Dizzyness

Questions to ask:

At the grocery store, are you stable while holding the grocery cart?

Yes. Dysequilibrium of Age; Multisensory deficit.

Do you get dizzy when you turn over in bed for a short duration

Yes. Change in head position relative to gravity with repeated spinning sensation.  BPPV

Dx: Dix-Hallpike; Tx: Epley manuever.

Was your first attack a sever vertigo lasting hours to days with nausea and vomiting?

Vestibular neuritis.  Spinning every day.  Pt will develop central compesnation.  Slower recovery with age.

Tx: Physica therapy, vestibular rehab.  Do not use meclizine.

Does your ear feel full before or during your dizzy attack?

Yes. Meniere's.  Tx: Diet, meds, surg.

Does it occur with migrain symptoms and last approximately 30 minutes?

Vestibular Migraine.  Typically a 30F.

Reasons not to send to ENT:

Do you pass out completely with your dizzyness? (Never the ear; need neurologist)

Do you get lightheaded when you get up from a chair/bed? (Orthostasis)

Photosensitive? Migraine.

Neck Problems

Problems with feet? eyes? Neck? Ears?