Non-Vertigo Dizziness

Non-Vertigo Dizziness - #21

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Learn a systems-based approach to evaluation non-vertigo dizziness.

Emergency department visit.

Assess non-vertigo dizziness in elderly emergency department patients. Approaching a patient with dizziness is challenging due to the non-specific presentation and its broad differential diagnosis. To facilitate the assessment of the patient complaining of dizziness, Drachman and Hart classified dizziness into four categories: vertigo, near-syncope, disequilibrium, and other (non-specific)1.

Non-vertigo dizziness describes a wide range of sensations experienced by the patient. Patients may report feeling light headed, weak, unsteady, or motion sickness, unevenness, or restlessness. These sensations are distinct from the classical description of vertigo dizziness, which is the sensation of spinning or rotation sensations in the absence of movement. For vertigo causes of dizziness see Geriatric Fast Fact #19.

Recognize and assess non-vertigo causes of dizziness in the elderly.

  1. Sloane PD, Coeytaux RR, Beck RS, et al. Dizziness: state of the science. Ann Intern Med. 2011;134:823-832
  2. Newman, DE, Hsieh, YH, Camargo, CA, Pelletier AJ, Butchy GT, Edlow JT. Spectrum of dizziness visits to US emergency departments: cross-sectional analysis from a nationally representative sample. Mayo Clin Proc. 2008; 83(7): 765-775.
  3. Pacala JT, Sullivan GM, eds. Geriatrics Review Syllabus: A Core Curriculum in Geriatric Medicine, 7th ed. Chapter 24, New York, NY: American Geriatrics Society; 2010.
  4. Hazzard’s Geriatric Medicine and Gerontology. Chapter 56. New York: McGraw-Hill Medical. 2009.
This GFF ___ my competence in geriatrics.

Catherine Tsufis, Kathryn Denson MD, Colleen Crowe MD, Gabriel Manzi MD, Yana Thaker, Judi Rehm

Medical College of Wisconsin, Milwaukee, Wisconsin