Dizziness is a term used frequently by patients and should be avoided by the interviewer. "Dizziness" may be the patient's description of vertigo, ataxia, or lightheadedness. Any time the patient uses this term, it must be clarified by additional questioning, because different pathophysiologic mechanisms may be responsible. The interviewer needs to differentiate vertigo from ataxia. If the patient complains of "dizziness," it is important to ask these questions:
''Would you describe the dizziness as a strange spinning sensation in your head?'' ''Did the room spin, or did it feel as if you were spinning?'' ''Were you unsteady while walking?''
Vertigo is partially discussed in Chapter 11, The Ear and Nose. Vertigo is the hallucination of movement. Acute vertigo may be associated with nausea, vomiting, perspiration, and a sense of anxiety. Ask patients whether they have the sensation that objects are moving around them or that they are spinning or moving. In addition to the questions in Chapter 11, ask the following:
During the attack, did you experience any nausea or vomiting?'' ' 'Have you noticed any problem with your hearing or ringing in your ears?'' ''Have you ever been given an antibiotic called gentamicin?''
Meniere's disease can result in protracted attacks of severe vertigo associated with vomiting. Many patients with Meniere's disease also have the symptoms of tinnitus and hearing loss. During the attack, the patient is unsteady, with horizontal nystagmus directed away from the affected ear. Certain drugs (such as gentamicin) are associated with changes in the labyrinth of the ear and can cause vertigo and deafness.
Dizziness and stumbling are commonly associated with a stroke.
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Are you sick of feeling like the whole world Is spinning out of control. Do You Feel Weak Helpless Nauseous? Are You Scared to Move More Than a Few Inches From The Safety of Your Bed! Then you really need to read this page. You see, I know exactly what you are going through right now, believe me, I understand because I have been there & experienced vertigo at it's worst!