Dizziness (Dizzy) (cont.)
How is vertigo diagnosed?
The diagnosis of vertigo is most often made based upon history and clinical
presentation. If the patient is experiencing a spinning sensation that worsens by
a change in position, and
lessens by lying still, the health care practitioner can confirm the cause of
dizziness as vertigo.
Further history may be taken to make certain that the symptom of vertigo is
isolated to an inner ear condition and not due to a problem in the brain (for
example, a stroke).
Neurological examination
Physical examination will focus on the neurologic examination and may involve
looking at eye movements. With vertigo, nystagmus may be
present. This is an involuntary movement of the eyes, slow and smooth in one
direction with fast twitches in the other. It is the eyes' attempt to compensate
for the abnormal
signals being created in the inner ear.
The patient's hearing may be tested to assess
potential hearing loss. This may be seen in Meniere's Disease or with an acoustic neuroma, but not necessarily with labyrinthitis or benign positional
vertigo.
The rest of the neurologic examination may be done to look for
one-sided weakness or loss of coordination as potential signs of stroke.
Evaluation for BPPV or labyrinthitis is often complete at this point,
although depending upon the health care practitioner's concerns, further testing may
be indicated. Referral may be made to a physical therapist specially trained in
vestibular therapy.
If there is confusion as to the potential cause of
vertigo, imaging of the brain may be needed. Magnetic resonance imaging (MRI)
may be indicated since this test evaluates the cerebellum more accurately. Computerized tomography
(CT scan) may be used in an emergency to
assess bleeding.
Next: How is dizziness treated? »
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