Dizziness physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
Physical examination of patients includes reproducing dizziness in the clinic by following these maneuvers<ref name="pmid10086438">{{cite journal| author=McGee S, Abernethy WB, Simel DL| title=The rational clinical examination. Is this patient hypovolemic? | journal=JAMA | year= 1999 | volume= 281 | issue= 11 | pages= 1022-9 | pmid=10086438 | doi=10.1001/jama.281.11.1022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10086438 }} </ref><ref name="pmid8842072">{{cite journal| author=Colledge NR, Barr-Hamilton RM, Lewis SJ, Sellar RJ, Wilson JA| title=Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study. | journal=BMJ | year= 1996 | volume= 313 | issue= 7060 | pages= 788-92 | pmid=8842072 | doi=10.1136/bmj.313.7060.788 | pmc=2352174 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8842072 }} </ref><ref name="pmid11774054">{{cite journal| author=Goebel JA| title=The ten-minute examination of the dizzy patient. | journal=Semin Neurol | year= 2001 | volume= 21 | issue= 4 | pages= 391-8 | pmid=11774054 | doi=10.1055/s-2001-19410 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11774054 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref>: | Physical examination of patients includes reproducing dizziness in the clinic by following these maneuvers<ref name="pmid10086438">{{cite journal| author=McGee S, Abernethy WB, Simel DL| title=The rational clinical examination. Is this patient hypovolemic? | journal=JAMA | year= 1999 | volume= 281 | issue= 11 | pages= 1022-9 | pmid=10086438 | doi=10.1001/jama.281.11.1022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10086438 }} </ref><ref name="pmid8842072">{{cite journal| author=Colledge NR, Barr-Hamilton RM, Lewis SJ, Sellar RJ, Wilson JA| title=Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study. | journal=BMJ | year= 1996 | volume= 313 | issue= 7060 | pages= 788-92 | pmid=8842072 | doi=10.1136/bmj.313.7060.788 | pmc=2352174 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8842072 }} </ref><ref name="pmid11774054">{{cite journal| author=Goebel JA| title=The ten-minute examination of the dizzy patient. | journal=Semin Neurol | year= 2001 | volume= 21 | issue= 4 | pages= 391-8 | pmid=11774054 | doi=10.1055/s-2001-19410 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11774054 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref>: | ||
*Dix-Hallpike maneuver- Turning the patient's head at 45 degrees to one side, and rapidly laying the patient into a supine position with the head hanging about 20 degrees over the end of the table, any abnormal eye movement within 30 seconds indicates vestibular debris. | *[[Dix-Hallpike maneuver]]- Turning the patient's head at 45 degrees to one side, and rapidly laying the patient into a supine position with the head hanging about 20 degrees over the end of the table, any abnormal eye movement within 30 seconds indicates vestibular debris. | ||
*Orthostatic blood pressure measurement- Drop-in blood pressure from supine to standing position indicates orthostatic hypotension. | *[[Orthostatic blood pressure measurement]]- Drop-in blood pressure from supine to standing position indicates [[orthostatic hypotension]]. | ||
*Romberg test- Swaying or leaning towards one side is indicative of ipsilateral vestibular dysfunction. | *[[Romberg test]]- Swaying or leaning towards one side is indicative of [[ipsilateral vestibular dysfunction]]. | ||
*Observation of gait- To look for any symptoms of | *Observation of gait- To look for any symptoms of [[Parkinson's disease]] such as small steps and less arm swing. | ||
==References== | ==References== | ||
Latest revision as of 20:08, 20 February 2021
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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
Physical examination of patients with dizziness is usually remarkable for balance problems and nystagmus on Dix-Hall pike maneuver.
Physical Examination
Physical examination of patients includes reproducing dizziness in the clinic by following these maneuvers[1][2][3][4][5]:
- Dix-Hallpike maneuver- Turning the patient's head at 45 degrees to one side, and rapidly laying the patient into a supine position with the head hanging about 20 degrees over the end of the table, any abnormal eye movement within 30 seconds indicates vestibular debris.
- Orthostatic blood pressure measurement- Drop-in blood pressure from supine to standing position indicates orthostatic hypotension.
- Romberg test- Swaying or leaning towards one side is indicative of ipsilateral vestibular dysfunction.
- Observation of gait- To look for any symptoms of Parkinson's disease such as small steps and less arm swing.
References
- ↑ McGee S, Abernethy WB, Simel DL (1999). "The rational clinical examination. Is this patient hypovolemic?". JAMA. 281 (11): 1022–9. doi:10.1001/jama.281.11.1022. PMID 10086438.
- ↑ Colledge NR, Barr-Hamilton RM, Lewis SJ, Sellar RJ, Wilson JA (1996). "Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study". BMJ. 313 (7060): 788–92. doi:10.1136/bmj.313.7060.788. PMC 2352174. PMID 8842072.
- ↑ Goebel JA (2001). "The ten-minute examination of the dizzy patient". Semin Neurol. 21 (4): 391–8. doi:10.1055/s-2001-19410. PMID 11774054.
- ↑ Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA; et al. (1992). "Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care". Ann Intern Med. 117 (11): 898–904. doi:10.7326/0003-4819-117-11-898. PMID 1443950.
- ↑ Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E; et al. (1999). "Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy". Brain. 122 ( Pt 7): 1349–55. doi:10.1093/brain/122.7.1349. PMID 10388800.