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Dizziness pathophysiology

2021-03-02T16:05:27Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral:

-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.

-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.

-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.

-Systemic or central vestibular dysfunction: involves the vestibular nuclei.

-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.

-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.

-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central causes can be further divided based on issues with circulation and other miscellaneous causes as follows

-Circulation related causes:

-Cardiogenic, such as: infarction, occlusion. Conditions that compromise blood supply to the brain for example; cardiac failure, aortic stenosis, arrhythmia, etc can causes dizziness.
-Occlusion of the carotid artery: usually not a cause for dizziness unless both anterior and posterior circulations are compromised.
-Cerebrovascular accidents which involve both large and small vessel ischemia or stroke.
-Large vessel syndromes:
-Veretebrobasilar insufficiency
-Vertebral artery thrombosis
-Basilar artery thrombosis
-Small vessel syndromes:
-Wallenberg(Lateral medullary) syndrome: accompanying features are Horner's syndrome, dysarthria, hemiataxia
-Anterior inferior cerebellar artery syndrome- labyrinthine artery ischemia causing unilateral deafness, ataxia and facial weakness
-Labyrythnine artery syndrome
-Other causes:

-Acoustic neuroma: benign tumor of the eighth cranial nerve causing hearing loss that is high frequency and sensorineural. Unilateral tinnitus, dizziness is seen in <20% of the population, upto 70% may have imbalance.
-Cervicogenic
-Metabolic dizziness: comprising of low blood sugar (hypoglycemia) and accompanied by other symptoms such as tremors, palpitations, sweating, etc. Thyroid conditions (both hypothyroidism and hyperthyroidism) as well as low blood magnesium levels can also cause dizziness.
-Migraine- Neuhauser and his colleagues formed the following list of criteria for migrainous vertigo:
-recurrent attacks of vertigo
-headache meeting criteria of International Headache Society
-At least one of the following symptoms during at least two of these attacks: migraine headache, intolerance to light, intolerance to sound, presence of an aura, absence of other causes
-Pathophysiologic- integration of the visual, vestibular, autonomic, and proprioceptive systems. Not necessarily pathologic, example: feeling of falling while standing on the ledge of a building that is very tall.
-Anxiety and related disorders: may or may not be related to hyperventilation. Possible exacerbation by a vestibular syndrome. Phobic dizziness/ postural vertigo is the fear of falling without gait instability. Usually associated with panic disorder or agoraphobia.
-Vestibular epilepsy: episode of dizziness or vertigo accompanied by a seizure or preceding the aura.

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T15:35:47Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral:

-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.

-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.

-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.

-Systemic or central vestibular dysfunction: involves the vestibular nuclei.

-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.

-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.

-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central causes can be further divided based on issues with circulation and other miscellaneous causes as follows

-Circulation related causes:

-Cardiogenic, such as: infarction, occlusion. Conditions that compromise blood supply to the brain for example; cardiac failure, aortic stenosis, arrhythmia, etc can causes dizziness.
-Occlusion of the carotid artery: usually not a cause for dizziness unless both anterior and posterior circulations are compromised.
-Cerebrovascular accidents which involve both large and small vessel ischemia or stroke.
-Large vessel syndromes:
-Veretebrobasilar insufficiency
-Vertebral artery thrombosis
-Basilar artery thrombosis
-Small vessel syndromes:
-Wallenberg(Lateral medullary) syndrome: accompanying features are Horner's syndrome, dysarthria, hemiataxia
-Anterior inferior cerebellar artery syndrome- labyrinthine artery ischemia causing unilateral deafness, ataxia and facial weakness
-Labyrythnine artery syndrome
-Other causes:

-Acoustic neuroma: benign tumor of the eighth cranial nerve causing hearing loss that is high frequency and sensorineural. Unilateral tinnitus, dizziness is seen in <20% of the population, upto 70% may have imbalance.
-Cervicogenic
-Metabolic dizziness: comprising of low blood sugar (hypoglycemia) and accompanied by other symptoms such as tremors, palpitations, sweating, etc. Thyroid conditions (both hypothyroidism and hyperthyroidism) as well as low blood magnesium levels can also cause dizziness.
-Migraine- Neuhauser and his colleagues formed the following list of criteria for migrainous vertigo:
-recurrent attacks of vertigo
-headache meeting criteria of International Headache Society
-At least one of the following symptoms during at least two of these attacks: migraine headache, intolerance to light, intolerance to sound, presence of an aura, absence of other causes
-Pathophysiologic
-Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T15:18:20Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral:

-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.

-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.

-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.

-Systemic or central vestibular dysfunction: involves the vestibular nuclei.

-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.

-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.

-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central causes can be further divided based on issues with circulation and other miscellaneous causes as follows

-Circulation related causes:

-Cardiogenic, such as: infarction, occlusion. Conditions that compromise blood supply to the brain for example; cardiac failure, aortic stenosis, arrhythmia, etc can causes dizziness.
-Occlusion of the carotid artery: usually not a cause for dizziness unless both anterior and posterior circulations are compromised.
-Cerebrovascular accidents which involve both large and small vessel ischemia or stroke.
-Large vessel syndromes:
-Veretebrobasilar insufficiency
-Vertebral artery thrombosis
-Basilar artery thrombosis
-Small vessel syndromes:
-Wallenberg(Lateral medullary) syndrome: accompanying features are Horner's syndrome, dysarthria, hemiataxia
-Anterior inferior cerebellar artery syndrome- labyrinthine artery ischemia causing unilateral deafness, ataxia and facial weakness
-Labyrythnine artery syndrome
-Other causes:

-Acoustic neuroma: benign tumor of the eighth cranial nerve causing hearing loss that is high frequency and sensorineural. Unilateral tinnitus, dizziness is seen in <20% of the population, upto 70% may have imbalance.
-Cervicogenic
-Metabolic dizziness: comprising of low blood sugar (hypoglycemia) and accompanied by other symptoms such as tremors, palpitations, sweating, etc. Thyroid conditions (both hypothyroidism and hyperthyroidism) as well as low blood magnesium levels can also cause dizziness.
-Migraine
-Pathophysiologic
-Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T14:59:48Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral:

-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.
-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.

-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.

-Systemic or central vestibular dysfunction: involves the vestibular nuclei.

-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.

-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.

-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central causes can be further divided based on issues with circulation and other miscellaneous causes as follows

-Circulation related causes:

-Cardiogenic, such as: infarction, occlusion. Conditions that compromise blood supply to the brain for example; cardiac failure, aortic stenosis, arrhythmia, etc can causes dizziness
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T14:58:51Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral:

-.Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.

-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.

-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.

-Systemic or central vestibular dysfunction: involves the vestibular nuclei.

-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.

-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.

-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central causes can be further divided based on issues with circulation and other miscellaneous causes as follows

-Circulation related causes:

-Cardiogenic, such as: infarction, occlusion. Conditions that compromise blood supply to the brain for example; cardiac failure, aortic stenosis, arrhythmia, etc can causes dizziness
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T14:58:06Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral:

-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.

-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.

-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.

-Systemic or central vestibular dysfunction: involves the vestibular nuclei.

-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.

-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.

-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central causes can be further divided based on issues with circulation and other miscellaneous causes as follows

-Circulation related causes:

-Cardiogenic, such as: infarction, occlusion. Conditions that compromise blood supply to the brain for example; cardiac failure, aortic stenosis, arrhythmia, etc can causes dizziness
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T14:54:36Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral:

-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.

-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.

-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.

-Systemic or central vestibular dysfunction: involves the vestibular nuclei.

-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.

-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.

-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central:

-Circulation related causes:
--Cardiogenic like infarction, occlusion
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T14:53:45Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral:

-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.
-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.
-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.
-Systemic or central vestibular dysfunction: involves the vestibular nuclei.
-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.
-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.
-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central:

-Circulation related causes:
--Cardiogenic like infarction, occlusion
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T14:52:45Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral:

1. Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.
2.Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.
3.Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.
4.Systemic or central vestibular dysfunction: involves the vestibular nuclei.
5.Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.
6.BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.
7.Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central
-Circulation related causes:
--Cardiogenic like infarction, occlusion
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T14:52:06Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral:

1. Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.
-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.
-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.
-Systemic or central vestibular dysfunction: involves the vestibular nuclei.
-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.
-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.
-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central
-Circulation related causes:
--Cardiogenic like infarction, occlusion
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T14:50:55Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral

-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.
-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.
-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.
-Systemic or central vestibular dysfunction: involves the vestibular nuclei.
-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.
-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.
-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central
-Circulation related causes:
--Cardiogenic like infarction, occlusion
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T14:50:34Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral

-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.
-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.
-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.
-Systemic or central vestibular dysfunction: involves the vestibular nuclei.
-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.
-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.
-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central
-Circulation related causes:
--Cardiogenic like infarction, occlusion
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-02T14:49:52Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral
-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.
-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.
-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.
-Systemic or central vestibular dysfunction: involves the vestibular nuclei.
-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.
-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.
-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central
-Circulation related causes:
--Cardiogenic like infarction, occlusion
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-01T01:08:04Z

Debduti Mukhopadhyay: /* Pathophysiology */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Meniere's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Pathophysiology==
The pathophysiology of [[dizziness]] depends on the etiological subtype, and area of pathology involved<ref name="pmid11510399">{{cite journal| author=Hanley K, O'Dowd T, Considine N| title=A systematic review of vertigo in primary care. | journal=Br J Gen Pract | year= 2001 | volume= 51 | issue= 469 | pages= 666-71 | pmid=11510399 | doi= | pmc=1314080 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11510399 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10569302">{{cite journal| author=Hoffman RM, Einstadter D, Kroenke K| title=Evaluating dizziness. | journal=Am J Med | year= 1999 | volume= 107 | issue= 5 | pages= 468-78 | pmid=10569302 | doi=10.1016/s0002-9343(99)00260-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10569302 }} </ref><ref name="pmid12574760">{{cite journal| author=Kentala E, Rauch SD| title=A practical assessment algorithm for diagnosis of dizziness. | journal=Otolaryngol Head Neck Surg | year= 2003 | volume= 128 | issue= 1 | pages= 54-9 | pmid=12574760 | doi=10.1067/mhn.2003.47 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12574760 }} </ref>.
{| class="wikitable"
|+Pathophysiology based on the causes
!Cause
!Pathophysiology
!Category of dizziness
|-
|[[Orthostatic hypotension]]
|It is a drop in [[blood pressure]] on changing the position or can be due to the side effect of the medicine
|[[Presyncope]]
|-
|[[Benign paroxysmal positional vertigo]]
|The [[semicircular canal]] contains loose [[otolith]], which gives a false sense of motion.
|[[Vertigo]]
|-
|[[Meniere's disease]]
|Excessive [[endolymphatic]] fluid in the [[inner ear]]
|[[Vertigo]]
|-
|[[Hyperventilation syndrome]]
|Hyperventilation leads to [[respiratory alkalosis]]
|[[Lightheadedness]]
|-
|[[Peripheral neuropathy]]
|Decrease [[tactile sensation]] may cause patients to lack the feeling of feet to be touched to the ground leading to [[falls]] and [[imbalance]].
|[[Disequilibrium]]
|-
|[[Parkinson disease]]
|[[Gait]] dysfunction cause falls and imbalance
|Disequilibrium
|-
|Vestibular [[migraine]]
|Uncertain
|Vertigo
|}

The pathophysiology of dizziness can be explained according to one of its classification systems based on central and peripheral, although there is often overlap between the two. <ref name="pmid3875013">{{cite journal |vauthors=Hughes GB, Kinney SE, Hamid MA, Barna BP, Calabrese LH |title=Autoimmune vestibular dysfunction: preliminary report |journal=Laryngoscope |volume=95 |issue=8 |pages=893–7 |date=August 1985 |pmid=3875013 |doi=10.1288/00005537-198508000-00001 |url=}}</ref> <ref name="pmid7224522">{{cite journal |vauthors=Goodhill V |title=Ben H. Senturia lecture. Leaking labyrinth lesions, deafness, tinnitus and dizziness |journal=Ann Otol Rhinol Laryngol |volume=90 |issue=2 Pt 1 |pages=99–106 |date=1981 |pmid=7224522 |doi=10.1177/000348948109000201 |url=}}</ref> <ref name="pmid11710462">{{cite journal |vauthors=Oas JG |title=Benign paroxysmal positional vertigo: a clinician's perspective |journal=Ann N Y Acad Sci |volume=942 |issue= |pages=201–9 |date=October 2001 |pmid=11710462 |doi=10.1111/j.1749-6632.2001.tb03746.x |url=}}</ref> <ref name="pmid2932668">{{cite journal |vauthors=Pearson BW, Brackmann DE |title=Committee on Hearing and Equilibrium guidelines for reporting treatment results in Meniere's disease |journal=Otolaryngol Head Neck Surg |volume=93 |issue=5 |pages=579–81 |date=October 1985 |pmid=2932668 |doi=10.1177/019459988509300501 |url=}}</ref> <ref name="pmid9525507">{{cite journal |vauthors=Minor LB, Solomon D, Zinreich JS, Zee DS |title=Sound- and/or pressure-induced vertigo due to bone dehiscence of the superior semicircular canal |journal=Arch Otolaryngol Head Neck Surg |volume=124 |issue=3 |pages=249–58 |date=March 1998 |pmid=9525507 |doi=10.1001/archotol.124.3.249 |url=}}</ref> <ref name="pmid11222783">{{cite journal |vauthors=Neuhauser H, Leopold M, von Brevern M, Arnold G, Lempert T |title=The interrelations of migraine, vertigo, and migrainous vertigo |journal=Neurology |volume=56 |issue=4 |pages=436–41 |date=February 2001 |pmid=11222783 |doi=10.1212/wnl.56.4.436 |url=}}</ref> <ref name="pmid24427594">{{cite journal |vauthors=Xie S, Guo J, Wu Z, Qiang D, Huang J, Zheng Y, Yao Q, Chen S, Tian D |title=Vibration-induced nystagmus in patients with unilateral peripheral vestibular disorders |journal=Indian J Otolaryngol Head Neck Surg |volume=65 |issue=4 |pages=333–8 |date=December 2013 |pmid=24427594 |pmc=3851498 |doi=10.1007/s12070-013-0638-6 |url=}}</ref> <ref name="pmid11153554">{{cite journal |vauthors=Wrisley DM, Sparto PJ, Whitney SL, Furman JM |title=Cervicogenic dizziness: a review of diagnosis and treatment |journal=J Orthop Sports Phys Ther |volume=30 |issue=12 |pages=755–66 |date=December 2000 |pmid=11153554 |doi=10.2519/jospt.2000.30.12.755 |url=}}</ref> <ref name="pmid11094095">{{cite journal |vauthors=Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, Hain T, Goebel J, Demer J, Eviatar L |title=Assessment: vestibular testing techniques in adults and children: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology |journal=Neurology |volume=55 |issue=10 |pages=1431–41 |date=November 2000 |pmid=11094095 |doi=10.1212/wnl.55.10.1431 |url=}}</ref> <ref name="pmid7443266">{{cite journal |vauthors=Epley JM |title=New dimensions of benign paroxysmal positional vertigo |journal=Otolaryngol Head Neck Surg (1979) |volume=88 |issue=5 |pages=599–605 |date=1980 |pmid=7443266 |doi=10.1177/019459988008800514 |url=}}</ref> <ref name="pmid16015173">{{cite journal |vauthors=White J, Savvides P, Cherian N, Oas J |title=Canalith repositioning for benign paroxysmal positional vertigo |journal=Otol Neurotol |volume=26 |issue=4 |pages=704–10 |date=July 2005 |pmid=16015173 |doi=10.1097/01.mao.0000178128.66482.7e |url=}}</ref>

-Peripheral
-Vestibular dysfunction which involves vestibular neuritis/neuronitis can occur as a single attack or multiple attacks. When there is concurrent hearing loss, it is termed at neurolabyrinthitis. The hair cell bodies are said to be involved that help in transducing movement.
-Bilateral vestibular hypofunction (partial or complete): usually by toxic (gentamicin) or immune mechanisms.
-Autoimmune: rapidly progressive and bilateral. Like any other autoimmune disease, there is a female preponderance in the reproductive age group.
-Systemic or central vestibular dysfunction: involves the vestibular nuclei.
-Meniere's disease which is the tetrad of vertigo, tinnitus, sensorineural hearing loss and aural fullness. The exact etiology is unknown although viral causes have been implicated. The symptoms arise because of endolymphatic pressure change.
-BPPV: The posterior semicircular canal is the most commonly involved space. The most likely etiology is dislodgment of an otoconia.
-Perilymphatic fistula: Fistula is an abnormal communication between two structures; in this case between the membranous labyrinth and middle ear. Can be due to causes like barotrauma (implosive) or increased intracranial pressure (explosive). Acquired fistulas may result from chronic ear surgery.

-Central
-Circulation related causes:
--Cardiogenic like infarction, occlusion
-Other causes:
--Acoustic neuroma
--Cervicogenic
--Metabolic
--Migraine
--Pathophysiologic
--Anxiety and related disorders

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness pathophysiology

2021-03-01T00:57:02Z

Debduti Mukhopadhyay: /* Pathophysiology */

Dizziness pathophysiology

2021-03-01T00:49:35Z

Debduti Mukhopadhyay: /* Pathophysiology */

Dizziness pathophysiology

2021-03-01T00:45:15Z

Debduti Mukhopadhyay: /* Pathophysiology */

Dizziness pathophysiology

2021-03-01T00:44:56Z

Debduti Mukhopadhyay: /* Pathophysiology */

Dizziness pathophysiology

2021-03-01T00:26:19Z

Debduti Mukhopadhyay: /* Pathophysiology */

Dizziness pathophysiology

2021-02-21T20:40:57Z

Debduti Mukhopadhyay: /* Pathophysiology */

Dizziness pathophysiology

2021-02-21T20:40:26Z

Debduti Mukhopadhyay: /* Pathophysiology */

Dizziness classification

2021-02-21T20:38:34Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness. Vertigo can further be classified into timing and trigger as well as based on the area of pathology such as central and/ or peripheral.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology (explained further under the pathophysiology section): <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>
-Central:
-[[Ischemia]] or [[infarction of the brainstem]]
-[[Vertebrobasilar insuffiency]]
-[[Demyelination]] syndromes like [[multiple sclerosis]]
-[[Space occupying lesions]] (both benign and malignant)
-[[Arnold-Chiari malformation]]
-[[Vestibular migraine]]

-Peripheral:
-[[Benign Paroxysmal Positional Vertigo]] (BPPV)
-[[Cogan syndrome]] ([[autoimmune]] condition that affects [[eyes]] and [[inner ears]])
-[[Acoustic neuroma]]
-[[Herpes zoster]]
-[[Labyrynthitis]]
-[[Vestibular neuritis]]
-[[Medication toxicity]] (e.g., [[aminoglycosides]], etc)
-[[Perilymphatic fistula]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:38:10Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness. Vertigo can further be classified into timing and trigger as well as based on the area of pathology such as central and/ or peripheral.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology: (explained further under the pathophysiology section) <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>
-Central:
-[[Ischemia]] or [[infarction of the brainstem]]
-[[Vertebrobasilar insuffiency]]
-[[Demyelination]] syndromes like [[multiple sclerosis]]
-[[Space occupying lesions]] (both benign and malignant)
-[[Arnold-Chiari malformation]]
-[[Vestibular migraine]]

-Peripheral:
-[[Benign Paroxysmal Positional Vertigo]] (BPPV)
-[[Cogan syndrome]] ([[autoimmune]] condition that affects [[eyes]] and [[inner ears]])
-[[Acoustic neuroma]]
-[[Herpes zoster]]
-[[Labyrynthitis]]
-[[Vestibular neuritis]]
-[[Medication toxicity]] (e.g., [[aminoglycosides]], etc)
-[[Perilymphatic fistula]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness pathophysiology

2021-02-21T20:36:44Z

Debduti Mukhopadhyay: /* Pathophysiology */

Dizziness pathophysiology

2021-02-21T20:35:26Z

Debduti Mukhopadhyay: /* Pathophysiology */

Dizziness classification

2021-02-21T20:31:49Z

Debduti Mukhopadhyay: /* Overview */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness. Vertigo can further be classified into timing and trigger as well as based on the area of pathology such as central and/ or peripheral.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology: <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>
-Central:
-[[Ischemia]] or [[infarction of the brainstem]]
-[[Vertebrobasilar insuffiency]]
-[[Demyelination]] syndromes like [[multiple sclerosis]]
-[[Space occupying lesions]] (both benign and malignant)
-[[Arnold-Chiari malformation]]
-[[Vestibular migraine]]

-Peripheral:
-[[Benign Paroxysmal Positional Vertigo]] (BPPV)
-[[Cogan syndrome]] ([[autoimmune]] condition that affects [[eyes]] and [[inner ears]])
-[[Acoustic neuroma]]
-[[Herpes zoster]]
-[[Labyrynthitis]]
-[[Vestibular neuritis]]
-[[Medication toxicity]] (e.g., [[aminoglycosides]], etc)
-[[Perilymphatic fistula]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:30:31Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology: <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>
-Central:
-[[Ischemia]] or [[infarction of the brainstem]]
-[[Vertebrobasilar insuffiency]]
-[[Demyelination]] syndromes like [[multiple sclerosis]]
-[[Space occupying lesions]] (both benign and malignant)
-[[Arnold-Chiari malformation]]
-[[Vestibular migraine]]

-Peripheral:
-[[Benign Paroxysmal Positional Vertigo]] (BPPV)
-[[Cogan syndrome]] ([[autoimmune]] condition that affects [[eyes]] and [[inner ears]])
-[[Acoustic neuroma]]
-[[Herpes zoster]]
-[[Labyrynthitis]]
-[[Vestibular neuritis]]
-[[Medication toxicity]] (e.g., [[aminoglycosides]], etc)
-[[Perilymphatic fistula]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:29:48Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology: <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>
-Central:
-[[Ischemia]] or [[infarction of the brainstem]]
-[[Vertebrobasilar insuffiency]]
-[[Demyelination]] syndromes like [[multiple sclerosis]]
-[[Space occupying lesions]] (both benign and malignant)
-[[Arnold-Chiari malformation]]
-[[Vestibular migraine]]

-Peripheral:
-[[Benign Paroxysmal Positional Vertigo]] (BPPV)
-[[Cogan syndrome]] (autoimmune condition that affects eyes and inner ears)
-[[Acoustic neuroma]]
-[[Herpes zoster]]
-[[Labyrynthitis]]
-[[Vestibular neuritis]]
-[[Medication toxicity]] (e.g., [[aminoglycosides]], etc)
-[[Perilymphatic fistula]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:27:13Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology: <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>
-Central:
-Ischemia or infarction of the brainstem
-Vertebrobasilar insuffiency
-Demyelination syndromes like multiple sclerosis
-Space occupying lesions (both benign and malignant)
-Arnold-Chiari malformation
-Vestibular migraine
-Peripheral:
-Benign Paroxysmal Positional Vertigo (BPPV)
-Cogan syndrome (autoimmune condition that affects eyes and inner ears)
-Acoustic neuroma
-Herpes zoster
-Labyrynthitis
-Vestibular neuritis
-Medication toxicity (e.g., aminoglycosides, etc)
-Perilymphatic fistula

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:23:39Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology: <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>
-Central:
-Ischemia or infarction of the brainstem
-Vertebrobasilar insuffiency
-Demyelination syndromes like multiple sclerosis
-Space occupying lesions (both benign and malignant)
-Arnold-Chiari malformation
-Vestibular migraine

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:21:27Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology: <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>
-Central:
-Ischemia or infarction of the brainstem

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:21:05Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology: <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>
-Central:
-Ischemia or infarction of the brainstem

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:19:30Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology: <ref name="pmid28722891">{{cite journal |vauthors=Lui F, Foris LA, Willner K, Tadi P |title= |journal= |volume= |issue= |pages= |date= |pmid=28722891 |doi= |url=}}</ref><ref name="pmid28613548">{{cite journal |vauthors=Baumgartner B, Taylor RS |title= |journal= |volume= |issue= |pages= |date= |pmid=28613548 |doi= |url=}}</ref>

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:14:05Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

One way to classify dizziness and vertigo is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology:

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:12:59Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

Another way to classify is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology:

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness classification

2021-02-21T20:12:37Z

Debduti Mukhopadhyay: /* Classification */

{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness.

==Classification==
[[Dizziness]] may be classified into subtypes based on the symptoms<ref name="pmid21250167">{{cite journal| author=Walker HK, Hall WD, Hurst JW| title=Clinical Methods: The History, Physical, and Laboratory Examinations | journal= | year= 1990 | volume= | issue= | pages= | pmid=21250167 | doi= | pmc= | url= }} </ref>:
{| class="wikitable"
! colspan="3" |Classification of Dizziness<ref name="pmid15260396">{{cite journal| author=Mukherjee A, Chatterjee SK, Chakravarty A| title=Vertigo and dizziness--a clinical approach. | journal=J Assoc Physicians India | year= 2003 | volume= 51 | issue= | pages= 1095-101 | pmid=15260396 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15260396 }} </ref>
|-
|Type of Dizziness
|Description
|Origin of Disorder
|-
|Type I Dizziness
(Vertigo)
|
* Rotational/spinning sensation
* Often instantaneous
* [[Oscillopsia]] may occur
* Often accompanied by [[nausea]], [[vomiting]], and a [[staggering gait]]
|Vestibular system disorder

(Peripheral OR Central)
|-
|Type II Dizziness
(Impending faint/[[Presyncope]])
|
* Sensation of impending faint/[[loss of consciousness]]
* [[Pallor]], dimness of vision, roaring in the ears, and [[diaphoresis]] may occur
* Recovery upon assuming the [[recumbent]] position is common
| rowspan="3" |Non Vestibular system disorder
|-
|Type III Dizziness (Disequilibrium)
|
* [[Loss of balance]] without an abnormal sensation in the head occurs
* Occurs when walking and disappears upon sitting down.
* Occurs as a result of a disorder of [[motor system]] control
|-
|Type IV Dizziness
|
* Vague [[lightheadedness]] occurs
* It includes dizziness that cannot be identified with certainty as any of the other types
|}

==Classification==

Another way to classify is based on the timing and trigger as follows:<ref name="pmid26231273">{{cite journal |vauthors=Newman-Toker DE, Edlow JA |title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo |journal=Neurol Clin |volume=33 |issue=3 |pages=577–99, viii |date=August 2015 |pmid=26231273 |pmc=4522574 |doi=10.1016/j.ncl.2015.04.011 |url=}}</ref>

-New episodic:
- With triggers:
-Triggered episodic [[vestibular syndrome]] (e.g., [[positional vertigo]] from [[BPPV]])
- Without triggers:
-Spontaneous episodic vestibular syndrome (e.g., [[arrhythmia]] from cardiac causes)

-New continuous:
- Post-exposure acute vestibular syndrome (e.g., after [[gentamicin]])
- Spontaneous acute vestibular syndrome (e.g., [[stroke]] of [[posterior fossa]])

-Chronic, persistent:
- Chronic vestibular syndrome (unilateral vestibular loss, present with [[head movement]])
- Spontaneous chronic vestibular syndrome (associated with degeneration of [[cerebellum]])

Vertigo can be further classified into peripheral and central based on the area of pathology

==References==
{{Reflist|2}}
{{WH}}
{{WS}}
[[Category: (name of the system)]]

==References==
{{reflist|2}}

Dizziness overview

2021-02-21T20:09:58Z

Debduti Mukhopadhyay: /* Overview */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{SI}} {{Norina Usman}}
==Overview==
Dizziness is a symptom rather than a condition on its own. It is a complex and subjective complaint that encompasses a wide spectrum of symptomatology.It is a sensation of postural unsteadiness or deceptive motion. It is one of the most communal presenting complaints that accounts for 5% of primary care practice for individuals aged 65 or older. Dizziness is a nonspecific term mainly used by many people and is classified into different categories: vertigo, spinning, disequilibrium, giddiness, presyncope, faintness, lightheadedness, or feeling woozy.<ref name="pmid19365263">{{cite journal| author=Chan Y| title=Differential diagnosis of dizziness. | journal=Curr Opin Otolaryngol Head Neck Surg | year= 2009 | volume= 17 | issue= 3 | pages= 200-3 | pmid=19365263 | doi=10.1097/MOO.0b013e32832b2594 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19365263 }} </ref> It is one of the most common presenting symptom among patients seen by emergency medical physicians, primary care physicians, neurologists, and otolaryngologists.<ref name="pmid19365263">{{cite journal| author=Chan Y| title=Differential diagnosis of dizziness. | journal=Curr Opin Otolaryngol Head Neck Surg | year= 2009 | volume= 17 | issue= 3 | pages= 200-3 | pmid=19365263 | doi=10.1097/MOO.0b013e32832b2594 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19365263 }} </ref>

==Classification==
Dizziness may be classified based on the symptoms of the patient into 4 main subtypes including [[vertigo]], [[presyncope]], [[BPPV], and [[disequilibrium]].

==Pathophysiology==
It is understood that pathophysiology of dizziness depends on the etiological subtype including orthostatic hypotension, benign paroxysmal positional vertigo, Menier's disease, Parkinson's disease, hyperventilation syndrome, peripheral neuropathy, and vestibular migraine.

==Causes==
Dizziness may be caused by hypotension, dehydration, arrhythmia, labyrinthitis, Meniere's disease, stroke, or hypoglycemia. Other causes are based on the organ system such as cardiovascular, neurological, musculoskeletal, dermatological, endocrine, infectious, pulmonological or side effects of the medicine.

==Differentiating dizziness from other diseases==
Dizziness must be differentiated from other [[Disease|diseases]] that cause [[vertigo]], [[nystagmus]], and [[Hearing impairment|hearing problems]], such as [[Vestibular neuronitis|vestibular neuritis]], [[Herpes simplex virus|HSV]] oticus, [[Ménière's disease|Meniere disease]], labyrinrhine [[concussion]], [[Perilymph fistula|perilymphatic fistula]], [[semicircular canal]] dehiscence syndrome, [[Vestibular system|vestibular]] paroxysmia, [[Cogan syndrome]], [[vestibular schwannoma]], [[otitis media]], [[aminoglycoside]] toxicity, recurrent vestibulopathy, vestibular [[migraine]], [[epileptic]] [[vertigo]], [[multiple sclerosis]], [[Brain tumor|brain tumors]], [[cerebellar infarction]]/[[hemorrhage]], [[brain stem]] [[ischemia]], [[Arnold-Chiari malformation|chiari malformation], [[presyncope]] and [[disequilibrium]].

==Epidemiology and Demographics==
Dizziness is one of the most common complaints in ambulatory care, accounting for nearly 8 million outpatient visits annually in the United States. The incidence of dizziness is approximately 50–100 million worldwide, and around 4.3 million patients in the United States. The lifetime prevalence of dizziness is expected to be 30%. Idiopathic dizziness commonly affects individuals 25 years and older in an emergency department.

==Risk factors==
Common risk factors in the development of dizziness include family history of thromboembolic factors (diabetes, hypertension, high cholesterol, and rheumatic disease), cardiac arrhythmias, stroke, medication side effect (diuretics, antiepileptic drugs, opioid-based analgesics, antipsychotic drugs, antidepressants, antihypertensive, antifungal, lithium, benzodiazepines, antiarrhythmic, antimalarial and anti-HIV-drugs). Multiple sclerosis, seizures, brain tumors, benign positional vertigo, and labyrinthitis.

==Natural history, complications and prognosis==
If left untreated, patients may experience spontaneous recovery. Common complications of dizziness include nausea, vomiting, fainting, fall, imbalance and hearing loss, and neurological complications following Dix Hallpike or Epley maneuvers. Prognosis is generally good, and the 10-year mortality rate of patients with dizziness is low approximately (hazard ratio [HR] = 0.62; 95% CI, 0.40-0.96)

== References ==
{{Reflist|2}}
{{WH}}
{{WS}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]

Dizziness medical therapy

2021-02-20T20:22:12Z

Debduti Mukhopadhyay: /* Approach to the Patient with Dizziness: */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The mainstay of treatment for dizziness is supportive, medical, and [[physical therapy]]<ref name="pmid11904109">{{cite journal| author=Shannon JR, Diedrich A, Biaggioni I, Tank J, Robertson RM, Robertson D | display-authors=etal| title=Water drinking as a treatment for orthostatic syndromes. | journal=Am J Med | year= 2002 | volume= 112 | issue= 5 | pages= 355-60 | pmid=11904109 | doi=10.1016/s0002-9343(02)01025-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11904109 }} </ref><ref name="pmid12521357">{{cite journal| author=Hain TC, Uddin M| title=Pharmacological treatment of vertigo. | journal=CNS Drugs | year= 2003 | volume= 17 | issue= 2 | pages= 85-100 | pmid=12521357 | doi=10.2165/00023210-200317020-00002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521357 }} </ref><ref name="pmid18523693">{{cite journal| author=Kuo CH, Pang L, Chang R| title=Vertigo - part 2 - management in general practice. | journal=Aust Fam Physician | year= 2008 | volume= 37 | issue= 6 | pages= 409-13 | pmid=18523693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18523693 }} </ref>.

==Medical Therapy==
===Supportive therapy:===
*Treatment for lightheadedness can include drinking plenty of water or other fluids (unless the lightheadedness is the result of [[water intoxication]]in which case the drinking water is quite dangerous)
*Eating something sugary
*Lying down or sitting and reducing the elevation of the head relative to the body (for example by positioning the head between the knees).
*[[Intravenous]] fluids in case of nausea and vomiting from drinking too much liquid.
*During attacks of [[vertigo]] from any cause, rest and lie still. Avoiding sudden changes in position as well as bright lights.
*Cautious about driving or using machinery.
*Salt restriction (less than 1 to 2 g of sodium per day)

===Medication:===
*[[Diuretics]] (such as [[hydrochlorothiazide]]/[[triamterene]])
*[[Antihistamines]]
*[[Sedatives]]
*[[Intratympanic]] [[gentamicin]] or [[dexamethasone]]
*[[Methylprednisolone]]
*[[Pills]] for [[nausea]]
*[[Migraine prophylaxis]] [[serotonin]] 5-HT1 receptor agonists ([[triptans]])
*[[Midodrine]]
*[[Pseudoephedrine]]
*[[Beta blockers]]
*[[Antianxiety agents]]

===Approach to the Patient with Dizziness:===
{{familytree/start |summary=PE diagnosis Algorithm.}}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Patient with [[dizziness]]s<ref name="pmid20704166">{{cite journal| author=Post RE, Dickerson LM| title=Dizziness: a diagnostic approach. | journal=Am Fam Physician | year= 2010 | volume= 82 | issue= 4 | pages= 361-8, 369 | pmid=20704166 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20704166 }} </ref>}}
{{familytree | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Presentation episodic or countinuous?}}
{{familytree | | | |,|-|-|-|-|-|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|-|.| | | | | }}
{{familytree | | | F01 | | | | | | | | | | | | | | | | | | | | F02 |F01= [[Episodic]]|F02= [[Countinuous]]}}
{{familytree | |,|-|^|-|-|-|.| | | | | | | | | | | | | | | | | |!| | | | | }}
{{familytree | F01 | | | | F02 | | | | | | | | | | | | | | | | F03 |F01=Triggered |F02=Spontaneous |F03=Is it associated with [[trauma]] or [[toxins]] or spontaneous? }}
{{familytree | |!| | |,|-|-|-|+|-|-|-|.| | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | G01 | | G02| | G03 | | G04 | | | | | | | | G05 | | | | G06 | |G01=[[Dix-Hallpike]] maneuver|G02=Hearing loss|G03=Migraine|G04=Psychiatric Symptoms|G05=Trauma or toxin|G06=Spontaneous }}
{{familytree |,|^|-|-|.| | | |!| | | |!| | | | | | | | | |!| | | | | | |!| | | | }}
{{familytree | H01 | | H02 | | H03 | | H04 | | | | | | | H05 | | | | H06 | | | |H01=Positive|H02=Negative|H03=Vestibular Migraine|H04=Panic attack |H05= [[Barotrauma]],Medication |H06= HINTS Examination }}
{{familytree |!| | | | |!| | | | | | | | | | | | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | I01 | | I02 | | | | | | | | | | | | | | | | | I03 | | | | I04 |I01=Benign Paroxysml Vertigo|I02=Access for orthostatic hypotension|I03=[[Saccade]] present Undirectional horizontal nystagmus Normal test of skew|I04=No saccade,[[Nystagmus]] dominantly vertical torsional or gaze-evoked bidirectional,Abnormal test of skew }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | K01 | | | K02 | |K01=Peripheral etiology|K02=Central etiology }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | L01 | | | L02| | |L01=[[Vestibular neuritis]]|L02=Stroke or transient ischemic attack }}
{{familytree/end}}

===Physical therapy:===
Therapies for dizziness include<ref name="pmid17676355">{{cite journal| author=Holmberg J, Karlberg M, Harlacher U, Magnusson M| title=One-year follow-up of cognitive behavioral therapy for phobic postural vertigo. | journal=J Neurol | year= 2007 | volume= 254 | issue= 9 | pages= 1189-92 | pmid=17676355 | doi=10.1007/s00415-007-0499-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17676355 }} </ref>:
*[[Epley maneuver]] (canalith repositioning)
*[[Vestibular rehabilitation]]
*Breathing control exercises
*[[Balance therapy]]
*[[Psychotherapy]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Needs overview]]
[[Category:Needs content]]
[[Category:Emergency medicine]]

Dizziness medical therapy

2021-02-20T20:21:16Z

Debduti Mukhopadhyay: /* Approach to the Patient with Dizziness: */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The mainstay of treatment for dizziness is supportive, medical, and [[physical therapy]]<ref name="pmid11904109">{{cite journal| author=Shannon JR, Diedrich A, Biaggioni I, Tank J, Robertson RM, Robertson D | display-authors=etal| title=Water drinking as a treatment for orthostatic syndromes. | journal=Am J Med | year= 2002 | volume= 112 | issue= 5 | pages= 355-60 | pmid=11904109 | doi=10.1016/s0002-9343(02)01025-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11904109 }} </ref><ref name="pmid12521357">{{cite journal| author=Hain TC, Uddin M| title=Pharmacological treatment of vertigo. | journal=CNS Drugs | year= 2003 | volume= 17 | issue= 2 | pages= 85-100 | pmid=12521357 | doi=10.2165/00023210-200317020-00002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521357 }} </ref><ref name="pmid18523693">{{cite journal| author=Kuo CH, Pang L, Chang R| title=Vertigo - part 2 - management in general practice. | journal=Aust Fam Physician | year= 2008 | volume= 37 | issue= 6 | pages= 409-13 | pmid=18523693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18523693 }} </ref>.

==Medical Therapy==
===Supportive therapy:===
*Treatment for lightheadedness can include drinking plenty of water or other fluids (unless the lightheadedness is the result of [[water intoxication]]in which case the drinking water is quite dangerous)
*Eating something sugary
*Lying down or sitting and reducing the elevation of the head relative to the body (for example by positioning the head between the knees).
*[[Intravenous]] fluids in case of nausea and vomiting from drinking too much liquid.
*During attacks of [[vertigo]] from any cause, rest and lie still. Avoiding sudden changes in position as well as bright lights.
*Cautious about driving or using machinery.
*Salt restriction (less than 1 to 2 g of sodium per day)

===Medication:===
*[[Diuretics]] (such as [[hydrochlorothiazide]]/[[triamterene]])
*[[Antihistamines]]
*[[Sedatives]]
*[[Intratympanic]] [[gentamicin]] or [[dexamethasone]]
*[[Methylprednisolone]]
*[[Pills]] for [[nausea]]
*[[Migraine prophylaxis]] [[serotonin]] 5-HT1 receptor agonists ([[triptans]])
*[[Midodrine]]
*[[Pseudoephedrine]]
*[[Beta blockers]]
*[[Antianxiety agents]]

===Approach to the Patient with Dizziness:===
{{familytree/start |summary=PE diagnosis Algorithm.}}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Patient with [[dizziness]]s<ref name="pmid20704166">{{cite journal| author=Post RE, Dickerson LM| title=Dizziness: a diagnostic approach. | journal=Am Fam Physician | year= 2010 | volume= 82 | issue= 4 | pages= 361-8, 369 | pmid=20704166 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20704166 }} </ref>}}
{{familytree | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Presentation episodic or countinuous?}}
{{familytree | | | |,|-|-|-|-|-|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|-|.| | | | | }}
{{familytree | | | F01 | | | | | | | | | | | | | | | | | | | | F02 |F01= [[Episodic]]|F02= [[Countinuous]]}}
{{familytree | |,|-|^|-|-|-|.| | | | | | | | | | | | | | | | | |!| | | | | }}
{{familytree | F01 | | | | F02 | | | | | | | | | | | | | | | | F03 |F01=Triggered |F02=Spontaneous |F03=Is it associated with trauma or toxins or spontaneous? }}
{{familytree | |!| | |,|-|-|-|+|-|-|-|.| | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | G01 | | G02| | G03 | | G04 | | | | | | | | G05 | | | | G06 | |G01=[[Dix-Hallpike]] maneuver|G02=Hearing loss|G03=Migraine|G04=Psychiatric Symptoms|G05=Trauma or toxin|G06=Spontaneous }}
{{familytree |,|^|-|-|.| | | |!| | | |!| | | | | | | | | |!| | | | | | |!| | | | }}
{{familytree | H01 | | H02 | | H03 | | H04 | | | | | | | H05 | | | | H06 | | | |H01=Positive|H02=Negative|H03=Vestibular Migraine|H04=Panic attack |H05= Barotrauma,Medication |H06= HINTS Examination }}
{{familytree |!| | | | |!| | | | | | | | | | | | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | I01 | | I02 | | | | | | | | | | | | | | | | | I03 | | | | I04 |I01=Benign Paroxysml Vertigo|I02=Access for orthostatic hypotension|I03=[[Saccade]] present Undirectional horizontal nystagmus Normal test of skew|I04=No saccade,[[Nystagmus]] dominantly vertical torsional or gaze-evoked bidirectional,Abnormal test of skew }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | K01 | | | K02 | |K01=Peripheral etiology|K02=Central etiology }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | L01 | | | L02| | |L01=[[Vestibular neuritis]]|L02=Stroke or transient ischemic attack }}
{{familytree/end}}

===Physical therapy:===
Therapies for dizziness include<ref name="pmid17676355">{{cite journal| author=Holmberg J, Karlberg M, Harlacher U, Magnusson M| title=One-year follow-up of cognitive behavioral therapy for phobic postural vertigo. | journal=J Neurol | year= 2007 | volume= 254 | issue= 9 | pages= 1189-92 | pmid=17676355 | doi=10.1007/s00415-007-0499-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17676355 }} </ref>:
*[[Epley maneuver]] (canalith repositioning)
*[[Vestibular rehabilitation]]
*Breathing control exercises
*[[Balance therapy]]
*[[Psychotherapy]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Needs overview]]
[[Category:Needs content]]
[[Category:Emergency medicine]]

Dizziness medical therapy

2021-02-20T20:17:46Z

Debduti Mukhopadhyay: /* Medication: */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The mainstay of treatment for dizziness is supportive, medical, and [[physical therapy]]<ref name="pmid11904109">{{cite journal| author=Shannon JR, Diedrich A, Biaggioni I, Tank J, Robertson RM, Robertson D | display-authors=etal| title=Water drinking as a treatment for orthostatic syndromes. | journal=Am J Med | year= 2002 | volume= 112 | issue= 5 | pages= 355-60 | pmid=11904109 | doi=10.1016/s0002-9343(02)01025-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11904109 }} </ref><ref name="pmid12521357">{{cite journal| author=Hain TC, Uddin M| title=Pharmacological treatment of vertigo. | journal=CNS Drugs | year= 2003 | volume= 17 | issue= 2 | pages= 85-100 | pmid=12521357 | doi=10.2165/00023210-200317020-00002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521357 }} </ref><ref name="pmid18523693">{{cite journal| author=Kuo CH, Pang L, Chang R| title=Vertigo - part 2 - management in general practice. | journal=Aust Fam Physician | year= 2008 | volume= 37 | issue= 6 | pages= 409-13 | pmid=18523693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18523693 }} </ref>.

==Medical Therapy==
===Supportive therapy:===
*Treatment for lightheadedness can include drinking plenty of water or other fluids (unless the lightheadedness is the result of [[water intoxication]]in which case the drinking water is quite dangerous)
*Eating something sugary
*Lying down or sitting and reducing the elevation of the head relative to the body (for example by positioning the head between the knees).
*[[Intravenous]] fluids in case of nausea and vomiting from drinking too much liquid.
*During attacks of [[vertigo]] from any cause, rest and lie still. Avoiding sudden changes in position as well as bright lights.
*Cautious about driving or using machinery.
*Salt restriction (less than 1 to 2 g of sodium per day)

===Medication:===
*[[Diuretics]] (such as [[hydrochlorothiazide]]/[[triamterene]])
*[[Antihistamines]]
*[[Sedatives]]
*[[Intratympanic]] [[gentamicin]] or [[dexamethasone]]
*[[Methylprednisolone]]
*[[Pills]] for [[nausea]]
*[[Migraine prophylaxis]] [[serotonin]] 5-HT1 receptor agonists ([[triptans]])
*[[Midodrine]]
*[[Pseudoephedrine]]
*[[Beta blockers]]
*[[Antianxiety agents]]

===Approach to the Patient with Dizziness:===
{{familytree/start |summary=PE diagnosis Algorithm.}}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Patient with [[dizziness]]s<ref name="pmid20704166">{{cite journal| author=Post RE, Dickerson LM| title=Dizziness: a diagnostic approach. | journal=Am Fam Physician | year= 2010 | volume= 82 | issue= 4 | pages= 361-8, 369 | pmid=20704166 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20704166 }} </ref>}}
{{familytree | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Presentation episodic or countinuous?}}
{{familytree | | | |,|-|-|-|-|-|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|-|.| | | | | }}
{{familytree | | | F01 | | | | | | | | | | | | | | | | | | | | F02 |F01= [[Episodic]]|F02= [[Countinuous]]}}
{{familytree | |,|-|^|-|-|-|.| | | | | | | | | | | | | | | | | |!| | | | | }}
{{familytree | F01 | | | | F02 | | | | | | | | | | | | | | | | F03 |F01=Triggered |F02=Spontaneous |F03=Is it associated with trauma or toxins or spontaneous? }}
{{familytree | |!| | |,|-|-|-|+|-|-|-|.| | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | G01 | | G02| | G03 | | G04 | | | | | | | | G05 | | | | G06 | |G01=[[Dix-Hallpike]] maneuver|G02=Hearing loss|G03=Migraine|G04=Psychiatric Symptoms|G05=Trauma or toxin|G06=Spontaneous }}
{{familytree |,|^|-|-|.| | | |!| | | |!| | | | | | | | | |!| | | | | | |!| | | | }}
{{familytree | H01 | | H02 | | H03 | | H04 | | | | | | | H05 | | | | H06 | | | |H01=Positive|H02=Negative|H03=Vestibular Migraine|H04=Panic attack |H05= Barotrauma,Medication |H06= HINTS Examination }}
{{familytree |!| | | | |!| | | | | | | | | | | | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | I01 | | I02 | | | | | | | | | | | | | | | | | I03 | | | | I04 |I01=Benign Paroxysml Vertigo|I02=Access for orthostatic hypotension|I03=Saccade present Undirectional horizontal nystagmus Normal test of skew|I04=No saccade,Nystagmus dominantly vertical torsional or gaze-evoked bidirectional,Abnormal test of skew }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | K01 | | | K02 | |K01=Peripheral etiology|K02=Central etiology }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | L01 | | | L02| | |L01=Vestibular neuritis|L02=Stroke or transient ischemic attack }}
{{familytree/end}}

===Physical therapy:===
Therapies for dizziness include<ref name="pmid17676355">{{cite journal| author=Holmberg J, Karlberg M, Harlacher U, Magnusson M| title=One-year follow-up of cognitive behavioral therapy for phobic postural vertigo. | journal=J Neurol | year= 2007 | volume= 254 | issue= 9 | pages= 1189-92 | pmid=17676355 | doi=10.1007/s00415-007-0499-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17676355 }} </ref>:
*[[Epley maneuver]] (canalith repositioning)
*[[Vestibular rehabilitation]]
*Breathing control exercises
*[[Balance therapy]]
*[[Psychotherapy]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Needs overview]]
[[Category:Needs content]]
[[Category:Emergency medicine]]

Dizziness medical therapy

2021-02-20T20:13:30Z

Debduti Mukhopadhyay: /* Medication: */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The mainstay of treatment for dizziness is supportive, medical, and [[physical therapy]]<ref name="pmid11904109">{{cite journal| author=Shannon JR, Diedrich A, Biaggioni I, Tank J, Robertson RM, Robertson D | display-authors=etal| title=Water drinking as a treatment for orthostatic syndromes. | journal=Am J Med | year= 2002 | volume= 112 | issue= 5 | pages= 355-60 | pmid=11904109 | doi=10.1016/s0002-9343(02)01025-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11904109 }} </ref><ref name="pmid12521357">{{cite journal| author=Hain TC, Uddin M| title=Pharmacological treatment of vertigo. | journal=CNS Drugs | year= 2003 | volume= 17 | issue= 2 | pages= 85-100 | pmid=12521357 | doi=10.2165/00023210-200317020-00002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521357 }} </ref><ref name="pmid18523693">{{cite journal| author=Kuo CH, Pang L, Chang R| title=Vertigo - part 2 - management in general practice. | journal=Aust Fam Physician | year= 2008 | volume= 37 | issue= 6 | pages= 409-13 | pmid=18523693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18523693 }} </ref>.

==Medical Therapy==
===Supportive therapy:===
*Treatment for lightheadedness can include drinking plenty of water or other fluids (unless the lightheadedness is the result of [[water intoxication]]in which case the drinking water is quite dangerous)
*Eating something sugary
*Lying down or sitting and reducing the elevation of the head relative to the body (for example by positioning the head between the knees).
*[[Intravenous]] fluids in case of nausea and vomiting from drinking too much liquid.
*During attacks of [[vertigo]] from any cause, rest and lie still. Avoiding sudden changes in position as well as bright lights.
*Cautious about driving or using machinery.
*Salt restriction (less than 1 to 2 g of sodium per day)

===Medication:===
*[[Diuretics]] (such as [[hydrochlorothiazide]]/[[triamterene]])
*[[Antihistamines]]
*[[Sedatives]]
*[[Intratympanic]] [[gentamicin]] or [[dexamethasone]]
*[[Methylprednisolone]]
*[[Pills]] for [[nausea]]
*[[Migraine prophylaxis]] [[serotonin]] 5-HT1 receptor agonists [[(triptans)]]
*[[Midodrine]]
*[[Pseudoephedrine]]
*[[Beta blockers]]
*[[Antianxiety agents]]

===Approach to the Patient with Dizziness:===
{{familytree/start |summary=PE diagnosis Algorithm.}}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Patient with [[dizziness]]s<ref name="pmid20704166">{{cite journal| author=Post RE, Dickerson LM| title=Dizziness: a diagnostic approach. | journal=Am Fam Physician | year= 2010 | volume= 82 | issue= 4 | pages= 361-8, 369 | pmid=20704166 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20704166 }} </ref>}}
{{familytree | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Presentation episodic or countinuous?}}
{{familytree | | | |,|-|-|-|-|-|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|-|.| | | | | }}
{{familytree | | | F01 | | | | | | | | | | | | | | | | | | | | F02 |F01= [[Episodic]]|F02= [[Countinuous]]}}
{{familytree | |,|-|^|-|-|-|.| | | | | | | | | | | | | | | | | |!| | | | | }}
{{familytree | F01 | | | | F02 | | | | | | | | | | | | | | | | F03 |F01=Triggered |F02=Spontaneous |F03=Is it associated with trauma or toxins or spontaneous? }}
{{familytree | |!| | |,|-|-|-|+|-|-|-|.| | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | G01 | | G02| | G03 | | G04 | | | | | | | | G05 | | | | G06 | |G01=[[Dix-Hallpike]] maneuver|G02=Hearing loss|G03=Migraine|G04=Psychiatric Symptoms|G05=Trauma or toxin|G06=Spontaneous }}
{{familytree |,|^|-|-|.| | | |!| | | |!| | | | | | | | | |!| | | | | | |!| | | | }}
{{familytree | H01 | | H02 | | H03 | | H04 | | | | | | | H05 | | | | H06 | | | |H01=Positive|H02=Negative|H03=Vestibular Migraine|H04=Panic attack |H05= Barotrauma,Medication |H06= HINTS Examination }}
{{familytree |!| | | | |!| | | | | | | | | | | | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | I01 | | I02 | | | | | | | | | | | | | | | | | I03 | | | | I04 |I01=Benign Paroxysml Vertigo|I02=Access for orthostatic hypotension|I03=Saccade present Undirectional horizontal nystagmus Normal test of skew|I04=No saccade,Nystagmus dominantly vertical torsional or gaze-evoked bidirectional,Abnormal test of skew }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | K01 | | | K02 | |K01=Peripheral etiology|K02=Central etiology }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | L01 | | | L02| | |L01=Vestibular neuritis|L02=Stroke or transient ischemic attack }}
{{familytree/end}}

===Physical therapy:===
Therapies for dizziness include<ref name="pmid17676355">{{cite journal| author=Holmberg J, Karlberg M, Harlacher U, Magnusson M| title=One-year follow-up of cognitive behavioral therapy for phobic postural vertigo. | journal=J Neurol | year= 2007 | volume= 254 | issue= 9 | pages= 1189-92 | pmid=17676355 | doi=10.1007/s00415-007-0499-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17676355 }} </ref>:
*[[Epley maneuver]] (canalith repositioning)
*[[Vestibular rehabilitation]]
*Breathing control exercises
*[[Balance therapy]]
*[[Psychotherapy]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Needs overview]]
[[Category:Needs content]]
[[Category:Emergency medicine]]

Dizziness medical therapy

2021-02-20T20:12:16Z

Debduti Mukhopadhyay: /* Supportive therapy: */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The mainstay of treatment for dizziness is supportive, medical, and [[physical therapy]]<ref name="pmid11904109">{{cite journal| author=Shannon JR, Diedrich A, Biaggioni I, Tank J, Robertson RM, Robertson D | display-authors=etal| title=Water drinking as a treatment for orthostatic syndromes. | journal=Am J Med | year= 2002 | volume= 112 | issue= 5 | pages= 355-60 | pmid=11904109 | doi=10.1016/s0002-9343(02)01025-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11904109 }} </ref><ref name="pmid12521357">{{cite journal| author=Hain TC, Uddin M| title=Pharmacological treatment of vertigo. | journal=CNS Drugs | year= 2003 | volume= 17 | issue= 2 | pages= 85-100 | pmid=12521357 | doi=10.2165/00023210-200317020-00002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521357 }} </ref><ref name="pmid18523693">{{cite journal| author=Kuo CH, Pang L, Chang R| title=Vertigo - part 2 - management in general practice. | journal=Aust Fam Physician | year= 2008 | volume= 37 | issue= 6 | pages= 409-13 | pmid=18523693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18523693 }} </ref>.

==Medical Therapy==
===Supportive therapy:===
*Treatment for lightheadedness can include drinking plenty of water or other fluids (unless the lightheadedness is the result of [[water intoxication]]in which case the drinking water is quite dangerous)
*Eating something sugary
*Lying down or sitting and reducing the elevation of the head relative to the body (for example by positioning the head between the knees).
*[[Intravenous]] fluids in case of nausea and vomiting from drinking too much liquid.
*During attacks of [[vertigo]] from any cause, rest and lie still. Avoiding sudden changes in position as well as bright lights.
*Cautious about driving or using machinery.
*Salt restriction (less than 1 to 2 g of sodium per day)

===Medication:===
*Diuretics (such as hydrochlorothiazide/triamterene)
*[[Antihistamines]]
*[[Sedatives]]
*Intratympanic gentamicin or dexamethasone
*[[Methylprednisolone]]
*[[Pills]] for [[nausea]]
*Migraine prophylaxis [[serotonin]] 5-HT1 receptor agonists [[(triptans)]]
*[[Midodrine]]
*[[Pseudoephedrine]]
*[[Beta blockers]]
*[[Antianxiety agents]]

===Approach to the Patient with Dizziness:===
{{familytree/start |summary=PE diagnosis Algorithm.}}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Patient with [[dizziness]]s<ref name="pmid20704166">{{cite journal| author=Post RE, Dickerson LM| title=Dizziness: a diagnostic approach. | journal=Am Fam Physician | year= 2010 | volume= 82 | issue= 4 | pages= 361-8, 369 | pmid=20704166 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20704166 }} </ref>}}
{{familytree | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Presentation episodic or countinuous?}}
{{familytree | | | |,|-|-|-|-|-|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|-|.| | | | | }}
{{familytree | | | F01 | | | | | | | | | | | | | | | | | | | | F02 |F01= [[Episodic]]|F02= [[Countinuous]]}}
{{familytree | |,|-|^|-|-|-|.| | | | | | | | | | | | | | | | | |!| | | | | }}
{{familytree | F01 | | | | F02 | | | | | | | | | | | | | | | | F03 |F01=Triggered |F02=Spontaneous |F03=Is it associated with trauma or toxins or spontaneous? }}
{{familytree | |!| | |,|-|-|-|+|-|-|-|.| | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | G01 | | G02| | G03 | | G04 | | | | | | | | G05 | | | | G06 | |G01=[[Dix-Hallpike]] maneuver|G02=Hearing loss|G03=Migraine|G04=Psychiatric Symptoms|G05=Trauma or toxin|G06=Spontaneous }}
{{familytree |,|^|-|-|.| | | |!| | | |!| | | | | | | | | |!| | | | | | |!| | | | }}
{{familytree | H01 | | H02 | | H03 | | H04 | | | | | | | H05 | | | | H06 | | | |H01=Positive|H02=Negative|H03=Vestibular Migraine|H04=Panic attack |H05= Barotrauma,Medication |H06= HINTS Examination }}
{{familytree |!| | | | |!| | | | | | | | | | | | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | I01 | | I02 | | | | | | | | | | | | | | | | | I03 | | | | I04 |I01=Benign Paroxysml Vertigo|I02=Access for orthostatic hypotension|I03=Saccade present Undirectional horizontal nystagmus Normal test of skew|I04=No saccade,Nystagmus dominantly vertical torsional or gaze-evoked bidirectional,Abnormal test of skew }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | K01 | | | K02 | |K01=Peripheral etiology|K02=Central etiology }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | L01 | | | L02| | |L01=Vestibular neuritis|L02=Stroke or transient ischemic attack }}
{{familytree/end}}

===Physical therapy:===
Therapies for dizziness include<ref name="pmid17676355">{{cite journal| author=Holmberg J, Karlberg M, Harlacher U, Magnusson M| title=One-year follow-up of cognitive behavioral therapy for phobic postural vertigo. | journal=J Neurol | year= 2007 | volume= 254 | issue= 9 | pages= 1189-92 | pmid=17676355 | doi=10.1007/s00415-007-0499-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17676355 }} </ref>:
*[[Epley maneuver]] (canalith repositioning)
*[[Vestibular rehabilitation]]
*Breathing control exercises
*[[Balance therapy]]
*[[Psychotherapy]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Needs overview]]
[[Category:Needs content]]
[[Category:Emergency medicine]]

Dizziness medical therapy

2021-02-20T20:11:47Z

Debduti Mukhopadhyay: /* Overview */

__NOTOC__
{{Dizziness}}
{{CMG}} {{AE}} {{FB}} {{Norina Usman}}
==Overview==
The mainstay of treatment for dizziness is supportive, medical, and [[physical therapy]]<ref name="pmid11904109">{{cite journal| author=Shannon JR, Diedrich A, Biaggioni I, Tank J, Robertson RM, Robertson D | display-authors=etal| title=Water drinking as a treatment for orthostatic syndromes. | journal=Am J Med | year= 2002 | volume= 112 | issue= 5 | pages= 355-60 | pmid=11904109 | doi=10.1016/s0002-9343(02)01025-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11904109 }} </ref><ref name="pmid12521357">{{cite journal| author=Hain TC, Uddin M| title=Pharmacological treatment of vertigo. | journal=CNS Drugs | year= 2003 | volume= 17 | issue= 2 | pages= 85-100 | pmid=12521357 | doi=10.2165/00023210-200317020-00002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12521357 }} </ref><ref name="pmid18523693">{{cite journal| author=Kuo CH, Pang L, Chang R| title=Vertigo - part 2 - management in general practice. | journal=Aust Fam Physician | year= 2008 | volume= 37 | issue= 6 | pages= 409-13 | pmid=18523693 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18523693 }} </ref>.

==Medical Therapy==
===Supportive therapy:===
*Treatment for lightheadedness can include drinking plenty of water or other fluids (unless the lightheadedness is the result of [[water intoxication]]in which case the drinking water is quite dangerous)
*Eating something sugary
*Lying down or sitting and reducing the elevation of the head relative to the body (for example by positioning the head between the knees).
*[[Intravenous]] fluids in case of nausea and vomiting from drinking too much liquid.
*During attacks of [[vertigo]] from any cause, rest and lie still. Avoiding sudden changes in position as well as bright lights.
*Cautious about driving or using machinery.
*Salt restriction (less than 1 to 2 g of sodium per day)
===Medication:===
*Diuretics (such as hydrochlorothiazide/triamterene)
*[[Antihistamines]]
*[[Sedatives]]
*Intratympanic gentamicin or dexamethasone
*[[Methylprednisolone]]
*[[Pills]] for [[nausea]]
*Migraine prophylaxis [[serotonin]] 5-HT1 receptor agonists [[(triptans)]]
*[[Midodrine]]
*[[Pseudoephedrine]]
*[[Beta blockers]]
*[[Antianxiety agents]]

===Approach to the Patient with Dizziness:===
{{familytree/start |summary=PE diagnosis Algorithm.}}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Patient with [[dizziness]]s<ref name="pmid20704166">{{cite journal| author=Post RE, Dickerson LM| title=Dizziness: a diagnostic approach. | journal=Am Fam Physician | year= 2010 | volume= 82 | issue= 4 | pages= 361-8, 369 | pmid=20704166 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20704166 }} </ref>}}
{{familytree | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | | | | | | | | A01 |A01= Presentation episodic or countinuous?}}
{{familytree | | | |,|-|-|-|-|-|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|-|.| | | | | }}
{{familytree | | | F01 | | | | | | | | | | | | | | | | | | | | F02 |F01= [[Episodic]]|F02= [[Countinuous]]}}
{{familytree | |,|-|^|-|-|-|.| | | | | | | | | | | | | | | | | |!| | | | | }}
{{familytree | F01 | | | | F02 | | | | | | | | | | | | | | | | F03 |F01=Triggered |F02=Spontaneous |F03=Is it associated with trauma or toxins or spontaneous? }}
{{familytree | |!| | |,|-|-|-|+|-|-|-|.| | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | G01 | | G02| | G03 | | G04 | | | | | | | | G05 | | | | G06 | |G01=[[Dix-Hallpike]] maneuver|G02=Hearing loss|G03=Migraine|G04=Psychiatric Symptoms|G05=Trauma or toxin|G06=Spontaneous }}
{{familytree |,|^|-|-|.| | | |!| | | |!| | | | | | | | | |!| | | | | | |!| | | | }}
{{familytree | H01 | | H02 | | H03 | | H04 | | | | | | | H05 | | | | H06 | | | |H01=Positive|H02=Negative|H03=Vestibular Migraine|H04=Panic attack |H05= Barotrauma,Medication |H06= HINTS Examination }}
{{familytree |!| | | | |!| | | | | | | | | | | | | | | | | | | |,|-|-|^|-|-|.| }}
{{familytree | I01 | | I02 | | | | | | | | | | | | | | | | | I03 | | | | I04 |I01=Benign Paroxysml Vertigo|I02=Access for orthostatic hypotension|I03=Saccade present Undirectional horizontal nystagmus Normal test of skew|I04=No saccade,Nystagmus dominantly vertical torsional or gaze-evoked bidirectional,Abnormal test of skew }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | K01 | | | K02 | |K01=Peripheral etiology|K02=Central etiology }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | |!| | | | |!| | }}
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | L01 | | | L02| | |L01=Vestibular neuritis|L02=Stroke or transient ischemic attack }}
{{familytree/end}}

===Physical therapy:===
Therapies for dizziness include<ref name="pmid17676355">{{cite journal| author=Holmberg J, Karlberg M, Harlacher U, Magnusson M| title=One-year follow-up of cognitive behavioral therapy for phobic postural vertigo. | journal=J Neurol | year= 2007 | volume= 254 | issue= 9 | pages= 1189-92 | pmid=17676355 | doi=10.1007/s00415-007-0499-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17676355 }} </ref>:
*[[Epley maneuver]] (canalith repositioning)
*[[Vestibular rehabilitation]]
*Breathing control exercises
*[[Balance therapy]]
*[[Psychotherapy]]

==References==
{{Reflist|2}}
{{WH}}
{{WS}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Needs overview]]
[[Category:Needs content]]
[[Category:Emergency medicine]]

Dizziness MRI

2021-02-20T20:11:06Z

Debduti Mukhopadhyay: /* Overview */

__NOTOC__
{{Dizziness}}
{{SI}}
{{CMG}}; {{Norina Usman}}
==Overview==
A head MRI may be helpful in the diagnosis of dizziness. Findings on MRI suggestive of dizziness include [[inflammatory]] and [[degenerative changes]].
===MRI===
MRI head may be helpful in the diagnosis of dizziness. Findings on MRI suggestive of dizziness include<ref name="pmid22906582">{{cite journal| author=Kim HA, Lee H| title=Recent advances in central acute vestibular syndrome of a vascular cause. | journal=J Neurol Sci | year= 2012 | volume= 321 | issue= 1-2 | pages= 17-22 | pmid=22906582 | doi=10.1016/j.jns.2012.07.055 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22906582 }} </ref><ref name="pmid3390028">{{cite journal| author=Halmagyi GM, Curthoys IS| title=A clinical sign of canal paresis. | journal=Arch Neurol | year= 1988 | volume= 45 | issue= 7 | pages= 737-9 | pmid=3390028 | doi=10.1001/archneur.1988.00520310043015 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3390028 }} </ref><ref name="pmid23463752">{{cite journal| author=Newman-Toker DE, Saber Tehrani AS, Mantokoudis G, Pula JH, Guede CI, Kerber KA | display-authors=etal| title=Quantitative video-oculography to help diagnose stroke in acute vertigo and dizziness: toward an ECG for the eyes. | journal=Stroke | year= 2013 | volume= 44 | issue= 4 | pages= 1158-61 | pmid=23463752 | doi=10.1161/STROKEAHA.111.000033 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23463752 }} </ref>:
*[[Inflammatory]]
*[[Degenerative disease]]
*[[Neoplastic lesions]]

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]
[[Category:Needs content]]

Dizziness CT

2021-02-20T20:10:25Z

Debduti Mukhopadhyay: /* Overview */

__NOTOC__
{{Dizziness}}

{{CMG}}; '''Associate Editor-In-Chief:''' {{Norina Usman}}
==Overview==
A [[head CT scan]]may be helpful in the diagnosis of dizziness. Findings on CT scan suggestive of dizziness include [[ischemic changes]], [[tumor]], and [[hemorrhage]].
===CT Scan===
A Head CT scan may be helpful in the diagnosis of dizziness. Findings on CT scan suggestive of dizziness include<ref name="pmid17258669">{{cite journal| author=Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM | display-authors=etal| title=Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. | journal=Lancet | year= 2007 | volume= 369 | issue= 9558 | pages= 293-8 | pmid=17258669 | doi=10.1016/S0140-6736(07)60151-2 | pmc=1859855 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17258669 }} </ref>:
*[[Hemorrhage]]
*[[Tumor]]
*[[Ischemic]] changes

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]
[[Category: Needs content]]

Dizziness physical examination

2021-02-20T20:08:59Z

Debduti Mukhopadhyay: /* Physical Examination */

__NOTOC__
{{Dizziness}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{Norina Usman}}
==Overview==
[[Physical examination]] of [[patients]] with dizziness is usually remarkable for [[Balance disorder|balance problems]] and [[nystagmus]] on [[Dix-Hallpike test|Dix-Hall pike maneuver]].

==Physical Examination==
Physical examination of patients includes reproducing dizziness in the clinic by following these maneuvers<ref name="pmid10086438">{{cite journal| author=McGee S, Abernethy WB, Simel DL| title=The rational clinical examination. Is this patient hypovolemic? | journal=JAMA | year= 1999 | volume= 281 | issue= 11 | pages= 1022-9 | pmid=10086438 | doi=10.1001/jama.281.11.1022 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10086438 }} </ref><ref name="pmid8842072">{{cite journal| author=Colledge NR, Barr-Hamilton RM, Lewis SJ, Sellar RJ, Wilson JA| title=Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study. | journal=BMJ | year= 1996 | volume= 313 | issue= 7060 | pages= 788-92 | pmid=8842072 | doi=10.1136/bmj.313.7060.788 | pmc=2352174 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8842072 }} </ref><ref name="pmid11774054">{{cite journal| author=Goebel JA| title=The ten-minute examination of the dizzy patient. | journal=Semin Neurol | year= 2001 | volume= 21 | issue= 4 | pages= 391-8 | pmid=11774054 | doi=10.1055/s-2001-19410 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11774054 }} </ref><ref name="pmid1443950">{{cite journal| author=Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Wehrle PA | display-authors=etal| title=Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. | journal=Ann Intern Med | year= 1992 | volume= 117 | issue= 11 | pages= 898-904 | pmid=1443950 | doi=10.7326/0003-4819-117-11-898 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1443950 }} </ref><ref name="pmid10388800">{{cite journal| author=Ebersbach G, Sojer M, Valldeoriola F, Wissel J, Müller J, Tolosa E | display-authors=etal| title=Comparative analysis of gait in Parkinson's disease, cerebellar ataxia and subcortical arteriosclerotic encephalopathy. | journal=Brain | year= 1999 | volume= 122 ( Pt 7) | issue= | pages= 1349-55 | pmid=10388800 | doi=10.1093/brain/122.7.1349 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10388800 }} </ref>:
*[[Dix-Hallpike maneuver]]- Turning the patient's head at 45 degrees to one side, and rapidly laying the patient into a supine position with the head hanging about 20 degrees over the end of the table, any abnormal eye movement within 30 seconds indicates vestibular debris.
*[[Orthostatic blood pressure measurement]]- Drop-in blood pressure from supine to standing position indicates [[orthostatic hypotension]].
*[[Romberg test]]- Swaying or leaning towards one side is indicative of [[ipsilateral vestibular dysfunction]].
*Observation of gait- To look for any symptoms of [[Parkinson's disease]] such as small steps and less arm swing.

==References==
{{reflist|2}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Neurology]]
[[Category:Otolaryngology]]
[[Category:Emergency medicine]]
[[Category:Needs content]]

Dizziness history and symptoms

2021-02-20T20:07:08Z

Debduti Mukhopadhyay: /* History */

__NOTOC__
{{Dizziness}}

{{CMG}}; '''Associate Editor-In-Chief:''' {{MUT}} {{Norina Usman}}
==Overview==
A positive history of [[hyperlipidemia]], [[hypertension]], [[smoking]], [[diabetes mellitus]], [[Thyroid Disease|thyroid dysfunction]], [[general anesthesia]], and advanced [[age]] is suggestive of dizziness. The most common [[symptoms]] of dizziness include positional [[vertigo]], [[imbalance]], [[nausea]], [[vomiting]], [[altered mental status]], [[transient loss of consciousness]], [[headache]], [[neck pain]], [[chest/back pain]], [[abdominal/back pain]], [[dyspnea]], [[palpitations]], [[bleeding]] or fluid losses, new/recent medication use, [[fever]] or [[chills]] and abnormal [[glucose]].

==History and Symptoms==
===History===
Patients with dizziness may have a positive history of<ref name="pmid23385126">{{cite journal| author=Rosin C, Bingisser R| title=[Not Available]. | journal=Ther Umsch | year= 2013 | volume= 70 | issue= 1 | pages= 27-9 | pmid=23385126 | doi=10.1024/0040-5930/a000359 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23385126 }} </ref><ref name="pmid19762709">{{cite journal| author=Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE| title=HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. | journal=Stroke | year= 2009 | volume= 40 | issue= 11 | pages= 3504-10 | pmid=19762709 | doi=10.1161/STROKEAHA.109.551234 | pmc=4593511 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19762709 }} </ref>:
*[[Hypertension]]
*[[Thromboembolic disease]]
*Positive family history
*[[Upper respiratory tract infection]]
*[[Tinnitus]]
*[[Hearing loss]]

===Common Symptoms===
Common symptoms of dizziness include<ref name="pmid16738272">{{cite journal| author=Katon WJ| title=Clinical practice. Panic disorder. | journal=N Engl J Med | year= 2006 | volume= 354 | issue= 22 | pages= 2360-7 | pmid=16738272 | doi=10.1056/NEJMcp052466 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16738272 }} </ref><ref name="pmid21172577">{{cite journal| author=Kanner AM| title=Ictal panic and interictal panic attacks: diagnostic and therapeutic principles. | journal=Neurol Clin | year= 2011 | volume= 29 | issue= 1 | pages= 163-75, ix | pmid=21172577 | doi=10.1016/j.ncl.2010.11.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21172577 }} </ref><ref name="pmid21172577">{{cite journal| author=Kanner AM| title=Ictal panic and interictal panic attacks: diagnostic and therapeutic principles. | journal=Neurol Clin | year= 2011 | volume= 29 | issue= 1 | pages= 163-75, ix | pmid=21172577 | doi=10.1016/j.ncl.2010.11.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21172577 }} </ref><ref name="pmid23635415">{{cite journal| author=Compter A, Kappelle LJ, Algra A, van der Worp HB| title=Nonfocal symptoms are more frequent in patients with vertebral artery than carotid artery stenosis. | journal=Cerebrovasc Dis | year= 2013 | volume= 35 | issue= 4 | pages= 378-84 | pmid=23635415 | doi=10.1159/000348849 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23635415 }} </ref>:
{| class="wikitable"
! colspan="1" rowspan="1" |Symptom or finding
|-
| colspan="1" rowspan="1" |Altered mental status
|-
| colspan="1" rowspan="1" |Transient loss of consciousness
|-
| colspan="1" rowspan="1" |Headache
|-
| colspan="1" rowspan="1" |Neck pain
|-
| colspan="1" rowspan="1" |Chest/back pain
|-
| colspan="1" rowspan="1" |Abdominal/back pain
|-
| colspan="1" rowspan="1" |Dyspnea
|-
| colspan="1" rowspan="1" |Palpitations
|-
| colspan="1" rowspan="1" |Bleeding or fluid losses
|-
| colspan="1" rowspan="1" |New/recent medication use
|-
| colspan="1" rowspan="1" |Fever or chills
|-
| colspan="1" rowspan="1" |Abnormal glucose
|}

==References==
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Dizziness natural history, complications and prognosis

2021-02-20T20:06:22Z

Debduti Mukhopadhyay: /* Complication */

__NOTOC__
{{Dizziness}}
Please help WikiDoc by adding more content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.

{{CMG}}; '''Associate Editor-In-Chief:''' {{MUT}} {{Norina Usman}}

==Overview==
If left untreated, patients may experience spontaneous recovery. Common [[complications]] of dizziness include [[nausea]], [[vomiting]], [[fainting]], fall, imbalance and [[hearing loss]] and [[neurological]] [[complications]] following [[Dix-Hallpike test|Dix Hallpike]] or Epley maneuvers. Prognosis is generally good, and the 10-year mortality rate of patients with dizziness is low approximately (hazard ratio [HR] = 0.62; 95% CI, 0.40-0.96)<ref name="pmid32152013">{{cite journal| author=van Vugt VA, Bas G, van der Wouden JC, Dros J, van Weert HCPM, Yardley L | display-authors=etal| title=Prognosis and Survival of Older Patients With Dizziness in Primary Care: A 10-Year Prospective Cohort Study. | journal=Ann Fam Med | year= 2020 | volume= 18 | issue= 2 | pages= 100-109 | pmid=32152013 | doi=10.1370/afm.2478 | pmc=7062481 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32152013 }} </ref>.

===Natural history===
The symptoms of dizziness typically develop gradually over years and may have a history of cardiovascular disease (for e.g; [[arrhythmia]], [[myocardial infarction]], [[ischemic heart disease]], and neurological disorders such as [[Parkinson's disease]], [[migraine]], [[stroke]], and [[epilepsy]]<ref name="pmid10568646">{{cite journal| author=Spitzer RL, Kroenke K, Williams JB| title=Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. | journal=JAMA | year= 1999 | volume= 282 | issue= 18 | pages= 1737-44 | pmid=10568646 | doi=10.1001/jama.282.18.1737 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10568646 }} </ref>.

===Complication===
Common complications of dizziness include:
*[[Fall]]
*[[Imbalance]]
*[[Hearing loss]]

===Prognosis===
Depending on the extent of the disease progression at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.

==References==
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Dizziness natural history, complications and prognosis

2021-02-20T20:05:53Z

Debduti Mukhopadhyay: /* Natural history */

__NOTOC__
{{Dizziness}}
Please help WikiDoc by adding more content here. It's easy! Click [[Help:How_to_Edit_a_Page|here]] to learn about editing.

{{CMG}}; '''Associate Editor-In-Chief:''' {{MUT}} {{Norina Usman}}

==Overview==
If left untreated, patients may experience spontaneous recovery. Common [[complications]] of dizziness include [[nausea]], [[vomiting]], [[fainting]], fall, imbalance and [[hearing loss]] and [[neurological]] [[complications]] following [[Dix-Hallpike test|Dix Hallpike]] or Epley maneuvers. Prognosis is generally good, and the 10-year mortality rate of patients with dizziness is low approximately (hazard ratio [HR] = 0.62; 95% CI, 0.40-0.96)<ref name="pmid32152013">{{cite journal| author=van Vugt VA, Bas G, van der Wouden JC, Dros J, van Weert HCPM, Yardley L | display-authors=etal| title=Prognosis and Survival of Older Patients With Dizziness in Primary Care: A 10-Year Prospective Cohort Study. | journal=Ann Fam Med | year= 2020 | volume= 18 | issue= 2 | pages= 100-109 | pmid=32152013 | doi=10.1370/afm.2478 | pmc=7062481 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32152013 }} </ref>.

===Natural history===
The symptoms of dizziness typically develop gradually over years and may have a history of cardiovascular disease (for e.g; [[arrhythmia]], [[myocardial infarction]], [[ischemic heart disease]], and neurological disorders such as [[Parkinson's disease]], [[migraine]], [[stroke]], and [[epilepsy]]<ref name="pmid10568646">{{cite journal| author=Spitzer RL, Kroenke K, Williams JB| title=Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. | journal=JAMA | year= 1999 | volume= 282 | issue= 18 | pages= 1737-44 | pmid=10568646 | doi=10.1001/jama.282.18.1737 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10568646 }} </ref>.

===Complication===
Common complications of dizziness include:
*[Fall]
*[Imbalance]
*[Hearing loss]

===Prognosis===
Depending on the extent of the disease progression at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as good.

==References==
{{reflist|2}}
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[[Category:Neurology]]
[[Category:Otolaryngology]]
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Dizziness epidemiology and demographics

2021-02-20T20:04:00Z

Debduti Mukhopadhyay: /* Overview */

__NOTOC__
{{Dizziness}}
{{SI}}
{{CMG}}; {{VR}} {{Norina Usman}}

==Overview==
[[Dizziness]] is the most common non-pain symptom following [[fatigue]] in clinic and community populations.It is also one of the most common complaints in [[ambulatory]] care, accounting for nearly 8 million outpatient visits annually in the United States.<ref name="Kroenke-1990">{{Cite journal | last1 = Kroenke | first1 = K. | last2 = Arrington | first2 = ME. | last3 = Mangelsdorff | first3 = AD. | title = The prevalence of symptoms in medical outpatients and the adequacy of therapy. | journal = Arch Intern Med | volume = 150 | issue = 8 | pages = 1685-9 | month = Aug | year = 1990 | doi = | PMID = 2383163 }}</ref><ref name="Sloane-">{{Cite journal | last1 = Sloane | first1 = PD. | last2 = Dallara | first2 = J. | last3 = Roach | first3 = C. | last4 = Bailey | first4 = KE. | last5 = Mitchell | first5 = M. | last6 = McNutt | first6 = R. | title = Management of dizziness in primary care. | journal = J Am Board Fam Pract | volume = 7 | issue = 1 | pages = 1-8 | month = | year = | doi = | PMID = 8135132 }}</ref>.

==Epidemiology and Demographics==

===Incidence/Prevalance===
Annually, the incidence of dizziness is estimated to be 50–100 million worldwide, and around 4.3 million patients in the United States. The lifetime prevalence of dizziness is expected to be 30%<ref name="pmid29282699">{{cite journal| author=Spiegel R, Kirsch M, Rosin C, Rust H, Baumann T, Sutter R | display-authors=etal| title=Dizziness in the emergency department: an update on diagnosis. | journal=Swiss Med Wkly | year= 2017 | volume= 147 | issue= | pages= w14565 | pmid=29282699 | doi=10.4414/smw.2017.14565 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29282699 }} </ref><ref name="pmid26231273">{{cite journal| author=Newman-Toker DE, Edlow JA| title=TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo. | journal=Neurol Clin | year= 2015 | volume= 33 | issue= 3 | pages= 577-99, viii | pmid=26231273 | doi=10.1016/j.ncl.2015.04.011 | pmc=4522574 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26231273 }} </ref>.
===Age===
The incidence of dizziness increases with age; is most commonly seen in individuals 25 years and older in an emergency department<ref name="pmid18638027">{{cite journal| author=Kerber KA, Meurer WJ, West BT, Fendrick AM| title=Dizziness presentations in U.S. emergency departments, 1995-2004. | journal=Acad Emerg Med | year= 2008 | volume= 15 | issue= 8 | pages= 744-50 | pmid=18638027 | doi=10.1111/j.1553-2712.2008.00189.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18638027 }} </ref><ref name="pmid2738548">{{cite journal| author=Sloane PD| title=Dizziness in primary care. Results from the National Ambulatory Medical Care Survey. | journal=J Fam Pract | year= 1989 | volume= 29 | issue= 1 | pages= 33-8 | pmid=2738548 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2738548 }} </ref>.
===Race===
There is no racial predilection to dizziness.

== References ==
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