Vertigo history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
History and Symptoms
- Important factors in history:
- Confirm true vertigo
- True vertigo is described as the room spinning around the patient.
- Once true vertigo is established next step is to identify if the origin of dysfunction is central or peripheral.
- Time course:
- Lasting a Day or Longer: Vestibular neuronitis, vertebrobasilar ischemia with labyrinth infarct, Brainstem stroke, Inferior cerebellar infarct/bleed
- Lasting Minutes to Hours: Meniere’s disease, vertebrobasilar transient ischemic attack (TIA), Migraine headache, Perilymph fistula.
- Lasting Seconds: Benign paroxysmal positional vertigo
- Associated Signs and symptoms:
- Benign paroxysmal positional vertigo: Triggered by a change in head position.
- Vertebrobasilar stroke: diplopia, dysphagia, dysarthria, and numbness or weakness.
- Acoustic neuroma: tinnitus, ear pain, aural fullness, headache, facial weakness.
- Vestibular Migraine: headache, photophobia, visual aura.
- Ménière disease: hearing loss, tinnitus
- Acute labyrinthitis or vestibular neuritis: recent viral infection
- Medication induced: aminoglycosides, anticonvulsants(phenytoin), anti-depressants(tricyclic antidepressants, monoamine oxidase), antihypertensives, diuretics (furosemide), barbiturates, cocaine, nitroglycerin, salicylates
- Confirm true vertigo