Diagnostic Approaches to the Patient with Dizziness

Tae-Kyeong Lee; Ki-Bum Sung

doi:10.5124/jkma.2008.51.11.960

J Korean Med Assoc > Volume 51(11); 2008 > Article

Lee and Sung: Diagnostic Approaches to the Patient with Dizziness

Focused Issue of This Month

Diagnosis and Treatment of Dizziness

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2008; 51(11): 960-974.

Published online: November 30, 2008

DOI: http://dx.doi.org/10.5124/jkma.2008.51.11.960

Diagnostic Approaches to the Patient with Dizziness

Tae-Kyeong Lee, MD, Ki-Bum Sung, MD

Department of Neurology, Soonchunhyang University College of Medicine, Korea. sungkb@schbc.ac.kr

Abstract

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.

Dizziness; Diagnostic approach; Neuro-otologic examination; Vestibulo-ocular reflex; Vestibular disorders

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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.