Dizziness as Common Complaint and Differential Diagnose

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Table of Contents

Introduction
Brief Description of the Common Complaint
The Differential Diagnose
Clinical Guidelines for the Diagnosis
Evidence-Based Diagnostic Plan
Evidence-Based Management Plan
A Case Study
Conclusion
References

Introduction

As the feeling of being lightheaded or unbalanced, dizziness is a tremendously common complaint among numerous people regardless of their age or gender. Even though it is usually not associated with life-threatening diseases, this symptom should be taken into consideration. In case the episodes of dizziness last on a regular basis, it is recommended to make an appointment with a highly qualified doctor. In turn, appropriate diagnostic tools will be used in order to determine the primary cause of this condition. As a result, depending on the identified cause of dizziness, healthcare providers may either prescribe medications or surgery that can improve the overall well-being. At the same time, occasional dizziness is not considered to be something to worry about. Thus, dizziness can be described as an impairment of spatial orientation, which considerably lowers the quality of life, which is why it is essential to take this condition into account.

Brief Description of the Common Complaint

Most frequently, dizziness is characterized as feeling faint, woozy, weak, or unsteady. If people suffering from these symptoms ask for medical help, the healthcare specialist takes appropriate measures to determine the cause of this condition. At present time, dizziness is perceived as the result of inner ear disturbance, motion sickness, or overuse of medications (Murdin et al., 2016). Therefore, gathering information about the medical history of the patient is one of the first things that a doctor will do during a healthcare appointment. Simultaneously, it is crucial to note that dizziness can be accompanied by nausea, vomiting, or fainting. Sometimes, these symptoms may be worsened by walking or moving the head. Before making an appointment with a doctor, it is recommended to consider several vital prevention strategies. These include doing activities that improve balance, such as yoga, getting at least seven hours of sleep, as well as avoiding caffeine, alcohol, and tobacco.

When it comes to statistics, this data demonstrates a high level of prevalence of dizziness. In fact, nearly 90 million Americans make appointments with medical workers due to dizziness or balance problems (Kovacs et al., 2019). At the same time, representatives of the older population are more likely to visit physicians because of this health issue. For instance, the overall incidence of dizziness is around 10%, although this indicator reaches approximately 40% in patients older than 40 years (Kovacs et al., 2019). In other words, age is a significant contributor to the development of dizziness.

The Differential Diagnose

As it was mentioned above, there are several common causes of dizziness. For example, people experiencing these symptoms can be diagnosed with Meniere’s disease. This health issue is widely known as an inner-ear condition that frequently results in dizziness, hearing loss, and the feeling of ringing in the ear. Clear causes of this disease are still unknown, although there are some evidence-based theories explaining what might affect the fluid in the inner ear. It can be caused by poor drainage, autoimmune response, allergic reaction, and migraine headaches. Taking into consideration that it is a progressive disease, dizziness can be accompanied by anxiety, blurry vision, and nausea over time.

The next common health issue that is known for the symptoms of dizziness is an acoustic neuroma. It is a rare non-cancerous tumor that usually develops on the main nerve leading from the brain to the inner ear. Common systems of this disease include hearing loss, tinnitus, unsteadiness, dizziness, and weakness of muscle movement. Therefore, if the patient constantly faces dizziness, the healthcare specialist will likely check if it is caused by acoustic neuroma.

Finally, dizziness is most likely associated with vertigo. In fact, the inability to produce movements and interpret information about the body’s position in space is frequently classified as vertigo. Currently, health workers identify two main types of this health issue, such as peripheral and central vertigo. Peripheral vertigo is a condition that results from problems with the inner ear. In turn, central vertigo is a disease that originates from the central nervous system. There are multiple risk factors related to this condition, although vestibular neuritis, migraine, head injury, and medications are regarded as the main causes of this disease. In case this health issue is left untreated, it is likely to contribute to the development of life-long hearing loss in one ear, loss of balance, and significant loss of body fluids.

Clinical Guidelines for the Diagnosis

Clinical guidelines are usually used in order to produce optimal health outcomes for patients with the help of high-quality care. Based on recommendations provided by the American Academy of Otolaryngology, physicians treating patients with vertigo are required to take into account the Dix-Hallpike maneuver. This procedure is based on the idea to bring the patient from an upright to supine position with the head turned 45° to 1 side and neck extended 20° with the affected ear down (Bhattacharyya et al., 2017). Moreover, it is tremendously essential to use a supine roll test with the purpose to assess lateral semicircular canal BPPV. Lastly, healthcare providers have to test whether the health of a patient is affected by impaired mobility or central nervous system disorders.

At the same time, there is an update to this clinical guideline. In 2017, it was updated with new recommendations regarding the diagnosis of vertigo. As a result, healthcare specialists should pay attention to the impact radiographic testing has on the overall well-being of patients. In case the patient meets diagnostic criteria for vertigo in the absence of additional symptoms inconsistent with BPPV, physicians should not obtain radiographic imaging (Bhattacharyya et al., 2017). Furthermore, healthcare workers should not routinely treat vertigo with vestibular suppressant medications.

Evidence-Based Diagnostic Plan

The evidence-based diagnostic plan for vertigo should include several essential steps. First, the doctor is required to determine the cause of this condition. In turn, this goal can be achieved with the help of physical exams and medical procedures. During the physical exam, the healthcare specialist will be mainly focused on the patient’s eyes, as it is crucial to detect whether the person is affected by the inability to control eye movements.

In case no deviation from the norms was detected, the physician is likely to use medical testings. For instance, electronystagmography is frequently used with the goal to detect abnormal eye movement. As a result, this testing plays an essential role in determining whether vertigo is caused by inner ear disease or other factors. In addition, magnetic resonance imaging is widely used in the process of diagnosing vertigo. By creating cross-sectional images of the patient’s head and body, the doctor will have the opportunity to diagnose the person with various health issues, including vertigo. Also, the Dix-Hallpike maneuver and supine roll test can also be used to diagnose specific individuals with this condition.

Evidence-Based Management Plan

Vertigo is a condition that can improve over time without additional medical help, although there are cases that should be treated in medical settings. For example, if these symptoms are caused by severe disorders, such as Ménière’s disease, they need to be treated by a highly qualified specialist. At the same time, multiple treatment options may be offered to patients, as they depend on the cause of the main health issue. Vestibular rehabilitation may be prescribed to patients whose vestibular system sends signals to the brain about head and body movements inappropriately (Jeong et al., 2020). Moreover, some physicians prescribe canalith repositioning maneuvers to their patients. It is usually done with the goal to move the calcium deposits out of the canal into an inner ear chamber. Also, medications may be given in order to reduce the effect of vertigo on the body. Finally, some people will require surgery if this condition is caused by a tumor or injury to the brain.

When it comes to pharmacological treatment, vertigo is best treated with dimenhydrinate and meclizine. At the same time, there are numerous recommendations that should be taken into account by patients on the regular basis. For instance, it is essential to do simple exercises, sleep with the head slightly raised on several pillows, and avoid extending the neck (Jeong, 2020). Also, it is tremendously important to eat healthy food and avoid stressful situations. If all the treatment recommendations offered by a healthcare specialist are followed in the appropriate way, vertigo is expected to disappear over time. Otherwise, this health condition can lead to a variety of complications, such as dehydration caused by frequent nausea, as well as hearing loss.

A Case Study

A 32-year-old male professional basketball player reports suffering from the symptoms of acute-onset dizziness that developed after a lower limb soft tissue treatment. Based on the information from the patient, the main symptoms affecting his life were long-term spinning vertigo, headache, blurry vision, and disorientation. Diagnosis of the patient’s health status has helped identify a left posterior canalithiasis BPPV. The treatment plan offered to this person consisted of four essential elements, including two cycles of a left Epley manoeuvre, prohibition to drive, elimination of risk factors, and regular monitoring of the patient’s health status. Simultaneously, the male received the opportunity to return to playtime in the nearest future. However, considering that a vast number of people involved in a professional sport suffer from vertigo, it is crucial to conduct numerous epidemiological studies on this topic.

Conclusion

Vertigo affects the health of millions of individuals not only in the U.S. but also throughout the entire world. Therefore, the healthcare industry has always experienced a high demand for the best treatment options. In spite of the fact that the majority of cases associated with this health condition improve over time without additional help from doctors, some patients face considerable health complications in case vertigo is left untreated. In the context of long-term perspective, vertigo can result in dehydration developed due to frequent nausea. Therefore, it is important to treat these symptoms in the appropriate way. Depending on the cause of vertigo, the patient may be offered medications, surgery, canalith repositioning maneuvers, or vestibular rehabilitation. Furthermore, each patient suffering from vertigo should consume healthy food, get at least seven hours of sleep, avoid stressful situations, and exercise.

References

Bhattacharyya, N., Gubbels, S., Schwartz, S., Edlow, J., El-Kashlan, H., & Fife, T. (2017). Clinical practice guideline: Benign paroxysmal positional vertigo (update). Otolaryngology–Head and Neck Surgery, 156(3), 46-47. Web.

Jeong, S. (2020). Benign paroxysmal positional vertigo risk factors unique to perimenopausal women. Frontiers in Neurology, 11(1), 21-28. Web.

Jeong, S., Kim, J., Kim, H., Choi, J., Koo, J., & Choi, K. et al. (2020). Prevention of benign paroxysmal positional vertigo with vitamin D supplementation. Neurology, 95(9), 117-125. Web.

Kovacs, E., Wang, X., & Grill, E. (2019). Economic burden of vertigo: A systematic review. Health Economics Review, 9(1), 20-25. Web.

Murdin, L., Hussain, K., & Schilder, A. (2016). Betahistine for symptoms of vertigo. Cochrane Database of Systematic Reviews, 23(2), 1-15. Web.

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