New Spin on Vertigo

When a patient complains of dizziness, ask him or her todescribe symptoms without using the word "dizzy." The descriptionof an abnormal sensation of movement indicatestrue vertigo.
The time course of the symptoms can help you honein on the cause:

• Episodes of vertigo that last less than 1 minute and areprovoked by sudden head movements or turning over inbed are associated with benign positional vertigo.
• Episodes that last from 30 minutes to several hours aregenerally associated with Meniere disease; tinnitus andhearing loss are also likely to be present.
• Virtually constant vertigo that is exacerbated by headmovements is likely caused by vestibular neuronitis (alsoknown as labyrinthitis). This condition usually follows aviral upper respiratory tract illness; patients with viralneuronitis are often bedridden for the first few days of theillness and may have residual vestibulopathy for monthsor years.

-- Tina Clark, CRNP
   Bel Air, Md