APPENDIX 30-1: Situational Vertigo Questionnaire

Situational Vertigo Questionnaire

Vertigo is the medical term used for symptoms which patients often describe as feelings of unusual disorientation, dizziness, giddiness, lightheadedness, or unsteadiness.

Please circle a number to indicate the degree to which each of the situations listed below causes feelings of vertigo, or makes your vertigo worse. If you have never been in one of the situations, then for that item ring “N.T.” for “Not Tried.”

The categories are:

Riding as a passenger in a car on straight, flat roads

Riding as a passenger in a car on winding or bumpy roads

Walking down a supermarket aisle

Standing in a lift while it stops

Standing in a lift^∗ while it moves at a steady speed

Riding in a car at a steady speed

Starting or stopping in a car

Standing in the middle of a wide open space (e.g., large field or square)

Sitting on a bus