Dizziness, Vertigo, and Imbalance Questions & Answers

Updated: Mar 13, 2017
  • Author: Hesham M Samy, MD, PhD; Chief Editor: Robert A Egan, MD  more...
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Questions & Answers

Overview

What is the role of the vestibular exam in the evaluation of dizziness, vertigo, and imbalance?

Which patient group is at highest risk for falls due to dizziness and vertigo?

What is the overall incidence of dizziness, vertigo, and imbalance in the US?

What is the global prevalence of dizziness, vertigo, and imbalance?

What is the most common disability associated with dizziness, vertigo, and imbalance?

Which type of disorders are vertigo and dizziness most often associated with?

Which specialists should be consulted in the management of dizziness, vertigo, and imbalance?

What are the treatment options for dizziness, vertigo, and imbalance?

What patient education resources are available for dizziness, vertigo, and imbalance?

What are the common causes of peripheral vertigo and central dizziness?

What are the inner ear pathologies associated with dizziness, vertigo, and imbalance?

What is the association between neurologic disorders and dizziness, vertigo, and imbalance?

What is the incidence of dizziness, vertigo, and imbalance in the US?

What is the global prevalence of dizziness, vertigo, and imbalance?

Presentation

What is included in the evaluation of dizziness, vertigo, and imbalance?

How are dizziness and vertigo characterized?

How is vertigo differentiated from other types of dizziness?

How does the time course of vertigo help identify its etiology?

What are the signs and symptoms of central vertigo?

How does medical history help differentiate migraine-related dizziness from vestibular neuronitis or Ménière disease?

Which sensory and motor symptoms suggest a specific etiology for dizziness and imbalance?

What history finding suggests pharmacologically-induced dizziness?

Which etiologies of dizziness, vertigo, and imbalance is most common in the elderly?

How is the etiology of dizziness, vertigo, and imbalance diagnosed?

What should be included in the physical exam of dizziness, vertigo, and imbalance?

What are the 2 most-used reflexes examined in patients with dizziness, vertigo, and imbalance?

What is included in the vestibular exam of dizziness, vertigo, and imbalance?

How is nystagmus characterized in patients with dizziness, vertigo, and imbalance?

Which ocular findings are used to differentiate peripheral from central nystagmus in the evaluation of dizziness, vertigo, and imbalance?

What is the role of positioning exam (Dix-Hallpike test) in the evaluation of dizziness, vertigo, and imbalance?

What does a positioning exam reveal about dizziness, vertigo, and imbalance?

How is a vertical component of benign positioning nystagmus assessed in patients with dizziness, vertigo, and imbalance?

Which physical findings suggests horizontal nystagmus in patients with dizziness, vertigo, and imbalance?

How is caloric testing performed in the evaluation of dizziness, vertigo, and imbalance?

What is the role of vestibulospinal reflex (VSR) exam in the evaluation of dizziness, vertigo, and imbalance?

How is the Romberg exam conducted in the evaluation of dizziness, vertigo, and imbalance?

What is the Hamid vestibular stress test for dizziness, vertigo, and imbalance?

What are the limitations of vestibular stress tests in the evaluation of dizziness, vertigo, and imbalance?

What is the role of hyperventilation testing in the evaluation of dizziness, vertigo, and imbalance?

DDX

What is the basis for forming a differential diagnosis for dizziness, vertigo, and imbalance?

What are the differential diagnoses for Dizziness, Vertigo, and Imbalance?

Workup

Which tests are performed in the diagnosis of dizziness, vertigo, and imbalance?

What is the role of MRI in the diagnosis for dizziness, vertigo, and imbalance?

What is the role of audiometry and vestibular testing in the diagnosis of dizziness, vertigo, and imbalance?

What type of training is necessary to interpret vestibular test results for dizziness, vertigo, and imbalance?

What are the most commonly performed vestibular tests for the diagnosis of dizziness, vertigo, and imbalance?

What is the included in the standard electro/videonystagmography (ENG) test battery for the diagnosis of dizziness, vertigo, and imbalance?

What is the role of the saccadic test in the diagnosis of dizziness, vertigo, and imbalance?

How is the saccadic test performed in the evaluation of dizziness, vertigo, and imbalance?

What is the role of the gaze test in the diagnosis of dizziness, vertigo, and imbalance?

What is the role of the pursuit eye-movement test in the diagnosis of dizziness, vertigo, and imbalance?

What is the role of the optokinetic nystagmus (OKN) test in the diagnosis of dizziness, vertigo, and imbalance?

What is the role of the head-shake nystagmus test in the diagnosis of dizziness, vertigo, and imbalance?

What is the role of the positional nystagmus test in the diagnosis of dizziness, vertigo, and imbalance?

What is the role of the Dix-Hallpike test in the diagnosis of dizziness, vertigo, and imbalance?

What is the role of the bithermal caloric test in the diagnosis of dizziness, vertigo, and imbalance?

What are the most important findings of the bithermal caloric test for the diagnosis of dizziness, vertigo, and imbalance?

When were rotating-chair test systems developed for the diagnosis of dizziness, vertigo, and imbalance?

What is the role of the rotating-chair test in the diagnosis of dizziness, vertigo, and imbalance?

What is an alternative to the rotating-chair test for the diagnosis of dizziness, vertigo, and imbalance?

What is the role of computerized dynamic posturography in the diagnosis of dizziness, vertigo, and imbalance?

What is the role of vestibular evoked myogenic potential (VEMP) in the diagnosis of dizziness, vertigo, and imbalance?

What are the limitations of vestibular tests for the diagnosis of dizziness, vertigo, and imbalance?

Treatment

What are the treatments options for acute dizziness and vertigo?

What is vestibular neuronitis-related acute vertigo?

What is Ménière disease?

What are the treatments options for vestibular neuronitis-related acute vertigo?

What is benign paroxysmal positioning vertigo (BPPV)?

What is the mechanism causing benign paroxysmal positioning vertigo (BPPV)?

What are the treatment options for benign paroxysmal positioning vertigo (BPPV)?

What are conservative therapies for Ménière disease?

What is the role of surgical therapy in the treatment of Ménière disease?

How is autoimmune inner-ear disease differentiated from Ménière disease?

What are the treatment options for autoimmune inner-ear disease?

What is migraine headache-caused dizziness?

How frequently is dizziness or vertigo a symptom of multiple sclerosis?

How is vestibular migraine diagnosed?

What is the pathogenesis of vestibular migraine?

What are the treatment options for vestibular migraine dizziness?

What are transient ischemic attacks (TIAs)?

How does a stroke cause vertigo?

What is a stroke differentiated from vestibular neuronitis?

What is the focus of evaluation of stroke?

How is multiple sclerosis diagnosed?

What is vestibular schwannoma (acoustic neuroma)?

What are the prevalence of dizziness in vestibular schwannoma (acoustic neuroma)?

What are some clinical manifestations of vestibular schwannoma (acoustic neuroma)?

How is vestibular schwannoma (acoustic neuroma) diagnosed?

What is the role of CNS in disequilibrium?

What is the cause of most falls in the elderly?

What is the role of vestibular rehabilitation in the management of dizziness, vertigo, and imbalance?

What are the goals of vestibular rehabilitation for dizziness, vertigo, and imbalance?

What is the efficacy of vestibular rehabilitation for dizziness, vertigo, and imbalance?

In which groups of patients in vestibular rehabilitation most beneficial for dizziness, vertigo, and imbalance?

What is the role of tai chi in the vestibular rehabilitation of dizziness, vertigo, and imbalance?

Medications

What are the goals of drug treatment for dizziness, vertigo, and imbalance?

Which medications in the drug class Anticholinergic Agents are used in the treatment of Dizziness, Vertigo, and Imbalance?

Which medications in the drug class Alpha/Beta Adrenergic Agonists are used in the treatment of Dizziness, Vertigo, and Imbalance?

Which medications in the drug class Phenothiazine Derivatives are used in the treatment of Dizziness, Vertigo, and Imbalance?

Which medications in the drug class Anxiolytics, Benzodiazepines are used in the treatment of Dizziness, Vertigo, and Imbalance?

Which medications in the drug class Antihistamines, 1st Generation are used in the treatment of Dizziness, Vertigo, and Imbalance?