What medical history is relevant in a dizziness evaluation?

Updated: Jun 26, 2018
  • Author: Wayne T Shaia, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Answer

Relevant medical history in a dizziness evaluation includes the following:

  • Determine if the patient has conditions such as diabetes (which can cause visual and proprioceptive problems), hypertension, cardiovascular or cerebrovascular disease, migraine, or neurologic disease (eg, multiple sclerosis).

  • Determine if the patient has any family history of cardiovascular disease, peripheral vascular disease, or migraine. Labyrinthine causes of vertigo usually are not inherited; however, rare exceptions (eg, Usher syndrome) are reported. Some clinical researchers believe that Ménière disease may have a hereditary predilection.

  • Inquire about the patient's medications. The list of medications that can cause dizziness is long; the most common culprits are antihypertensive agents. Ask if the onset of the patient's symptoms was associated with starting a new medication or a change in the dose or frequency of a medication.

  • Determine if the patient has had ear surgery. Although surgery for chronic ear disease only occasionally results in permanent vestibular injury, patients with a history of surgery for cholesteatoma may have an iatrogenic or acquired labyrinthine fistula. Patients who have undergone stapes surgery for otosclerosis or tympanosclerosis may develop vestibular symptoms because of perilymphatic fistula, adhesions between the oval window and saccule, or an overly long prosthesis.


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