Sandbox:Fahimeh
Patient present with dizziness[1][2][3][4] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Loss of consciousness? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Sense of motion/ spinning? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Other | Sweating Heaviness sensation in the legs "Tunnel" vision Feeling warm or hot Nausea Vomiting | History of seizure Aura Post-ictal phase Uncontrollable muscle spasms Drooling or frothing at the mouth Teeth clenching Tongue biting Sudden, rapid eye movements | Yes | No | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Electrolyte imbalance/ Intracranial process | Syncope | Seizure | Vertigo | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Sudden, and generally momentary, loss of consciousness, or blacking out caused by the Central Ischaemic Response | Temporary abnormal electro-physiologic phenomenon of the brain, resulting in abnormal synchronization of electrical neuronal activity | Sudden onset? Horizental vertigo? Auditory symptoms? No neurological problem? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Causes: •Hemorrhage •Hypotension •Hypoxia •Pulmonary embolism •Ruptured abdominal aortic aneurysm •Ventricular arrhythmia •Arrhythmia •Medication •Orthostatic hypotension •Vagal stimulation •Vertebrobasilar insufficiency | Causes: •Brain damage •Congenital abnormalities •Stroke •Infection •Genetic syndromes •Brain tumor •Epilepsy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Peripheral | Central | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
BPPV Vestibular neuritis HSV oticus Meniere disease Labyrinthine concussion Perilymphatic fistula Semicircular canal dehiscence syndrome Vestibular paroxysma Cogan syndrome Vestibular schwannoma Otitis media Aminoglycoside toxicity Recurrent vestibulopathy | Vestibular migraine Epileptic vertigo Multiple sclerosis Brain tumors Crebellar infarction/hemorrhage Brain stem ischemia Chiari malformation Parkinson | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Hyperventilation Psychiatric symptoms | Balance problem | Sweating Tunnel Vision Nausea Heart palpitations Abdominal discomfort Slurred speech | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Psychogenic dizziness | Dysequilibrium | Presyncope | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dizziness which is not characterized by true vertigo and it can be replicated by hyperventilation and psychiatric symptoms that usually precede its onset. | Impaired sense or absence of balance or equilibrioception that primarily occurs during standing or walking | Feeling of lightheadedness that can lead to syncope | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Causes: •Alcohol dependence •Conversion disorder •Fibromyalgia •Generalized anxiety •Hyperventilation •Major depression •Panic disorder | Y02 | Causes: •Hemorrhage •Hypotension •Hypoxia •Pulmonary embolism •Ruptured abdominal aortic aneurysm •Ventricular arrhythmia •Arrhythmia •Medication •Orthostatic hypotension •Vagal stimulation •Vertebrobasilar insufficiency | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
- ↑ Dieterich M, Staab JP, Brandt T (2016). "Functional (psychogenic) dizziness". Handb Clin Neurol. 139: 447–468. doi:10.1016/B978-0-12-801772-2.00037-0. PMID 27719862.
- ↑ Cheshire WP (April 2017). "Syncope". Continuum (Minneap Minn). 23 (2, Selected Topics in Outpatient Neurology): 335–358. doi:10.1212/CON.0000000000000444. PMID 28375909.
- ↑ Chan, Yvonne (2009). "Differential diagnosis of dizziness". Current Opinion in Otolaryngology & Head and Neck Surgery. 17 (3): 200–203. doi:10.1097/MOO.0b013e32832b2594. ISSN 1068-9508.
- ↑ Brandt, T (2001). "NOSOLOGICAL ENTITIES?: Cervical vertigo". Journal of Neurology, Neurosurgery & Psychiatry. 71 (1): 8–12. doi:10.1136/jnnp.71.1.8. ISSN 0022-3050.