- Preface
- List of Contributors
- List of Abbreviations
- Chapter 1 Biophysics of the Vestibular System
- Chapter 2 Vestibular Physiology: How to be a Clinician and Yet Think Physiologically
- Chapter 3 Eye Movements, Vision, and the Vestibulo-Ocular Reflexes
- Chapter 4 Postural Control and the Vestibulospinal System
- Chapter 5 The Vestibulo-Autonomic System
- Chapter 6 Multisensory Interaction and Vestibular Compensation
- Chapter 7 Functional Imaging of the Vestibular System
- Chapter 8 Clinical Anatomy and Physiology of the Vestibular System
- Chapter 9 I am an Otologist, What Neurology do I Need to Know?
- Chapter 10 I am a Neurologist, What Otology do I Need to Know?
- Chapter 11 Symptoms and Syndromes in the Patient with Dizziness or Unsteadiness
- Chapter 12 Clinical Bedside Examination
- Chapter 13 Oscillopsia and Visuo-Vestibular Symptoms<sup>1</sup>
- Chapter 14 The Role of Vestibular Laboratory Testing
- Chapter 15 Imaging of Vertigo and Labyrinthine Disorders
- Chapter 16 Vestibular Symptoms, Balance, and Their Disorders: How Will We Classify Them?
- Chapter 17 The Principles of Balance Treatment and Rehabilitation
- Chapter 18 The Epidemiology of Vertigo and Imbalance
- Chapter 19 Vestibular Neuritis
- Chapter 20 Positional Vertigo and Benign Paroxysmal Positional Vertigo
- Chapter 21 Migraine and Other Episodic Vestibular Disorders
- Chapter 22 Ménière’s Disease and Other Causes of Episodic Vertigo
- Chapter 23 Posterior Circulation Stroke and Vestibular Syndromes
- Chapter 24 Gait and Disequilibrium
- Chapter 25 Progressive Vestibulocerebellar Syndromes
- Chapter 26 Bilateral Vestibular Failure: Causes and Courses
- Chapter 27 Vertigo and Dizziness in General Medicine
- Chapter 28 Motion Sickness and Disorientation in Vehicles
- Chapter 29 Fits, Faints, Funny Turns, and Falls in the Differential Diagnosis of the Dizzy Patient
- Chapter 30 Behavioural Neuro-Otology
- Index
(p. 307) Fits, Faints, Funny Turns, and Falls in the Differential Diagnosis of the Dizzy Patient
- Chapter:
- (p. 307) Fits, Faints, Funny Turns, and Falls in the Differential Diagnosis of the Dizzy Patient
- Author(s):
Alexander A. Tarnutzer
and David E. Newman-Toker
- DOI:
- 10.1093/med/9780199608997.003.0029
Sudden unexplained falls may provide a diagnostic challenge to the physician as a broad differential diagnosis needs to be considered while confronted with an incomplete and potentially inaccurate history provided by the patient and eyewitnesses. Falls may go along with transient loss of consciousness (TLOC) and may be preceded by vertigo / dizziness (“funny turns”), which, however, may present in isolation also. The diagnostic approach should focus on the most frequent (reflex syncope (‘faints’), psychogenic syncope / seizure and epileptic seizures (“fits”)) and the most dangerous (cardiogenic syncope, symptomatic seizures, vertebrobasilar TIA) causes of TLOC and falls. Mimics of seizure include reflex syncope, autonomic failure and psychogenic non-epileptic seizures and their identification is important for a targeted treatment. The duration, onset and frequency of transient dizziness /vertigo needs to be carefully evaluated and potential triggers desire special attention to narrow the differential diagnosis of dizziness /vertigo. Diagnostic testing should be ordered based on the clinical findings only. While prognosis is usually excellent for certain differential diagnoses (e.g. reflex syncope), one-year mortality may reach values of up to 30% in others (e.g. cardiac syncope), underling the importance to distinguish between different conditions.
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- Preface
- List of Contributors
- List of Abbreviations
- Chapter 1 Biophysics of the Vestibular System
- Chapter 2 Vestibular Physiology: How to be a Clinician and Yet Think Physiologically
- Chapter 3 Eye Movements, Vision, and the Vestibulo-Ocular Reflexes
- Chapter 4 Postural Control and the Vestibulospinal System
- Chapter 5 The Vestibulo-Autonomic System
- Chapter 6 Multisensory Interaction and Vestibular Compensation
- Chapter 7 Functional Imaging of the Vestibular System
- Chapter 8 Clinical Anatomy and Physiology of the Vestibular System
- Chapter 9 I am an Otologist, What Neurology do I Need to Know?
- Chapter 10 I am a Neurologist, What Otology do I Need to Know?
- Chapter 11 Symptoms and Syndromes in the Patient with Dizziness or Unsteadiness
- Chapter 12 Clinical Bedside Examination
- Chapter 13 Oscillopsia and Visuo-Vestibular Symptoms<sup>1</sup>
- Chapter 14 The Role of Vestibular Laboratory Testing
- Chapter 15 Imaging of Vertigo and Labyrinthine Disorders
- Chapter 16 Vestibular Symptoms, Balance, and Their Disorders: How Will We Classify Them?
- Chapter 17 The Principles of Balance Treatment and Rehabilitation
- Chapter 18 The Epidemiology of Vertigo and Imbalance
- Chapter 19 Vestibular Neuritis
- Chapter 20 Positional Vertigo and Benign Paroxysmal Positional Vertigo
- Chapter 21 Migraine and Other Episodic Vestibular Disorders
- Chapter 22 Ménière’s Disease and Other Causes of Episodic Vertigo
- Chapter 23 Posterior Circulation Stroke and Vestibular Syndromes
- Chapter 24 Gait and Disequilibrium
- Chapter 25 Progressive Vestibulocerebellar Syndromes
- Chapter 26 Bilateral Vestibular Failure: Causes and Courses
- Chapter 27 Vertigo and Dizziness in General Medicine
- Chapter 28 Motion Sickness and Disorientation in Vehicles
- Chapter 29 Fits, Faints, Funny Turns, and Falls in the Differential Diagnosis of the Dizzy Patient
- Chapter 30 Behavioural Neuro-Otology
- Index