Non-specific. The three common types of ‘dizziness’ are:

• world spinning → Vertigo

  • May slowly subside (not chronic → would slowly subside)

• world bouncing → Oscillopsia

• light-headedness or presyncope → !Syncope

• gait unsteadiness/Dysequilibirum → Dis-equilibirum

  

Interview

The following is a list of important questions to ask when someone presents with dizziness. This list is not exhaustive and the clinician should try to steer away from any leading questions, particularly during the initial part of the interview (i.e., start with open questions).

• Quality: Can you describe what you mean by dizziness? What do you feel internally?
• Onset: Does it come on suddenly? Is it constant, or does it come and go? How long does it last?
• Provoking factors: Can you think of any triggers for your dizziness? Was there a preceding trigger of your current dizziness (e.g. viral infection, trauma)?
• Timing: Have you had this feeling of dizziness before? How often does it occur?

Assoc. Sign/Symptom

• GI: Did you feel nauseous at the same time you felt dizzy? Is there any associated vomiting?
  • N/V - Nausea/vomitting
• HEENT: Have you noticed any changes in your hearing, ringing in your ears, or a sensation that the ears are plugged?
  • Hearing Loss (<25 db), Tinnitus, Nystagmus
• NEURO: Do you have any other neurological symptoms, such as slurred speech, facial weakness, facial numbness, ataxia or diplopia?
  • Dysarthria, Ataxia, Diplopia, Numbness, Facial weakness/paralysis, Other focal neurological symptom.
  • *Dysequilibirum = physical exam finding of Axial Ataxia
    • feeling unsteady on their feet
    • but would often accompany vertigo and pre-psyncopy (so not very useful)
• CARDIOVASC: Is your dizziness associated with any chest pain, palpitations, or shortness of breath?
  • !SOB (Dyspnea), CP - Chest Pain, Palpitation