Abstract
The evaluation of patients presenting with vestibular complaints begins with a thorough and structured history and physical examination, which is then augmented by audiologic, vestibular, and radiologic testing. While these ancillary tests are important in establishing a definitive diagnosis, a complete and accurate history and physical exam is critical to narrowing down the differential diagnosis and results in cost-effective use of testing.
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References
Kentala E, Rauch SD. A practical assessment algorithm for diagnosis of dizziness. Otolaryngol Head Neck Surg. 2003;128(1):54–9.
Hullar TE, Zee DS, Minor LB. Evaluation of the patient with dizziness. In: Flint PW, Haughey BH, Lund VJ, et al., editors. Cummings otolaryngology—head & neck surgery. 6th ed. Philadelphia: Saunders; 2015. p. 2301–18.
Kutz JW Jr. The dizzy patient. Med Clin North Am. 2010;94(5):989–1002.
Lopez-Escamez JA, Carey J, Chung WH, et al. Diagnostic criteria for Menière’s disease. J Vestib Res Equilib Orientat. 2015;25(1):1–7.
Lee H, Sohn S-I, Cho Y-W, et al. Cerebellar infarction presenting isolated vertigo: frequency and vascular topographical patterns. Neurology. 2006;67(7):1178–83.
Minor LB, Solomon D, Zinreich JS, Zee DS. Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal. Arch Otolaryngol Head Neck Surg. 1998;124(3):249–58.
Minor LB. Superior canal dehiscence syndrome. Am J Otol. 2000;21(1):9–19.
Minor LB. Clinical manifestations of superior semicircular canal dehiscence. Laryngoscope. 2005;115(10):1717–27.
O’Connell Ferster AP, Priesol AJ, Isildak H. The clinical manifestations of vestibular migraine: a review. Auris Nasus Larynx. 2017;44(3):249–52.
Lempert T, Olesen J, Furman J, et al. Vestibular migraine: diagnostic criteria. J Vestib Res. 2012;22(4):167–72.
Strupp M, Feil K, Dieterich M, Brandt T. Bilateral vestibulopathy. Handb Clin Neurol. 2016;137:235–40.
Bauer CA, Jenkins HA. Otologic symptoms and syndromes. In: Flint PW, Haughey BH, Lund VJ, et al., editors. Cummings otolaryngology—head & neck surgery. 6th ed. Philadelphia: Saunders; 2015. p. 2401–10.
Locke AB, Kirst N, Shultz CG. Diagnosis and management of generalized anxiety disorder and panic disorder in adults. Am Fam Physician. 2015;91(9):617–24.
Brandt T, Dieterich M. The dizzy patient: don’t forget disorders of the central vestibular system. Nat Rev Neurol. 2017;13(6):352–62.
Karatas M. Central vertigo and dizziness. Neurologist. 2008;14(6):355–64.
Shoair OA, Nyandege AN, Slattum PW. Medication-related dizziness in the older adult. Otolaryngol Clin N Am. 2011;44(2):455–71.
Schwartz FD. Vestibular toxicity of gentamicin in the presence of renal disease. Arch Intern Med. 1978;138(11):1612–3.
Black FO, Pesznecker S, Stallings V. Permanent gentamicin vestibulotoxicity. Otol Neurotol. 2004;25(4):559–69.
O’Malley MR, Haynes DS. Clinical diagnosis. In: Gulya AJ, Minor LB, Poe DS, editors. Glasscock-Shambaugh surgery of the ear. 6th ed. Shelton CT: PMPH-USA; 2010. p. 171–88.
von Brevern M, Bertholon P, Brandt T, et al. Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res. 2015;25(3–4):105–17.
Hennebert C. A new syndrome in hereditary syphilis of the labyrinth. Presse Med Belg Brux. 1911;63:467.
Nadol JB Jr. Positive Hennebert’s sign in Meniere’s disease. Arch Otolaryngol. 1977;103(9):524–30.
Dix MR, Hallpike CS. The pathology symptomatology and diagnosis of certain common disorders of the vestibular system. Proc R Soc Med. 1952;45(6):341–54.
Imai T, Takeda N, Ikezono T, et al. Classification, diagnostic criteria and management of benign paroxysmal positional vertigo. Auris Nasus Larynx. 2017;44(1):1–6.
Hain TC, Fetter M, Zee DS. Head-shaking nystagmus in patients with unilateral peripheral vestibular lesions. Am J Otolaryngol. 1987;8(1):36–47.
Newman-Toker DE, Kattah JC, Alvernia JE, Wang DZ. Normal head impulse test differentiates acute cerebellar strokes from vestibular neuritis. Neurology. 2008;70(24, Part 2):2378–85.
Angeli SI, Velandia S, Snapp H. Head-shaking nystagmus predicts greater disability in unilateral peripheral vestibulopathy. Am J Otolaryngol. 2011;32(6):522–7.
Goebel JA. The ten-minute examination of the dizzy patient. Semin Neurol. 2001;21(4):391–8. https://doi.org/10.1055/s-2001-19410.
Ruggles RL, Koconis CA. Tympanic perforations: safe or not? Laryngoscope. 1967;77(3):337–40.
Chole RA. Chronic otitis media, mastoiditis, and petrositis. In: Flint PW, Haughey BH, Lund VJ, et al., editors. Cummings otolaryngology—head & neck surgery. 6th ed. Philadelphia: Saunders; 2015. p. 2139–55.
House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93(2):146–7.
House JW, Doherty JK, Fisher LM, et al. Meniere’s disease: prevalence of contralateral ear involvement. Otol Neurotol. 2006;27(3):355–61.
Staab JP, Eckhardt-Henn A, Horii A, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): consensus document of the committee for the classification of vestibular disorders of the barany society. J Vestib Res Equilib Orientat. 2017;27(4):191–208.
DeFlorio PT, Silbergleit R. Mal de debarquement presenting in the emergency department. J Emerg Med. 2006;31(4):377–9.
Cha Y-H. Mal de debarquement. Semin Neurol. 2009;29(5):520–7.
Yew A, Zarinkhou G, Spasic M, Trang A, Gopen Q, Yang I. Characteristics and management of superior semicircular canal dehiscence. J Neurol Surg B Skull Base. 2012;73(6):365–70.
Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE. HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Stroke. 2009;40(11):3504–10.
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Killeen, D.E., Isaacson, B., Walter Kutz, J. (2019). History and Physical Examination of the Dizzy Patient. In: Babu, S., Schutt, C., Bojrab, D. (eds) Diagnosis and Treatment of Vestibular Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-97858-1_3
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DOI: https://doi.org/10.1007/978-3-319-97858-1_3
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