Tag Archives: dizziness
A modified Epley maneuver for the treatment of left posterior semicircular canal benign paroxysmal positional vertigo. The head is turned 45° toward the left (A); then the patient reclines back with the head still turned left (B), and this position is maintained for approximately 30 seconds. If nystagmus is observed, the patient turns the head 90° toward the right side (C) while maintaining neck extension. The head-hanging-right position is then maintained for approximately 30 seconds. Next, the patient is turned further toward the right, into a side-lying position, such that the head is turned in the same direction, 90° beyond its last position; the nose should then be pointing in a direction that is about halfway between parallel and perpendicular to the floor (not shown). After approximately 30 seconds, the patient sits up. For the treatment of the right posterior canal variant, this procedure is followed with the modification of exchanging the words right and left. Treatments of the horizontal and anterior canal variants are outside the scope of this review.

Dizziness

  Dizziness is common, as reflected by the cost of assessing dizziness in U.S. emergency rooms, which reportedly exceeds $4 billion per year.1, 2 For many patients, the pathophysiology of dizziness will not be fully demonstrable by diagnostic tests. However, a systematic clinical approach allows for the identification of common forms of dizziness. Recognizing common patterns of […]

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Dizziness Symptom Type Prevalence and Overlap

  The traditional approach to dizziness encourages providers to emphasize the type of dizziness. However, symptom types might substantially overlap in individual patients, thus limiting the clinical value of this approach. We aimed to describe the overlap of types of dizziness using a US nationally representative sample. Methods The 2008 US National Health Interview Survey […]

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(A) Digital subtraction angiography (DSA) demonstrated focal stenosis of V2 segment of left vertebral artery (yellow arrow). (B) DSA revealed that the posterior circulation of the brain was otherwise normal beyond the level of stenosis.

Provoked Dizziness from Bow Hunter’s Syndrome

  A 62-year-old man was experiencing debilitating bouts of dizziness provoked by head rotation until ultimately finding relief with cervical spine fixation. He had a history of coronary artery disease, human immunodeficiency virus, tobacco use disorder, and generalized anxiety, and initially presented to a routine primary care visit with 3 weeks of episodic dizziness. During […]

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