Examination, and instrumental of the patient with dizziness/balance disorders
Summary, In the event of dizziness or balance disorder, the examination of the patient begins with a history of states, whose purpose is to guide the diagnosis on the basis of four different diagnostic hypotheses: short-term dizziness, positional, to repeat, like paroxysmal vertigo benign vertigo for a few hours, to repeat, with associated cochlear signs, such as the ear hydrops, large rotary vertigo for several days, such as vestibular neuritis, imbalances and instability.
The history is completed by a physical examination confirms the hypothesis that vestibular diagnosis in about three quarters of the cases: nystagmus with positional vertigo, which suggests a benign paroxysmal positional vertigo, the clinical signs of a peripheral vestibular deficit that evoke a harmonious neuritis; clinical signs that indicate a central concern; normal examination.
Depending on clinical guidance are prescribed several additional tests: videonistagmografico examination including caloric test, study video-oculography and the subjective vertical; sacculocollici otolithic evoked potentials; comprehensive audiometric assessment with auditory evoked potentials, blood tests and imaging, if necessary.
Among these imaging studies, the caloric test remains one of the tests which contribute most significantly to the diagnosis, in association with audiometric testing
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