Kettering Health Network



Patient with dizzinessVertigo sense of spinninglasts < 1 minuteVertigo provoked by change in head position related to gravity and answers yes to DHI 5 BPPV questionsYes test for BPPVNo - assess for neurological signsSpontaneous episodes lasting hoursLight and sound sensitivity? Hx of migraines?Yes – refer to specialistNo- Refer to specialist (ENT or Neurologist specializing in dizziness)No light and sound sensitivity but visual changes, loss of postural control, Facial paresthesias, change in taste, uncontrolled vomiting, cervical spine stiffness /pain at base of skull? risk factors for stroke.Assess with HINTS – head thrust test, nystagmus (direction changing) test of skew deviation. refer to neurologist/consider TIAsDisequilibriumWorse with standing and walking, better with sitting and supine.Yes- assess sensation, vision, and vestibular function for multifactorial dizzinessNo – consider referral to specialist vestibular rehab therapistSyncope/light headednessexertion induced?Yes -consider cardiac refer to physicianNo - test for orthostasisVague symptomsassess for cervicogenic and test vestibular, sensory, balance and gait function. Consider referral to vestibular therapist. ................
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