Dizziness differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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

References

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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)

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