Dizziness
Age: years old
Gender:
HISTORY:
Presents with a - history of dizziness
Described as
Pattern
Episodes last for , and occurred times
Worsening factors:
Alleviating factors: ,
Associated symptoms: *Try using right-click for negatives*
, episodes , ,
, , , ,
Contributing factors:
no history of: , , , , ,
no use of: , , , ,
EXAM:
General appearance: ,
Vital signs: , BP , HR , RR , SpO2 %, Temp °
Ears: tympanic membranes , auditory canal on , hearing
Neck: , , , c-spine
Heart: , ,
Lungs: , ,
Abdomen: , , , , bowel sounds , ,
Skin: on
Extremities: , , cap refill sec, pulses , ,
Neurologic:
- Mental status: , oriented to , speech
- Cranial nerves:
- Strength: except for on ,
- Sensation: to on
- Reflexes: except for on ,
- Cerebellar function: , finger-nose, rapid alternating movements, heel-shin, Romberg , Dix-Hallpike
- Gait: , tandem gait, heel walk and toe walk
ASSESSMENT:
DDx: benign paroxysmal positional vertigo, vestibular neuritis, Meniere's disease, orthostatic hypotension, medication-induced dizziness, dehydration, gastrointestinal bleeding, cardiac arrhythmias, valvular diseases, myocardial infarction, PE, infections, anemia, hypoglycemia, anxiety/panic disorder, central nervous system disorders, cerebellar stroke, brain tumor, vestibular migraine, cervical spondylosis, visual disorders, ear infections, acoustic neuroma, age-related balance dysfunction, alcohol intoxication, peripheral neuropathy
PLAN:
Investigations:
- Blood work: , , , , , ,
- ECG
- Blood pressure monitoring
- Holter monitor
- Echocardiogram
- CT scan of the brain
- MRI of the brain
- Audiogram
- Vestibular tests
Treatments:
-
-
- Dicontinue medications that may cause dizziness (antihypertensives, diuretics, anticonvulsants, sedatives)
- Vestibular rehabilitation therapy
- Lifestyle modifications: , , , ,
Further care:
- Referral to cardiologist
- Referral to neurologist
- Referral to otolaryngologist
- Follow-up in
- Return if dizziness persists, if new symptoms develop such as hearing loss, fainting, or neurological symptoms
HISTORY: Associated symptoms: EXAM: Neurologic: ASSESSMENT: PLAN: