DOCSLIB.ORG

Dizziness and Balance

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Dizziness and Balance Dizziness and balance Information for patients MSK Outpatients (Therapy) PROUD TO MAKE A DIFFERENCE SHEFFIELD TEACHING HOSPITALS NHS FOUNDATION TRUST How do we normally control our balance? Visual information Adjustments Brain to your eye combines movements input information Balance awareness Balance Other sensory Adjustments information to your body (e.g. body position, position motion, touch) page 2 of 12 There are three different balance senses that send the brain information to help control our balance: 1. The eyes send information to the brain about where you are and where you are going. 2. The inner ears (also called the vestibular system) send the brain information about head movements such as looking up, bending down and turning your head as well as movements such as moving in a car or in a lift. 3. Muscles and joints (also called the proprioceptive system) send the brain information about the body’s position and how the body is moving. The brain is like a computer that receives information from these three different senses. It then makes changes as necessary by sending information back to the eyes and body. This maintains our balance and allows our vision to remain stable. What is dizziness? Dizziness feels different to different people. Some people may feel unsteady, lightheaded, ‘woozy’ and / or a spinning sensation (sometimes called vertigo). Dizziness is not a disease or an illness but explains how we feel when our balance systems are not working normally. It is a common symptom and can get better by itself. It is very rarely due to a serious medical condition. However dizziness can still be very unpleasant and frightening and can result in other symptoms like feeling sick, being sick, tiredness and poor concentration. page 3 of 12 Why do I feel dizzy? The brain stores a memory bank of the information it receives from the three different senses. The brain can then access this information automatically so normally we do not have to think about our balance. If one of the balance systems is not working properly then the brain starts to receive incorrect information. The brain does not recognise this information as it does not match the information stored in the memory bank. This is when we can experience dizziness and / or unsteadiness. Normally the right and left inner ear balance organs work together. However if there is a problem with one side (for example following an ear infection) the inner ears may no longer work together. The brain perceives that your head is moving when it isn’t and you will feel dizzy. Why has my dizziness not improved? Often when a person has dizziness or a balance problem they naturally start to avoid certain movements that make them feel worse. They think “Why do something that makes me feel more dizzy or ill?” However recovery (also known as compensation) cannot occur if movements are avoided. If the brain does not sense dizziness then it does not realise something is wrong and cannot begin the recovery process. Can my dizziness improve? The good news is yes! Many people with dizziness or balance problems benefit from balance exercises, also known as vestibular rehabilitation. It is very important that you practice the exercises regularly as advised by your physiotherapist or doctor. Medication may help to control symptoms initially but it will not cure the problem. If used long term, some medications can stop the balance systems from working normally thereby preventing full recovery. Some medications can also cause feelings of dizziness. Please discuss this with your doctor before stopping any medication. page 4 of 12 Gaze stability exercise This is a type of exercise often given to patients with inner ear problems. Only carry these exercises out if advised by your therapist. These exercises are based on normal movements that occur in daily life so they should be totally safe unless you have been advised to avoid these movements. A BC Looking at a letter stuck to the wall, turn your head left to right and back 10 times in 10 seconds (as if you are shaking your head to say no). Keep your eyes fixed on the letter the whole time you are moving your head. Only turn your head as far as comfortable and definitely no more than about 45 degrees to the left or right. If this exercise makes you feel too dizzy or the letter is going blurry then slow the movement down. This exercise can be repeated by nodding your head up and down whilst looking at a letter. Try these exercises twice a day if possible. It is very unlikely, but stop the exercises if they bring on any symptoms that you do not usually have such as: feeling faint or blacking out; double vision; numbness, tingling or weakness; or severe, sharp or prolonged neck pain. If you are unsure please ring your therapist. As well as these exercises your therapist will ask you to carry out other exercises depending on what your main problems are. page 5 of 12 How do the exercises reduce dizziness? The exercises your physiotherapist asks you to do will make you feel slight dizziness or unsteadiness due to the mismatch of signals from the balance senses. Repeating the movements that make you feel dizzy allows the brain to learn to cope with the new balance information and accept the movement is normal again. The brain can also use more information from the eyes, ankles, legs and neck to maintain balance and minimise dizziness. The key to recovery is not to avoid any movements and to gradually increase your activity each week. Try to practice the movements that are difficult if you feel it is safe to do so. Can the exercises be harmful? Sometimes to begin with the exercises can make you feel more dizzy. Don’t worry, you are not doing any harm to your balance systems. Sometimes the brain can become a little ‘overloaded’ with new information it is receiving from the balance systems during the exercises. It is therefore best to start the exercises gradually and build up your tolerance to the movements slowly. If you find the exercises stop you from being able to carry out your daily activities then discuss this with your physiotherapist. You may need to reduce the number of exercises or perhaps do them more slowly to begin with. On the other hand if the exercises do not make you feel dizzy at all then it may be that you need to start doing more difficult exercises. When you are carrying out the exercises always make sure you are safe. If you are worried about falling or feeling very dizzy then have someone with you while you are doing the exercises. page 6 of 12 How quickly will it improve? The process of recovery can take a long time and does vary from person to person. Often the exercises start to feel easier as the balance systems are working better. However, it can then take time for the brain to adjust to the new information. People normally start to feel an improvement after around 3 to 6 months. Studies have shown that 4 out of 5 people who carried out exercises to reduce dizziness felt better within a few months. Those who did not do the exercises showed no improvement. Will I make a full recovery? You should be able to make a good recovery following the exercises despite having an inner ear or balance problem. The recovery process is not always 100% efficient and you may feel better on some days and worse on others. This can often be due to stress, tiredness or illness and is quite normal. It does not mean that the original problem is coming back or that your problem is getting worse. You should find that, as you continue to practice the exercises, there are fewer bad days. page 7 of 12 How and why does stress affect my dizziness? Dizziness and balance problems can cause worries, anxieties and stress. People may also have worries about work, social activities or family commitments. This can lead to a vicious cycle of stress, making the feelings of dizziness worse. One reason why stress increases dizziness is because when we become aware of dizziness or feeling off balance our brain consciously takes over and our balance is no longer automatic. This can trigger a response known as the ‘fight or flight’ reflex. This can cause symptoms like the heart beating fast, breathing quickly, feeling sick, feeling hot and sweaty or cold and clammy. This is a reaction to the feelings of dizziness but again can result in feeling more dizzy. People also find they are less able to cope with dizziness when under stress. If the body is trying hard to deal with the stress, it then finds it difficult to cope with the balance problem too. This is another reason why stress can increase dizziness. It is therefore important where possible to reduce anxiety, tension and stress as this can help to reduce dizziness too. It is important to speak to your physiotherapist if you feel this is a problem. There is further help you can get with this and it is a quite normal part of feeling dizzy. Breathing and relaxation exercises can help to reduce stress and allow people to feel in control in difficult situations. page 8 of 12 Is there anything else I can do to help myself? Keeping active by walking and taking part in sports are good ways to challenge your balance, keep you fit and keep your muscles strong.
Load more

Recommended publications
  • Fullness, and Tinni- Tus
    Neurology® Clinical Practice The evaluation of a patient with dizziness Kevin A. Kerber, MD Robert W. Baloh, MD Summary Dizziness is the quintessential symptom presenta- tion in all of clinical medicine. It can stem from a disturbance in nearly any system of the body. Pa- tient descriptions of the symptom are often vague and inconsistent, so careful probing is essential. The physical examination is performed by observ- ing the patient at rest and following simple move- ments or bedside tests. In general, no special tools are required. The causes of dizziness range from benign to life-threatening disorders, and features that distinguish among these may be subtle. When diagnostic testing is considered, parsimony should be the rule. Identifying common peripheral vestibu- lar disorders is a priority. Picking this “low hanging fruit” can be the key component to excluding more serious central causes of dizziness. eurologists play an important role in the evaluation and management of pa- tients with dizziness. The possibility of a serious neurologic disorder is un- Nnerving to front-line physicians who have ranked decision support for identifying central causes of vertigo as a top priority.1 Although dangerous cen- tral disorders do not commonly present as isolated dizziness, stroke and other neurologic disorders can occur in this manner. The history and physical examination are the critical elements in determining the management of these patients. In this article, we review the approach to the evaluation and management of patients with dizziness. History The first step in assessing a patient presenting with dizziness is to define the symptom (table 1).
    [Show full text]
  • Vertebral Artery Dissection Presenting As Transient Global Amnesia: a Case Report and Review of Literature
    Dementia and Neurocognitive Disorders 2014; 13: 46-49 CASE REPORT http://dx.doi.org/10.12779/dnd.2014.13.2.46 Vertebral Artery Dissection Presenting as Transient Global Amnesia: A Case Report and Review of Literature , Yeonsil Moon*, Seol-Heui Han* † Vertebral artery dissection is one of the most common causes of stroke in young adults. The course of the vertebral artery dissection is usually benign, and pure transient amnesia as an initial symptom has Department of Neurology*, Konkuk University Medical Center, Seoul; Center for Geriatric been rarely reported. We describe a patient with vertebral artery dissection who presented with acute Neuroscience Research, Institute of transient amnesia, and review the medical literatures about the pathophysiological mechanism of tran- Biomedical Science†, Konkuk University, sient global amenesia (TGA). This case could be a one of evidence which supports the cerebrovascular Seoul, Korea mechanism of TGA. Received: May 19, 2014 Revision received: June 26, 2014 Accepted: June 26, 2014 Address for correspondence Seol-Heui Han, M.D. Department of Neurology, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 143-729, Korea Tel: +82-2-2030-7561 Fax: +82-2-2030-7469 E-mail: [email protected] Key Words: Transient global amnesia, Vertebral artery dissection, Cerebrovascular Vertebral artery dissection is one of the most common longed cognitive decline and review the medical literatures causes of stroke in young adults [1]. The course of the verte- about the pathophysiological mechanism of transient global bral artery dissection is usually benign, but seldom reaches to amenesia (TGA). severe complication, such as brainstem infarction, subarach- noid hemorrhage (SAH) or death [2].
    [Show full text]
  • Second Edition
    COVID-19 Evidence Update COVID-19 Update from SAHMRI, Health Translation SA and the Commission on Excellence and Innovation in Health Updated 4 May 2020 – 2nd Edition “What is the prevalence, positive predictive value, negative predictive value, sensitivity and specificity of anosmia in the diagnosis of COVID-19?” Executive Summary There is widespread reporting of a potential link between anosmia (loss of smell) and ageusia (loss of taste) and SARS-COV-2 infection, as an early sign and with sudden onset predominantly without nasal obstruction. There are calls for anosmia and ageusia to be recognised as symptoms for COVID-19. Since the 1st edition of this briefing (25 March 2020), there has been a significant expansion of literature on this topic, including 3 systematic reviews. Predictive value: The reported prevalence of anosmia/hyposmia and ageusia/hypogeusia in SARS-COV-2 positive patients are in the order of 36-68% and 33-71% respectively. There are reports of anosmia as the first symptom in some patients. Estimates from one study for hyposmia and hypogeusia: • Positive likelihood ratios: 4.5 and 5.8 • Sensitivity: 46% and 62% • Specificity: 90% and 89% The US Centres for Disease Control and Prevention (CDC) has added new loss or taste or smell to its list of recognised symptoms for SARS-COV-2 infection. To date, the World Health Organization has not. Conclusion: There is sufficient evidence to warrant adding loss of taste and smell to the list of symptoms for COVID-19 and promoting this information to the public. Context • Early detection of COVID-19 is key to the ongoing management of the pandemic.
    [Show full text]
  • COVID-19 Vaccines: Update on Allergic Reactions, Contraindications, and Precautions
    Centers for Disease Control and Prevention Center for Preparedness and Response COVID-19 Vaccines: Update on Allergic Reactions, Contraindications, and Precautions Clinician Outreach and Communication Activity (COCA) Webinar Wednesday, December 30, 2020 Continuing Education Continuing education will not be offered for this COCA Call. To Ask a Question ▪ All participants joining us today are in listen-only mode. ▪ Using the Webinar System – Click the “Q&A” button. – Type your question in the “Q&A” box. – Submit your question. ▪ The video recording of this COCA Call will be posted at https://emergency.cdc.gov/coca/calls/2020/callinfo_123020.asp and available to view on-demand a few hours after the call ends. ▪ If you are a patient, please refer your questions to your healthcare provider. ▪ For media questions, please contact CDC Media Relations at 404-639-3286, or send an email to [email protected]. Centers for Disease Control and Prevention Center for Preparedness and Response Today’s First Presenter Tom Shimabukuro, MD, MPH, MBA CAPT, U.S. Public Health Service Vaccine Safety Team Lead COVID-19 Response Centers for Disease Control and Prevention Centers for Disease Control and Prevention Center for Preparedness and Response Today’s Second Presenter Sarah Mbaeyi, MD, MPH CDR, U.S. Public Health Service Clinical Guidelines Team COVID-19 Response Centers for Disease Control and Prevention National Center for Immunization & Respiratory Diseases Anaphylaxis following mRNA COVID-19 vaccination Tom Shimabukuro, MD, MPH, MBA CDC COVID-19 Vaccine
    [Show full text]
  • Dizziness Related to Anxiety and Stress
    Dizziness Related to Anxiety and Stress Author: Laura O. Morris, PT, NCS Fact Sheet Why does anxiety and stress cause me to be dizzy? Dizziness is a common symptom of anxiety stress and, and If one is experiencing anxiety, dizziness can result. On the other hand, dizziness can be anxiety producing. The vestibular system is responsible for sensing body position and movement in our surroundings. The vestibular system is made up of an inner ear on each side, specific areas of the brain, and the nerves that connect them. This system is responsible for the sense of dizziness when things go wrong. Scientists believe that the areas in the brain responsible for dizziness interact with the areas responsible for anxiety, and cause both symptoms. Produced by The dizziness that accompanies anxiety is often described as a sense of lightheadedness or wooziness. There may be a feeling of motion or spinning inside rather than in the environment. Sometimes there is a sense of swaying even though you are standing still. Environments like grocery stores, crowded malls or wide-open spaces may cause a sense of imbalance and disequilibrium. These symptoms are caused by legitimate physiologic changes within the brain. A Special Interest Group of If there is an abnormality in the vestibular system, the symptom of dizziness can be the result. If one already has a tendency toward anxiety, dizziness from the vestibular system and anxiety can interact, making symptoms worse. Often the anxiety and the dizziness must be treated together in order for improvement to be made. How does physical therapy help? Contact us: ANPT Scientists are starting to better understand how dizziness and 5841 Cedar Lake Rd S.
    [Show full text]
  • Practitioner's Guide to the Dizzy Patient
    PRACTITIONER’S GUIDE TO THE DIZZY PATIENT Alan L. Desmond, AuD Wake Forest Baptist Health Otolaryngology ABOUT THE PRACTITIONER’S GUIDE TO THE DIZZY PATIENT The information in this guide has been reviewed for accuracy by specialists in Audiology, Otolaryngology, Neurology, Physical Therapy and Emergency Medicine ABOUT THE AUTHOR Alan L. Desmond, AuD, is the director of the Balance Disorders Program at Wake Forest Baptist Medical Center and a faculty member of Wake Forest School of Medicine. He is the author of Vestibular Function: Evaluation and Treatment (Thieme, 2004), and Vestibular Function: Clinical and Practice Management (Thieme, 2011). He is a co-author of Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo. He serves as a representative of the American Academy of Audiology at the American Medical Association and received the Academy Presidents Award in 2015 for contributions to the profession. He also serves on several advisory boards and has presented numerous articles and lectures related to vestibular disorders. HOW TO MAKE AN APPOINTMENT WITH THE WAKE FOREST BAPTIST HEALTH BALANCE DISORDERS TEAM Physician referrals can be made through the STAR line at 336-713-STAR (7827). PRACTITIONER’S GUIDE TO THE DIZZY PATIENT TABLE OF CONTENTS How to Use the Practitioner’s Guide to the Dizzy Patient . 2 Typical Complaints of Various Vestibular and non-Vestibular Disorders . 3 Structure and Function of the Vestibular System . 4 Categorizing the Dizzy Patient . 5 Timing and Triggers of Common Disorders . 6 Initial Examination Checklist for Acute Vertigo: Peripheral versus Central . 7 Diagnosing Acute Vertigo . 8 Fall Risk Questionnaire . 10 Physician’s Guide to Fall Risk Questionnaire .
    [Show full text]
  • Neuropsychiatric Manifestations of COVID-19 Can Be Clustered in Three
    www.nature.com/scientificreports OPEN Neuropsychiatric manifestations of COVID‑19 can be clustered in three distinct symptom categories Fatemeh Sadat Mirfazeli1,8, Atiye Sarabi‑Jamab2,8, Amin Jahanbakhshi3, Alireza Kordi4, Parisa Javadnia4, Seyed Vahid Shariat1, Oldooz Aloosh5, Mostafa Almasi‑Dooghaee6 & Seyed Hamid Reza Faiz7* Several studies have reported clinical manifestations of the new coronavirus disease. However, few studies have systematically evaluated the neuropsychiatric complications of COVID‑19. We reviewed the medical records of 201 patients with confrmed COVID‑19 (52 outpatients and 149 inpatients) that were treated in a large referral center in Tehran, Iran from March 2019 to May 2020. We used clustering approach to categorize clinical symptoms. One hundred and ffty‑one patients showed at least one neuropsychiatric symptom. Limb force reductions, headache followed by anosmia, hypogeusia were among the most common neuropsychiatric symptoms in COVID‑19 patients. Hierarchical clustering analysis showed that neuropsychiatric symptoms group together in three distinct groups: anosmia and hypogeusia; dizziness, headache, and limb force reduction; photophobia, mental state change, hallucination, vision and speech problem, seizure, stroke, and balance disturbance. Three non‑ neuropsychiatric cluster of symptoms included diarrhea and nausea; cough and dyspnea; and fever and weakness. Neuropsychiatric presentations are very prevalent and heterogeneous in patients with coronavirus 2 infection and these heterogeneous presentations may be originating from diferent underlying mechanisms. Anosmia and hypogeusia seem to be distinct from more general constitutional‑like and more specifc neuropsychiatric symptoms. Skeletal muscular manifestations might be a constitutional or a neuropsychiatric symptom. In December 2019 a number of severe acute respiratory syndrome (SARS) were reported in Wuhan, China that became eventually a pandemic infection with over 8 million reported cases until June 2020 1.
    [Show full text]
  • Dizziness: Approach to Evaluation and Management HERBERT L
    Dizziness: Approach to Evaluation and Management HERBERT L. MUNCIE, MD, Louisiana State University School of Medicine, New Orleans, Louisiana SUSAN M. SIRMANS, PharmD, University of Louisiana at Monroe School of Pharmacy, Monroe, Louisiana ERNEST JAMES, MD, Louisiana State University School of Medicine, New Orleans, Louisiana Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient’s history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symp- toms is of limited clinical usefulness. Patients have difficulty describing the quality of their symptoms but can more consistently identify the timing and triggers. Episodic vertigo triggered by head motion may be due to benign parox- ysmal positional vertigo. Vertigo with unilateral hearing loss suggests Meniere disease. Episodic vertigo not associated with any trigger may be a symptom of vestibular neuritis. Evaluation focuses on determining whether the etiology is peripheral or central. Peripheral etiologies are usually benign. Central etiologies often require urgent treatment. The HINTS (head-impulse, nystagmus, test of skew) examination can help distinguish peripheral from central etiologies. The physical examination includes orthostatic blood pressure measurement, a full cardiac and neurologic examina- tion, assessment for nystagmus, and the Dix-Hallpike maneuver. Laboratory testing and imaging are not required and are usually not helpful. Benign paroxysmal positional vertigo can
    [Show full text]
  • DIAGNOSING DIZZINESS in the EMERGENCY DEPARTMENT Why “What Do You Mean by ‘Dizzy’?” Should Not Be the First Question You Ask
    DIAGNOSING DIZZINESS IN THE EMERGENCY DEPARTMENT Why “What do you mean by ‘dizzy’?” Should Not Be the First Question You Ask by David Edward Newman-Toker, M.D. A dissertation submitted to the Johns Hopkins University in conformity with the requirements for the degree of Doctor of Philosophy Baltimore, Maryland March, 2007 © 2007 David E. Newman-Toker All Rights Reserved Abstract Dizziness is a complex neurologic symptom reflecting a perturbation of normal balance perception and spatial orientation. It is one of the most common symptoms encountered in general medical practice. Considering the dual impact of symptom-related morbidity (e.g., falls with hip fractures) and direct medical expenses for diagnosis and treatment, dizziness represents a major healthcare burden for society. However, perhaps the dearest price is paid by those individuals who are misdiagnosed, with devastating consequences. Dizziness can be caused by numerous diseases, some of which are dangerous and manifest symptoms almost indistinguishable from benign causes. The risk appears highest among patients with new or severe symptoms, particularly those seeking medical attention in acute-care settings such as the emergency department. Nevertheless, even acute dizziness is more often caused by benign inner ear or cardiovascular disorders. Thus, a major challenge faced by frontline providers is to efficiently identify those patients at high risk of harboring a dangerous underlying disorder. Unfortunately, diagnostic performance in the assessment of dizzy patients is poor. In part, this simply reflects the generally high rates of medical misdiagnosis encountered in frontline settings. However, misdiagnosis of dizziness is disproportionately frequent. Although possible explanations are myriad, I propose that an important cause stems from the pervasive use of an antiquated, oversimplified clinical heuristic to drive diagnostic reasoning in the assessment of dizzy patients.
    [Show full text]
  • Cervicogenic Dizziness
    Cervicogenic Dizziness Author: Jean Marie Berliner, PT, DPT, NCS Fact Sheet Overview: The term cervicogenic dizziness is currently used in practice to describe symptoms of dizziness that arise from the cervical spine.1,2 It is referred to as cervical vertigo, proprioceptive vertigo, cervicogenic vertigo, and cervical dizziness.3 It has been found that the neck plays a critical role in balance.4 Abnormal afferent signals from the neck can create various sensations of altered orientation in space and disequilibrium.3,5 The physiologic mechanisms of cervicogenic dizziness are believed to be from 1) vasomotor changes due to irritation of the cervical sympathetic chain, 2) vertebrobasilar insufficiency/ vascular compression, or 3) altered proprioceptive input from the upper cervical spine.1,6,7 Dizziness with cervical spine dysfunction frequently results from flexion-extension injuries such as a whiplash injury.5 Additionally, patients with prior vestibular insults may modify or restrict head motion, thereby altering normal cervical spine mechanics and leading to further symptoms of Produced by dizziness from cervical origin. Symptoms: Can vary significantly from person to person. Some of the most common symptoms observed are:1-9 Dizziness Vertigo Disequilibrium Dizziness associated with headaches “Swimming sensation” Cervical range of motion restrictions Difficulty sleeping due to pain Referred pain to shoulders or scapular area Ataxia Unsteadiness of gait Postural imbalance with neck pain Headaches A Special Interest Group of Cervical pain Tinnitus Hearing loss Nausea Lightheadedness Wooziness Diagnosis: There is no “gold standard” definition or diagnostic tests to identify cervicogenic dizziness as well as no definitive treatment progression.1,2,4,5,7,8 A variety of various differential diagnoses can present similar to cervicogenic dizziness and a Contact us: ANPT combination of neck pain and dizziness should not be the only characteristics used to 7 Phone: 952.646.2038 describe this disorder.
    [Show full text]
  • Review of Systems
    Warren E. Hill, MD, FACS Neal A. Nirenberg, MD, FACS East Valley Ophthalmology, Ltd. Diplomate, American Board of Ophthalmology Diplomate, American Board of Ophthalmology 5620 E. Broadway Road Diplomate, American Board of Eye Surgery Cataract and Comprehensive Ophthalmology Mesa, Arizona 85206-1438 Cataract and Anterior Segment Surgery Telephone: (480) 981-6111 Facsimile: (480) 985-2426 Jonathan B. Kao, MD Yuri F. McKee, MD Internet www.doctor-hill.com Diplomate, American Board of Ophthalmology Diplomate, American Board of Ophthalmology Cataract, Cornea and External Disease Cataract, Cornea and Anterior Segment Surgery Glaucoma Surgery and Management Review of Systems For new patients, established patients who may be having new problems, or patients we have not seen in a while, we need to update your overall medical health. In each area, if you are not having any difficulties please circle No problems. If you are experiencing any of the symptoms listed, please circle the ones that apply, or you may write in ones that may not be listed. If you have any questions, please ask one of our staff. Cardiovascular Ears/Nose/Throat Musculoskeletal Respiratory Chest pain Dizziness Back pain Cough Irregular heartbeat Hearing loss Joint pain Trouble breathing Shortness of breath Hoarseness Muscle aches Wheezing ________________ Ringing in ears Stiffness ________________ Sore throat Swelling ________________ ________________ No problems No problems No problems No problems Constitutional Hematologic Neurologic Skin Fatigue Bleeding Balance problems
    [Show full text]
  • Epileptic Dizziness
    BRITISH MEDICAL JOURNAL VOLUME 282 28 FEBRUARY 1981 687 Br Med J (Clin Res Ed): first published as 10.1136/bmj.282.6265.687 on 28 February 1981. Downloaded from PAPERS AND SHORT REPORTS Epileptic dizziness J KOGEORGOS, D F SCOTT, M SWASH Abstract disequilibrium, with or without a feeling of rotation, was the sole or main reason for referral. In all patients investigation and the Clinical and electroencephalographic features and the results of treatment indicated that the dizziness was due to epilepsy response to treatment of 30 patients with episodic rather than any other disorder. Twenty-four patients were referred dizziness due to epilepsy were noted. The symptom direct by their general practitioners, three from the ear, nose, and consisted of a brief episode of disequilibrium, often with throat clinic at this hospital, and three by other doctors. Patients in a sensation of rotation, without evident precipitating whom dizziness was not the predominant symptom were excluded, factors or sequelae. as were those older than 65 years, those with a history of cerebral vascular disease, and those with symptoms of middle-ear disease. A history of "absences" or other features suggestive Each patient's assessment was based on the history and examination of temporal lobe epilepsy was elicited in over half the results, but all underwent otological and electroencephalographic patients, and seven (almost a quarter) had had one or assessments. The otological assessment consisted of clinical, audio- more generalised seizures before presentation. Electro- metric, and caloric tests. Radiological investigations, including encephalography showed a posterior temporal lobe focus radioisotopic scanning or computed tomography of the head, were in all but two patients, and there was a family history of carried out in five patients.
    [Show full text]