Dizziness

What does the patient mean by dizziness?

Vertigo
Impending feint
Loss of balance
Lightheadedness

Does the patient have falls?

Stokes-Adams attacks
Vertebrobasilar insufficiency
Akinetic type of minor epilepsy

Causes of syncope

Cardiac
- - - Stokes-Adams attacks
    - Myocardial infarction
    - Aortic stenosis
    - Pulmonary stenosis
Vasomotor
- - - Simple faint (vasovagal attack)
    - Prolonged standing
    - Hypotensive drugs
Cough and micturition syncope
Hypoglycaemia
Subclavian steal syndrome

Causes of lightheadedness

Cerebrovascular insufficiency
Anaemia
Post-tussive dizziness and syncope
Anxiety
Hyperventilation

Causes of vertigo

Vertebrobasilar insufficiency/cervical spondylosis
Meniere’s disease (vertigo/tinnitus/deafness)
Middle ear disease
Vestibular neuronitis
Benign positional vertigo
Drug therapy
- - - Salicylates
    - Phenytoin
    - Quinine
    - Gentamycin

10-minute consultation: Vertigo J Kanagalingam, D Hajioff, S Bennetthttp://bmj.com/cgi/content/full/330/7490/523?etoc

Rinne and Weber tests

Disease	Weber	Rinne
Middle ear	Better affected side	Bone > air
Inner ear	Better on normal side	Air > bone (both reduced)

[dizziness]

Vertigo (2009)

An approach to the evaluation and management of syncope in adults (2010)

Syncope

Investigations?

Treatment?

Prevention?