Document Detail

The ten-minute examination of the dizzy patient.
MedLine Citation:
PMID:  11774054     Owner:  NLM     Status:  MEDLINE    
Dizziness and postural instability are common presenting complaints in patients seen in otolaryngology practice. Unfortunately, these patients frequently do not receive optimal evaluation and therapy because of the difficulty in obtaining a thorough yet pertinent history and the perceived complexity of the physical examination. Over the last 10 years, we have utilized a standardized approach to evaluation of the dizzy patient that is user friendly and maximizes the time and effort spent by the clinician. First, a thorough history is taken from the patient in two forms: (1) a specially designed questionnaire filled out well before the examination and (2) a direct interview using the answers on the questionnaire as a guide. During the physical examination, emphasis is placed on the following subtests: (1) spontaneous nystagmus; (2) central oculomotor function; (3) the vestibulo-ocular reflex (VOR) battery--headshake, head thrust, dynamic visual acuity, and Hallpike positioning; (4) coordination; (5) posture; (6) gait; and (7) special examinations. This neurotologic examination is completed in about 10 minutes and is performed as a battery of tests following the routine otolaryngologic and/or neurologic examination. We feel that this test sequence is thorough yet easy to perform and ideally will demystify the examination of these challenging patients.
J A Goebel
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Seminars in neurology     Volume:  21     ISSN:  0271-8235     ISO Abbreviation:  Semin Neurol     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-01-04     Completed Date:  2002-02-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8111343     Medline TA:  Semin Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  391-8     Citation Subset:  IM    
Department of Otolaryngology, Division of Head and Neck Surgery, Washington University School of Medicine, Saint Louis, Missouri 63110, USA.
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MeSH Terms
Diagnosis, Differential
Dizziness / etiology*
Labyrinth Diseases / complications,  diagnosis*
Medical History Taking / methods
Nervous System Diseases / diagnosis*
Neurologic Examination / methods*
Physical Examination / methods
Vestibular Function Tests*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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