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Feature Article

The dizzy patient: a practical approach

David Pohl

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Abstract

Dizziness is a continuum of sensations ranging from light headedness or faintness to spinning or a feeling of imbalance. A history of the duration of attacks, precipitating factors and accompanying features is vital in reaching a practical understanding of the cause.

Key Points

  • ‘Vertigo’ generally describes a sensation or perception of motion of oneself or one’s environment.
  • Commonly, ‘dizziness’ refers to a continuum of sensations ranging from light headedness or faintness to spinning or a feeling of imbalance.
  • Determining the duration of attacks, precipitating factors and accompanying features is vital in reaching a practical understanding of the cause of vertigo in any particular patient.
  • When confronted with an acutely vertiginous patient in whom a diagnosis is yet to be made, the primary aim is to reduce rotational symptoms with the attendant nausea and vomiting.
  • The longer a patient remains immobile after an acute vestibular insult, the less likely full recovery will occur.

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