Dizziness - Diagnosis

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How is dizziness diagnosed?

The diagnosis of dizziness begins with the health care professional evaluating whether the complaint of dizziness refers to lightheadedness or vertigo. Further direction continues once this distinction is made.

The key to the diagnosis of dizziness is a thorough history and physical examination. Often the diagnosis is made by listening to the patient's story. The health care professional may ask about triggers that cause and relieve the symptoms of dizziness.

  • "Is it related to changing positions quickly?"
  • "Does it resolve on its own or does the patient have to do something, like lie down to make it better?"
  • "Does turning the head bring on the symptoms? Do they resolve when the patient is very still?"
  • "Is there associated hearing loss or ringing in the ears?"

A review of systems is a series of questions that review the patient's body functions. Questions may be asked about associated symptoms including fever, vomiting, diarrhea, chest pain, shortness of breath, palpitations, or abnormal bleeding. The past medical history may be reviewed, and this includes reviewing medications the patient is currently taking.

A thorough physical examination will likely be done; this may include:

Vital signs: Taking the patient's blood pressure and pulse rate lying down and standing (called orthostatic or postural vital signs) often will indicate the fluid status of the body. In patients who are dehydrated or bleeding, the vital signs may rise on changing position. However, patients taking medications such as beta blockers will not generate an increased pulse rate.

Tailored physical examination: Often, the physical examination is tailored to the patient based upon the information provided in the patient's medical history. For example, a woman with a heavy menstrual period may need a pelvic examination, or a patient with cough and shortness of breath may need a closer examination of the heart and lungs. A patient thought to have vertigo will have closer focus on the neurologic exam, including the cerebellum, the portion of hte brain responsible for balance and coordination.

Imaging studies and blood tests: The need for imaging studies and/or and blood tests will depend on the concerns the health care professional and patient have in regard to the cause of the dizziness. Common tests that may be ordered include:

  • Complete blood count (CBC) to screen for anemia or infection
  • Electrolyte levels
  • Blood sugar tests
  • Kidney function tests
  • Thyroid tests

X-rays, CT scans, and MRI may be indicated depending upon the patient's needs.

Return to Dizziness

See what others are saying

Comment from: ninkinindy, 55-64 Female (Patient) Published: May 21

When I"m dizzy if I close my eyes it feels like everything around me is moving; side to side and up and down. It feels like I"m on a boat with rough seas. I have some or all of the following: headache, blurred/double vision, poor balance - I look like I"m drunk; I am sweaty, very spacy, very shaky, and can"t think or remember. The doctor sent me to the emergency room (ER) for blood work and an MRI which was, thankfully, normal. Diagnosis was vertigo. I"d had some of the symptoms off and on for months, and couldn"t figure out why I felt so bad. I have many medical problems but none that would account for this. No medicines were prescribed, but ER doctor suggested Benadryl if symptoms got bad again. Last few days I"ve felt relatively normal. I"ve been referred to a neurologist. I"ve been told there"s not a lot that can be done for vertigo, but I"ll appreciate any relief.

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Comment from: radha, 35-44 Female (Patient) Published: May 21

I feel spaced out for a split second, while sitting, walking, talking, etc. Sometimes my vision gets blurred. This has been continuing for a week now. Six months back I had sustained a blunt head injury.

Was this comment helpful?Yes

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