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How is dizziness diagnosed?
The diagnosis of dizziness begins with the health care professional
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,
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
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
Blood sugar tests
Kidney function tests
X-rays, CT scans, and
be indicated depending upon the patient's needs.