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8 - Dizziness

from SECTION II - COMMON NEUROLOGICAL PRESENTATIONS

Published online by Cambridge University Press:  06 August 2009

By
Kevin M. Kelly ,
Steven A. Tellan ,
Moises A. Arriaga  and
Thomas M. Stein
Edited by
Sid M. Shah  and
Kevin M. Kelly
Kevin M. Kelly
Affiliation:
Associate Professor of Neurology Drexel University College of Medicine
Steven A. Tellan
Affiliation:
Department of Otolaryngology University of Michigan Ann Arbor, Michigan
Moises A. Arriaga
Affiliation:
Department of Neuro–otology Allegheny General Hospital Pittsburgh, Pennsylvania
Thomas M. Stein
Affiliation:
Department of Emergency Medicine Allegheny General Hospital Pittsburgh, Pennsylvania
Sid M. Shah
Affiliation:
Michigan State University
Kevin M. Kelly
Affiliation:
Drexel University, Philadelphia
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Summary

Dizziness or vertigo is frequently caused by a disorder of the vestibular system. The central vestibular system includes the vestibular nuclei and their central nervous system (CNS) connections. A carefully obtained history is critical in the evaluation of a patient's complaint of dizziness or vertigo. This is important diagnostically because vertigo usually results from vestibular system disorders, whereas nonvertiginous dizziness usually results from nonvestibular system disorders. The differential diagnosis of dizziness or vertigo can be approached by determining whether the disorder is due to an abnormality of the vestibular system or of nonvestibular systems. Imaging studies of the skull and brain may be indicated in the evaluation of a patient with dizziness or vertigo. A patient who presents to the emergency department (ED) acutely ill with vertigo accompanied by severe nausea and vomiting requires immediate stabilization. Benzodiazepines can be used acutely to treat moderately severe anxiety syndromes that cause dizziness.

Keywords

benzodiazepinesbraincentral nervous systemdizzinessnucleivertigovestibular systemnauseavomitting
Type
Chapter
Information
Principles and Practice of Emergency Neurology
Handbook for Emergency Physicians
 , pp. 68 - 91
Publisher: Cambridge University Press
Print publication year: 2003

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References

Epley, J M. The canalith repositioning procedure for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 1992; 107: 399–404CrossRefGoogle ScholarPubMed
Parnes, L S, Price-Jones, R G. Particle repositioning maneuver for treatment of benign paroxysmal vertigo. Ann Otol Rhinol Laryngol. 1993; 102: 325–31CrossRefGoogle Scholar
Shepard, N T, Telian, S A. Programmatic vestibular rehabilitation. Otolaryngol Head Neck Surg. 1995; 112: 173–82CrossRefGoogle ScholarPubMed
Smith D B. Dizziness: a clinical perspective. In: Kaufman A I, Smith D B, eds. Neurologic Clinics: Diagnostic Neurotology. Philadelphia, Pa: WB Saunders; 1990: 8
Victor M, Ropper A H. Adams and Victor's Principles of Neurology, 7th ed. New York, NY: McGraw-Hill: 2001

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  • Dizziness
    • By Kevin M. Kelly, Associate Professor of Neurology Drexel University College of Medicine, Steven A. Tellan, Department of Otolaryngology University of Michigan Ann Arbor, Michigan, Moises A. Arriaga, Department of Neuro–otology Allegheny General Hospital Pittsburgh, Pennsylvania, Thomas M. Stein, Department of Emergency Medicine Allegheny General Hospital Pittsburgh, Pennsylvania
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.009
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  • Dizziness
    • By Kevin M. Kelly, Associate Professor of Neurology Drexel University College of Medicine, Steven A. Tellan, Department of Otolaryngology University of Michigan Ann Arbor, Michigan, Moises A. Arriaga, Department of Neuro–otology Allegheny General Hospital Pittsburgh, Pennsylvania, Thomas M. Stein, Department of Emergency Medicine Allegheny General Hospital Pittsburgh, Pennsylvania
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.009
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Dizziness
    • By Kevin M. Kelly, Associate Professor of Neurology Drexel University College of Medicine, Steven A. Tellan, Department of Otolaryngology University of Michigan Ann Arbor, Michigan, Moises A. Arriaga, Department of Neuro–otology Allegheny General Hospital Pittsburgh, Pennsylvania, Thomas M. Stein, Department of Emergency Medicine Allegheny General Hospital Pittsburgh, Pennsylvania
  • Edited by Sid M. Shah, Michigan State University, Kevin M. Kelly, Drexel University, Philadelphia
  • Book: Principles and Practice of Emergency Neurology
  • Online publication: 06 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511547256.009
Available formats
×