Symptoms & Disease
Patients use this term to encompass a variety of sensations like light headedness, faintness, spinning, giddiness, mental confusion, blurred vision or headache.
Dizziness is Classified into four categories.
3 Miscellenous head sensation
4 Gait disturbances
Fainting [Syncope] is a loss of consciousness due to cerebral ischaemia.
It is a hallucination of self or environmental movement. It is a feeling of spinning due to disturbance in vestibular system.
3] Miscelleneous Head Sensations –
These include hyperventilation syndrome, hypoglycemia or somatic symptoms of a clinical depression. These patients will have a normal neurological examination, or vestibular function test.
4] Gait Disturbaces
Some individuals with gait disorders complain of dizziness, despite the absence of vertigo or other abnormal cephalic sensations. The term “dizziness” is used to describe disturbed a mobilty.
e.g: Peripheral neuropathy, Myelopathy, Spasticity, Parkinsonian rigidity, Cerebellar ataxia.
Their may be mild associated light headedness, with impaired sensations from the feet, or poor vision. This is more common in elderly persons who complain of dizziness only during ambulation. This is because a decreased position sense [secondary to neuropathy or myelopathy] and poor vision create an over reliance on the aging vestibular apparatus.
Nausea, postural unsteadiness
Gait ataxia, nystagmus
2. Benign positional vertigo
H/o head trauma
Vertigo on Head Movement in lying
in lying down position
3. Drug Inducted Vertigo
Streptomycin, aminoglycosides, aspiring,
4. Psychogenic Vertigo
Presence of agoraphobia
5. New/incorrect glasses
Correction of glasses
Weakness of one side of body Aphasia
Complete recovery within 24 hours
H/o risk factors like high B.P. smoking, diabetes
Not relieved by
No loss of
Occurs 2-3 hrs after lunch
Confusion/loss of conciousness H/o diabetic.
No sings of anxiety
No Change in pulse rate
B.P. or colour of skin
Romberg Test, Gait Test
Caloric Testing, Electrorystagmography [ENG]
Antihistamines- Meclizine Promethazine
H/o head trauma
Audiometry and caloric testing within normal limits
Specific exercise program of head and neck.
Stop the drug [e.g. Aspirin, Streptomycin, Aminoglycoside]
No symptoms of vestibular system or CNS involvement.
Correction of Glasses
Absecve of ear symptoms
Presence of risk factors
e.g. Family History
High Blood Cholesterol
Low fat diet
Treatment of High B.P. and Diabetes
Forced hyperventilation for one minute will reproduce an attack of anxiety. No ear symptoms. No loss of Consciousness.
Glucose tolerance test matching between exercise and insulin dosage.
No change in pulse rate
B.P. or skin colour
Psychiatric counseling behavioral therapy