Who are the Candidates for Dizziness?
A reference document for staff, clinician and technicians
Randolph McKenzie, M.D., Ph.D., F.A.C.S.
Bibliography
Dizziness is a common occurrence. Second to lower back pain, dizziness is the most common complaint heard in doctors’ offices. Forty-two percent of the adult population report dizziness or vertigo to their physicians. What causes dizziness?
Checklist of common causes of dizziness:
Patients over 55 with the onset of presbyastasis or degeneration of the normal balance
mechanisms with age
Vestibular disorders or various types of inner
ear disease
Motion sickness patients
Infections of the ear or central nervous system
Ototoxic drugs such as aminoglycosides
or chemotherapy
Tumors of the vestibular or acoustic nerves
Head trauma – the effects of which can linger
for months to years
Visual system diseases
Hyperventilation or hysterical patients
Medications affecting the central nervous system such as neuroleptics, sedative-hypnotics,
anti-depressants, centrally acting antihistamines
Cerebrovascular disease – decreases blood flow to the brain and can be caused by dehydration, orthostatic hypotension, vasovagal syndrome, osteoarthritis, atherosclerosis
Peripheral neuropathy – diminished nerve
function in the legs or feet causing unsteadiness when standing or walking
Disease affecting the cerebral cortex, cerebellum and brainstem
Post-operative total joint replacement surgical patients
Neoplastic and
degenerative
diseases of the central nervous system such as basal ganglion disorders and
multiple sclerosis
It is of vital importance to review one’s medical records and charts on a regular basis to determine which established patients as well as which new patients have demonstrated symptoms and signs of balance and movement disorders. These patients should be referred immediately for balance screening, and if medically indicated and necessary, for complete balance testing and vestibular rehabilitation therapy.
Randolph McKenzie, M.D., Ph.D., F.A.C.S. is Associate Professor of Otology / Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center College of Medicine.
Bibliography
American Academy of Otolaryngology: Why Do We Fall? Alexandria, VA, 1994,
AAO-HNSF.
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Ford-Smith C et al. Test-Retest Reliability of the Sensory Organization Test in Noninstitutionalized Older Adults. Arch Phys Med Rehabil 76:77, 1995.
Furman J M & Cass SP. Balance Disorders: A Case Study Approach. F A Davis Co., Philadelphia, 1996.
Hageman P. Gait Characteristics of Healthy Elderly; A Literature Review. Issues on Aging, 18, 2:14, 1995.
Russo S. Clinical Balance Measures: Literature Sources. Neurology Report 21, 1:29,1997.
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