Vertigo
HISTORY:
Vertigo for
Type:
Pattern:
Episodes: , lasts for
Frequency: times
Worsening factors:
Alleviating factors: ,
, episodes , ,
Occupation: risk of injury for self or others
Driving license:
Other elements:
EXAM:
General appearance:
Vital signs: , BP , HR , RR , SpO2 %, Temp °
Ears: -R: , -L:
Neck:
Heart: ,
Lungs: ,
Abdomen: , , ,
Skin:
Extremities: , , cap refill , pulses ,
Neurologic:
- Mental status: , oriented in , speech
- Cranial nerves:
- Strength: upper extremities -R /5 , -L /5
lower extremities -R /5 , -L /5
- Sensation: upper extremities -R , -L ,
lower extremities -R , -L
- Reflexes: triceps -R , -L , biceps -R , -L , brachioradialis -R , -L
patellar -R , -L , achilles -R , -L , plantar -R , -L
- Cerebellar function: , finger-nose , rapid alternating movements , heel-knee , Romberg , Dix-Hallpike ,
- Gait: , tandem walking , heel and toe walking
ASSESSMENT:
DDx:
PLAN:
- Blood work: , , , ,
- ECG
- Audiogram
- Vestibular tests
- CT scan of the brain
- MRI of the brain
-
-
- Stop medications that may contribute to vertigo (antihypertensives, sedatives)
- Vestibular Rehabilitation Therapy
- Dietary modifications: , ,
- Referral to otolaryngologist
- Referral to neurologist
- Follow-up in
- Return if vertigo worsens, if new symptoms develop such as hearing loss, tinnitus, or severe headache