Vertigo


DTH FFFUN


D Dizziness
T Tinnitus
H Hearing


F Fever
F Fullness
F Falls
U URI
N Nausea

PHYSICAL EXAMINATION for Dizziness:

HEENT: Inspect for Nystagmus, Rinne & Weber test, Whisper test, Otoscopy, Funduscopic exam, Mouth & Throat.
Cardiovascular: Auscultation
Pulmonary: Auscultation
Neuro: CN(2-12), Sensation, Motor, DTRs, Gait, Romberg test, Dix-Hallpike Maneuver


DIFFERENTIAL DIAGNOSIS for Dizziness:

Méniêre disease: Chronic vertigo, Tinnitus, Hearing loss.
Benign paroxysmal positional vertigo: vertigo on changing position and nystagmus, no tinnitus or hearing loss.
Labyrinthitis: Recent URI, acute vertigo, tinnitus, decrease hearing.
Vestibular neuritis: Recent URI, vertigo with no associated with position, NO tinnitus or hearing loss.
Acoustic neuroma: Vertigo, tinnitus, hearing loss, ataxia.
Perilymphatic fistula: History of truma or an explosion. vertigo, hearing loss, tinnitus.


DIAGNOSIS WORK UP for Dizziness:


Dix-Hallpick Maneuver
VDRL/RPR (to r/o syphilis associated with Méniêre disease)
Tilt table test
Audiometry
MRI of brain