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The History of the Dizzy Patient 

The History of the Dizzy Patient
Chapter:
The History of the Dizzy Patient
Author(s):

Robert W. Baloh

, Vicente Honrubia

, and Kevin A. Kerber

DOI:
10.1093/med/9780195387834.003.0005
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date: 24 June 2021

Vertigo is an episodic phenomenon, whereas nonvestibular dizziness is often continuous. An exception would be presyncopal light-headedness caused by postural hypotension or cardiac arrhythmia. Patients with psychophysiologic dizziness often report being dizzy from morning to night without changes for months to years at a time. Vertigo is typically aggravated by head movements, whereas nonvestibular dizziness is often aggravated by movement of visual targets. Episodes of dizziness induced by position change suggest a vestibular lesion if postural hypotension has been ruled out. Although stress can aggravate both vestibular and nonvestibular dizziness, dizziness that is reliably precipitated by stress suggests a nonvestibular cause. Finally, episodes of dizziness occurring only in specific situations (e.g., driving on the freeway, entering a crowded room, or shopping in a busy supermarket) suggest a nonvestibular cause.

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