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Description of the Symptom
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This chapter describes pathology that may lead to dizziness. Dizziness is described as a sensation of movement of self or surroundings (vertigo), light-headedness (presyncope), or imbalance (disequilibrium).
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Dizziness in the presence of any of the following symptoms and signs:
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Chest pain
Irregular heartbeat
A new onset of, or a change in, neurological status, including:
Weakness or paralysis in the face, arm, or leg, especially on one side of the body
Tremor
Change in mental status, such as confusion, memory loss, hallucinations
Difficulty talking
Difficulty understanding speech
Trouble seeing with one or both eyes
Loss of coordination
Loss of balance
Nystagmus that is spontaneous (resting), direction changing, or gaze evoked
Oculomotor abnormalities including abnormal smooth pursuit and saccades.
Loss of sensation
History of head or neck trauma and concerns of:
Changes in neurological status, as noted above
Long tract signs elicited by head or neck movements
Dizziness with sustained head or neck positions
Unwillingness to move the neck
Facial numbness or paresthesias
Palpitations that are:
Followed by loss of consciousness
Associated with significant shortness of breath, chest discomfort, light-headedness, or presyncopal symptoms
Associated with marked hypertension (ie, >220/110) or hypotension (ie, <90/60 in an individual who is typically normotensive)
Of sudden onset and last longer than 15 to 20 minutes
Occurring in an individual with a family history of sudden death.
Fever, chills, accompanied by a very stiff neck or other signs of infection
Unrelenting headache
Hyperpnea or dyspnea
Anxiety
Sudden hearing loss
Ear pain
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