Unsteadiness, balance disturbance, and ‘dizziness’ are common presenting complaints on the Acute Medical Unit. This article outlines key components in the evaluation of these problems and describes the most common clinical patterns of dizziness. A case history is used to highlight some key learning points.
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References
Furman JM, Cass SP. Vestibular disorders. A case-study approach 2nd Ed. Oxford University Press, Oxford, 2003.
Heaps T, Cooper N. A case of postural orthostatic tachycardia syndrome on the AMU. Acute Medicine 2009; 8(1): 29–31.
Strupp M, Arbusov V, Maag KP et al. Vestibular exercises improve central vestibulo-spinal compensation after vestibular neuronitis. Neurology 1998; 51: 838–44.
Doubal FN, Dennis MS, Wardlow JM. Characteristics of patients with minor ischaemic strokes and negative MRI: a cross-sectional study. J Neurol Neurosurg Psychiatry 2011; 82: 540–2.
Von Brevern M, Radtke A, Lezius F et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007; 78(7): 710.
Stewart WF, Shechter A, Rasmussen BK. Migraine prevalence. A review of population-based studies. Neurology. 1994; 44(6): S17–23.
Bronstein A and Lempert T. Migrainous vertigo. In: Dizziness. A practical approach to diagnosis and management. Cambridge University Press, Cambridge, 2007.
International Headache Society. The International Classification of Headache Disorders 2nd Edition. Cephalalgia 2004; 24 (1).
Kitahara M. Bilateral aspects of Meniére’s disease. Meniére’s disease with bilateral fluctuant hearing loss. Acta Otolaryngol Suppl. 1991; 485: 74–7.
Psychotherapy in Dizziness G Schmid; P Henningsen; M Dieterich; H Sattel; C Lahmann. J Neurol Neurosurg Psychiatry. 2011; 82(6): 601–6.
Bronstein A and Lempert T. Dizziness. A practical approach to diagnosis and management. Cambridge University Press, Cambridge, 2007. Highly recommended, and comes with a DVD demonstrating examination of the eyes and positional maneouvres.
Furman JM and Cass SP. Vestibular disorders. A case-study approach 2nd Ed. Oxford University Press, 2003. Covers common and more unusual cases of dizziness with discussion.
Cooper N, Forrest K and Mulley G. Falls. In: ABC of Geriatric Medicine. Wiley-Blackwell, Oxford, 2009. Contains a useful illustration of how to perform the Epley Maneouvre.
Hearing and balance disorders. Achieving excellence in diagnosis and management. Report of a Working Party. Royal College of Physicians, London, 2007. www.rcplondon.ac.uk Includes guidelines on referral to a specialist for a balance disorder.
Unsteadiness, balance disturbance, and ‘dizziness’ are common presenting complaints on the Acute Medical Unit. This article outlines key components in the evaluation of these problems and describes the most common clinical patterns of dizziness. A case history is used to highlight some key learning points.
Furman JM, Cass SP. Vestibular disorders. A case-study approach 2nd Ed. Oxford University Press, Oxford, 2003.
Heaps T, Cooper N. A case of postural orthostatic tachycardia syndrome on the AMU. Acute Medicine 2009; 8(1): 29–31.
Strupp M, Arbusov V, Maag KP et al. Vestibular exercises improve central vestibulo-spinal compensation after vestibular neuronitis. Neurology 1998; 51: 838–44.
Doubal FN, Dennis MS, Wardlow JM. Characteristics of patients with minor ischaemic strokes and negative MRI: a cross-sectional study. J Neurol Neurosurg Psychiatry 2011; 82: 540–2.
Von Brevern M, Radtke A, Lezius F et al. Epidemiology of benign paroxysmal positional vertigo: a population based study. J Neurol Neurosurg Psychiatry. 2007; 78(7): 710.
Stewart WF, Shechter A, Rasmussen BK. Migraine prevalence. A review of population-based studies. Neurology. 1994; 44(6): S17–23.
Bronstein A and Lempert T. Migrainous vertigo. In: Dizziness. A practical approach to diagnosis and management. Cambridge University Press, Cambridge, 2007.
International Headache Society. The International Classification of Headache Disorders 2nd Edition. Cephalalgia 2004; 24 (1).
Kitahara M. Bilateral aspects of Meniére’s disease. Meniére’s disease with bilateral fluctuant hearing loss. Acta Otolaryngol Suppl. 1991; 485: 74–7.
Psychotherapy in Dizziness G Schmid; P Henningsen; M Dieterich; H Sattel; C Lahmann. J Neurol Neurosurg Psychiatry. 2011; 82(6): 601–6.
Bronstein A and Lempert T. Dizziness. A practical approach to diagnosis and management. Cambridge University Press, Cambridge, 2007. Highly recommended, and comes with a DVD demonstrating examination of the eyes and positional maneouvres.
Furman JM and Cass SP. Vestibular disorders. A case-study approach 2nd Ed. Oxford University Press, 2003. Covers common and more unusual cases of dizziness with discussion.
Cooper N, Forrest K and Mulley G. Falls. In: ABC of Geriatric Medicine. Wiley-Blackwell, Oxford, 2009. Contains a useful illustration of how to perform the Epley Maneouvre.
Hearing and balance disorders. Achieving excellence in diagnosis and management. Report of a Working Party. Royal College of Physicians, London, 2007. www.rcplondon.ac.uk Includes guidelines on referral to a specialist for a balance disorder.
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MRCP
Consultant in Acute
Medicine, Leeds Teaching
Hospitals
Problem based review: the patient with dizziness on the AMU
Cite this article as:
Kennedy A, Cooper N. Problem based review: the patient with dizziness on the AMU. Acute Med. 2012;11(4):240-5. PMID: 23364110.
Problem based review: the patient with dizziness on the AMU
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