Dizziness physical examination

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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 parkinsonism disease such as small steps and less arm swing.

↑ 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.