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: Faith, 35-44 Female (Patient) Published: August 19

I had shakiness, dizziness, nausea, heart palpitations, and brain fog until I became totally home bound. I saw 50 doctors until one looked at my five inch thick chart and all these tests. I thought I had mycotoxins poisoning which is black mold. How is that possible! Well, we tore open a wall to look inside, and guess what, behind the sheet rock we had hidden black mold in our house. The mold was odorless, and invisible. We moved into our condominium and I slowly got better; it took 14 months to get well!

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Comment from: Eileen, 75 or over Female (Patient) Published: November 11

I have been having blackouts or near blackouts for about two years. It only happens at night. It started with one episode every four months to three weeks to three months with having about six in a cluster. I have had every test for heart, head and even kidneys. The doctors can't find anything. It's scary. Last night I woke up, and had a blackout followed with a hot flash and nausea. I had about six more.

Was this comment helpful?Yes


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