a primer | publisher=Dartmouth Medical School|last=Reeves | first= Alexander G | coauthors =Rand S. Swenson |title=Chapter 14: Evaluation of the Dizzy Patient |accessdate=2012-01-06}}</ref> muscular weakness, and feeling faint. | ||
| [[Faintness]]<br>[[Generalized weakness]]<br>[[Lightheadedness]]<br>[[Near blackout]]<br>[[Near fainting]]<br>[[Near syncope]] | | [[Faintness]]<br>[[Generalized weakness]]<br>[[Lightheadedness]]<br>[[Near blackout]]<br>[[Near fainting]]<br>[[Near syncope]] | ||
| [[Blurring of vision]]<br>[[Diaphoresis]]<br>[[Feeling of warmth]]<br>[[Nausea]]<br>[[Pallor]]<br>[[Palpitations]]<br>[[Paresthesia]] | | [[Blurring of vision]]<br>[[Diaphoresis]]<br>[[Feeling of warmth]]<br>[[Nausea]]<br>[[Pallor]]<br>[[Palpitations]]<br>[[Paresthesia]] | ||
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| '''[[Disequilibrium]]''' | | '''[[Disequilibrium]]''' | ||
|[[Disequilibrium]] is a continuous rather than an episodic symptom characterized by an impaired sense or absence of balance that primarily occurs during standing or walking. | |[[Disequilibrium]] is a continuous rather than an episodic symptom characterized by an impaired sense or absence of balance that primarily occurs during standing or walking. | ||
|[[Bad balance]]<br>[[Chronic dizziness]]<br>[[Imbalance]]<br>[[Instability]]<br>[[Loss of balance]]<br>[[Off balance]]<br>[[Unsteadiness]] | |[[Bad balance]]<br>[[Chronic dizziness]]<br>[[Imbalance]]<br>[[Disequilibrium|Instability]]<br>[[Loss of balance]]<br>[[Off balance]]<br>[[Unsteadiness]] | ||
|[[Gait abnormality]]<br>[[Muscle weakness]]<br>[[Numbness]]<br>[[Movement incoordination]]<br>[[Nystagmus]]<br>[[Visual impairment]] | |[[Gait abnormality]]<br>[[Muscle weakness]]<br>[[Numbness]]<br>[[Movement incoordination]]<br>[[Nystagmus]]<br>[[Visual impairment]] | ||
|} | |} | ||
==Differentiating Dizziness From Psychogenic Dizziness== | ==Differentiating Dizziness From Psychogenic Dizziness== | ||
* [[Psychogenic dizziness]] is not a true dizziness. It is associated with psychiatric symptoms that precede its onset. It occurs in anxious or phobic individuals and do not include any specific symptoms and it can be replicated by hyperventilation. | * [[Psychogenic dizziness]] is not a true dizziness. It is associated with psychiatric symptoms that precede its onset. It occurs in anxious or phobic individuals and do not include any specific symptoms and it can be replicated by hyperventilation<ref name="pmid29513688">{{cite journal| author=Kim SK, Kim JH, Jeon SS, Hong SM| title=Relationship between sleep quality and dizziness. | journal=PLoS One | year= 2018 | volume= 13 | issue= 3 | pages= e0192705 | pmid=29513688 | doi=10.1371/journal.pone.0192705 | pmc=5841657 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29513688 }} </ref><ref name="pmid29787922">{{cite journal| author=Indranada AM, Mullen SA, Duncan R, Berlowitz DJ, Kanaan RAA| title=The association of panic and hyperventilation with psychogenic non-epileptic seizures: A systematic review and meta-analysis. | journal=Seizure | year= 2018 | volume= 59 | issue= | pages= 108-115 | pmid=29787922 | doi=10.1016/j.seizure.2018.05.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29787922 }} </ref>. | ||
*Synonyms used to describe [[psychogenic dizziness]] include: | *Synonyms used to describe [[psychogenic dizziness]] include: | ||
**[[Functional dizziness]] | **[[Functional dizziness]] | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Otolaryngology]] | [[Category:Otolaryngology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
Latest revision as of 19:54, 30 August 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Norina Usman, M.B.B.S[2]
Overview
Dizziness is a common but vague symptom. A wide variety of symptoms are often referred to as dizziness, these symptoms include vertigo, presyncope and disequilibrium. Dizziness should also be differentiated from psychogenic dizziness.
Differentiating Dizziness From Other Symptoms
Dizziness must be differentiated from vertigo, presyncope, and disequilibrium[1][2][3][4][5].
| Symptom | Definition | Synonyms and Key Words | Coexistent Symptoms |
| Vertigo | Vertigo is a transient and episodic perception of false sensation of motion characterized by a spinning sensation of either the surrounding environment or self-motion. | Disorientation Moving Spinning Swaying Tilting Vague dizziness Whirling |
Diaphoresis Imbalance Nausea Pallor Tachycardia Vomiting |
| Presyncope | Presyncope is a state of lightheadedness,[6] muscular weakness, and feeling faint. | Faintness Generalized weakness Lightheadedness Near blackout Near fainting Near syncope |
Blurring of vision Diaphoresis Feeling of warmth Nausea Pallor Palpitations Paresthesia |
| Disequilibrium | Disequilibrium is a continuous rather than an episodic symptom characterized by an impaired sense or absence of balance that primarily occurs during standing or walking. | Bad balance Chronic dizziness Imbalance Instability Loss of balance Off balance Unsteadiness |
Gait abnormality Muscle weakness Numbness Movement incoordination Nystagmus Visual impairment |
Differentiating Dizziness From Psychogenic Dizziness
- Psychogenic dizziness is not a true dizziness. It is associated with psychiatric symptoms that precede its onset. It occurs in anxious or phobic individuals and do not include any specific symptoms and it can be replicated by hyperventilation[7][8].
- Synonyms used to describe psychogenic dizziness include:
References
- ↑ Bisdorff A, Von Brevern M, Lempert T, Newman-Toker DE (2009). "Classification of vestibular symptoms: towards an international classification of vestibular disorders". J Vestib Res. 19 (1–2): 1–13. doi:10.3233/VES-2009-0343. PMID 19893191.
- ↑ Drachman DA, Hart CW (1972). "An approach to the dizzy patient". Neurology. 22 (4): 323–34. doi:10.1212/wnl.22.4.323. PMID 4401538.
- ↑ Newman-Toker DE, Cannon LM, Stofferahn ME, Rothman RE, Hsieh YH, Zee DS (2007). "Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting". Mayo Clin Proc. 82 (11): 1329–40. doi:10.4065/82.11.1329. PMID 17976352.
- ↑ Tarnutzer AA, Berkowitz AL, Robinson KA, Hsieh YH, Newman-Toker DE (2011). "Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome". CMAJ. 183 (9): E571–92. doi:10.1503/cmaj.100174. PMC 3114934. PMID 21576300.
- ↑ Kerber KA, Newman-Toker DE (2015). "Misdiagnosing Dizzy Patients: Common Pitfalls in Clinical Practice". Neurol Clin. 33 (3): 565–75, viii. doi:10.1016/j.ncl.2015.04.009. PMID 26231272.
- ↑ Reeves, Alexander G. "Chapter 14: Evaluation of the Dizzy Patient". Disorders of the nervous system: a primer. Dartmouth Medical School. Retrieved 2012-01-06. Unknown parameter
|coauthors=ignored (help) - ↑ Kim SK, Kim JH, Jeon SS, Hong SM (2018). "Relationship between sleep quality and dizziness". PLoS One. 13 (3): e0192705. doi:10.1371/journal.pone.0192705. PMC 5841657. PMID 29513688.
- ↑ Indranada AM, Mullen SA, Duncan R, Berlowitz DJ, Kanaan RAA (2018). "The association of panic and hyperventilation with psychogenic non-epileptic seizures: A systematic review and meta-analysis". Seizure. 59: 108–115. doi:10.1016/j.seizure.2018.05.007. PMID 29787922.