Evaluation Of A Patient With Vertigo

HISTORY:

VERTIGO
  • Swaying:
  • Lightheadedness:
  • Turning to right/left:
  • Falling to right/left:
  • Blackouts:
  • Surrounding objects moving / true spinning:
  • Loss of consciousness:
OTHER SYMTOMS:
  • Sweating
  • Nausea
  • Vomiting
PRECIPITATING FACTORS:
  • SMotion:
  • Turning head
  • Bending down
  • Standing up
  • Gazing right/left
DURATION OF SYMPTOMS:
  • Hours
  • Days
  • Weeks
  • Months
  • Years
  • Decades
DURATION OF SINGLE ATTACK:
  • Few Seconds
  • Minutes
  • Hours
  • Days
  • Weeks
  • Months
  • Persistent
VISUAL DISTURBANCES:
  • Blurring of Vision
  • Diplopia
EAR SYMPTOMS:
  • Tinnitus
  • Deafness
  • Aural fullness
HISTORY OF DRUG INTAKE:
HISTORY OF OTOLOGIC SURGERIES:
HISTORY OF HEAD/EAR TRAUMA:
HISTORY OF SYSTEMIC ILLNESS:
  • Hypertension:
  • Diabetes Mellitus
  • Cardiac illness
  • Renal disease


CLINICAL EXAMINATION:

EXAMINATION OF EARS:
  • Tympanic Membrane
  • Facial nerve status
  • Tuning Fork Test
    • Rinne's Test
    • Webers Test
    • ABC
  • Tests for equilibrium and co- ordination:
    • Romberg's test
    • Gait Test
    • Unterberger's Test
    • Past pointing
    • Finger Nose Test
    • Rapidly alternately task test
  • Tests for Spontaneous eye movements:
    • Nystagmus:
    • Plane- Horizontal/ Vertical/ Rotatory
    • Direction- Fixed/ Changing
    • Degree- First/Second/Third
    • Type- Monocular/ Convergence/Divergence/See-saw/Up-beating/Down-beating
      • Opsoclonus
      • Pendular eye movements
      • Ocular bobbing
  • Tests of induced Nystagmus:
    • Gaze Test
    • Positional Test
    • Fistula Test

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