Dizziness classification: Difference between revisions

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{{Dizziness}}
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
{{CMG}} {{AE}}{{Debduti}} {{FB}} {{Norina Usman}}
==Overview==
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness. Vertigo can further be classified into timing and trigger as well as based on the area of pathology such as central and/ or peripheral.


==Classification==
==Classification==
Dizziness may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume=  | issue=  | pages=  | pmid=21250167 | doi= | pmc= | url= }} </ref>:
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume=  | issue=  | pages=  | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue=  | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396  }} </ref>
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue=  | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396  }} </ref>
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* Rotational/spinning sensation
* Rotational/spinning sensation
* Often instantaneous
* Often instantaneous
* Oscillopsia may occur
* [[Oscillopsia]] may occur
* Often accompanied by nausea, vomiting, and a staggering gait
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder
|Vestibular system disorder


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|-
|-
|Type II Dizziness
|Type II Dizziness
(Impending faint/Presyncope)
(Impending faint/[[Presyncope]])
|
|
* Sensation of impending faint/loss of consciousness
* Sensation of impending faint/[[loss of consciousness]]
* Pallor, dimness of vision, roaring in the ears, and diaphoresis may occur
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the recumbent position is common
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
| rowspan="3" |Non Vestibular system disorder
|-
|-
|Type III Dizziness (Disequilibrium)
|Type III Dizziness (Disequilibrium)
|
|
* Loss of balance without an abnormal sensation in the head occurs
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of motor system control
* Occurs as a result of a disorder of [[motor system]] control
|-
|-
|Type IV Dizziness
|Type IV Dizziness
|
|
* Vague lightheadedness occurs
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
* It includes dizziness that cannot be identified with certainty as any of the other types
|}
|}
==Overview==
There is no established system for the classification of vertigo. Classification is based on
OR
[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
OR
[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3].
[Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].
OR
Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
OR
If the staging system involves specific and characteristic findings and features:
According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
OR
The staging of [malignancy name] is based on the [staging system].
OR
There is no established system for the staging of [malignancy name].


==Classification==
==Classification==


There is no established system for the classification of [disease name].
One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>
 
OR
 
[Disease name] may be classified according to [classification method] into [number] subtypes/groups:
*[Group1]
*[Group2]
*[Group3]
*[Group4]


OR
*New episodic:
**With triggers:
***Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
**Without triggers:
***Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)


[Disease name] may be classified into [large number > 6] subtypes based on:
-New continuous:
*[Classification method 1]
  - Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
*[Classification method 2]
  - Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])
*[Classification method 3]


[Disease name] may be classified into several subtypes based on:  
-Chronic, persistent:
*[Classification method 1]
  - Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
*[Classification method 2]
  - Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])
*[Classification method 3]


OR
Vertigo can be further classified into peripheral and central based on the area of pathology (explained further under the pathophysiology section): <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>
-Central:
  -[[Ischemia]] or [[infarction of the brainstem]]
  -[[Vertebrobasilar insuffiency]]
  -[[Demyelination]] syndromes like [[multiple sclerosis]]
  -[[Space occupying lesions]] (both benign and malignant)
  -[[Arnold-Chiari malformation]]
  -[[Vestibular migraine]]


Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
-Peripheral:
 
  -[[Benign Paroxysmal Positional Vertigo]] (BPPV)
OR
  -[[Cogan syndrome]] ([[autoimmune]] condition that affects [[eyes]] and [[inner ears]])
 
  -[[Acoustic neuroma]]
'''If the staging system involves specific and characteristic findings and features:'''
  -[[Herpes zoster]]
 
  -[[Labyrynthitis]]
According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
  -[[Vestibular neuritis]]
 
  -[[Medication toxicity]] (e.g., [[aminoglycosides]], etc)
OR
  -[[Perilymphatic fistula]]
 
The staging of [malignancy name] is based on the [staging system].
 
OR
 
There is no established system for the staging of [malignancy name].


==References==
==References==
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{{WS}}
{{WS}}
[[Category: (name of the system)]]
[[Category: (name of the system)]]
==References==
{{reflist|2}}

Latest revision as of 18:23, 24 April 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Debduti Mukhopadhyay, M.B.B.S[2] Fatimo Biobaku M.B.B.S [3] Norina Usman, M.B.B.S[4]

Overview

Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness. Vertigo can further be classified into timing and trigger as well as based on the area of pathology such as central and/ or peripheral.

Classification

Dizziness may be classified into subtypes based on the symptoms[1]:

Classification of Dizziness[2]
Type of Dizziness Description Origin of Disorder
Type I Dizziness

(Vertigo)

Vestibular system disorder

(Peripheral OR Central)

Type II Dizziness

(Impending faint/Presyncope)

Non Vestibular system disorder
Type III Dizziness (Disequilibrium)
  • Loss of balance without an abnormal sensation in the head occurs
  • Occurs when walking and disappears upon sitting down.
  • Occurs as a result of a disorder of motor system control
Type IV Dizziness
  • Vague lightheadedness occurs
  • It includes dizziness that cannot be identified with certainty as any of the other types

Classification

One way to classify dizziness and vertigo is based on the timing and trigger as follows:[3] 

-New continuous:
  - Post-exposure acute vestibular syndrome (e.g., after gentamicin)
  - Spontaneous acute vestibular syndrome (e.g., stroke of posterior fossa)

-Chronic, persistent:
  - Chronic vestibular syndrome (unilateral vestibular loss, present with head movement)
  - Spontaneous chronic vestibular syndrome (associated with degeneration of cerebellum)

Vertigo can be further classified into peripheral and central based on the area of pathology (explained further under the pathophysiology section): [4][5] 

-Central:
  -Ischemia or infarction of the brainstem
  -Vertebrobasilar insuffiency
  -Demyelination syndromes like multiple sclerosis
  -Space occupying lesions (both benign and malignant)
  -Arnold-Chiari malformation
  -Vestibular migraine

-Peripheral:
  -Benign Paroxysmal Positional Vertigo (BPPV)
  -Cogan syndrome (autoimmune condition that affects eyes and inner ears)
  -Acoustic neuroma
  -Herpes zoster
  -Labyrynthitis
  -Vestibular neuritis
  -Medication toxicity (e.g., aminoglycosides, etc)
  -Perilymphatic fistula

References

  1. ↑ Walker HK, Hall WD, Hurst JW (1990). "Clinical Methods: The History, Physical, and Laboratory Examinations". PMID 21250167.
  2. ↑ Mukherjee A, Chatterjee SK, Chakravarty A (2003). "Vertigo and dizziness--a clinical approach". J Assoc Physicians India. 51: 1095–101. PMID 15260396.
  3. ↑ Newman-Toker DE, Edlow JA (August 2015). "TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo". Neurol Clin. 33 (3): 577–99, viii. doi:10.1016/j.ncl.2015.04.011. PMC 4522574. PMID 26231273.
  4. ↑ Lui F, Foris LA, Willner K, Tadi P. PMID 28722891. Missing or empty |title= (help)
  5. ↑ Baumgartner B, Taylor RS. PMID 28613548. Missing or empty |title= (help)

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