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J Korean Med Assoc > Volume 51(11); 2008 > Article
Lee and Sung: Diagnostic Approaches to the Patient with Dizziness


Dizziness is one of the most commonly presenting complaints in clinical practice. However, a systematic diagnostic approach to the dizzy patient remains challenging due to the wide range of diagnostic possibilities. As a symptom, dizziness is quite subjective and is resulted from diverse conditions. Therefore, classifying the patient's complaints into the etiology oriented categories through detailed histories should be the first step of the approach. Physicians should be acquainted with skills for the history taking and a brief but comprehensive neuro-otologic examination which can be done easily in clinical practice. This article focused on practical skills for history taking and bedside examination in the diagnostic approaches to the patient with dizziness.


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Table 1
Subtypes of dizziness

BPPV: benign paroxysmal positioning vertigo, VN: vestibular neuritis, MD: meniere's disease, MD: migrainous vertigo, VBI: vertebrobasialr insufficiency, OH: orthostatic hypotension, CHF: congestive heart failure.

Table 2
Differences between central and peripheral positional vertigo
Table 3
Differential points between central and peripheral vertigo
Table 4
Evaluation of static and dynamic vestibular imbalance
Table 5
Differences between central and peripheral nystagmus
Table 6
Pattern of nystagmus after horizontal head shaking
Table 7
Routine neuro-otologic tests


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