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Part 1 > Chapter 12　Dizziness and Vertigo

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著者：Evie Marcolini and Matthew S. Siket
 
Abstract
How to assess and manage the dizzy or vertiginous patient with special attention to differentiating the more benign peripheral from the more serious central causes.
 
Keywords
acute vestibular syndrome
associated symptoms
ATTEST
AVS
benign paroxysmal positional vertigo
BPPV
disequilibrium
Dix-Hallpike maneuver
Dizziness
episodic symptoms
Epley maneuver
head impulse test
HINTS exam
imbalance
incoordination
labyrinthitis
lightheadedness
nystagmus
persistent symptoms
room-spinning sensation
test of skew
triggers
vertigo
vestibular neuritis
vestibular neuronitis
vestibular syndrome
wooziness

Presentation  
    The patient presents with a complaint of dizziness, which may be abrupt or gradual in onset. The symptoms may be reported in many different ways, such as lightheadedness, disequilibrium, room-spinning vertigo, imbalance, wooziness, or incoordination. The patient may have persistent symptoms associated with severely debilitating nausea and hence be reluctant to engage in an examination or provocative maneuvers. However, differentiating benign from dangerous causes of dizziness can be challenging, and a careful history and physical examination are key to accurate diagnosis and management.
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