Dizziness history questions Character Qualitative Ask generally How is it affecting daily life Quantitative Clinical markers. Falls Loss of consciousness Time questions Previous episodes Reliving factors Context and aggravating factors: Ask generally Context at onset Lifestyle changes Moving head Recent illness Associated features Fever Nausea Ear pain Ear discharge Vomiting Weakness Dizziness Vision changes Auditory changes Altered mental status Coordination difficulty Medications Past medical history Past surgical history Family history Social history: Diet Life stressors Alcohol history Smoking history Patient demographics Recreational drug history Differentials Vestibular neuritis Severe vertigo made worse ny motion Nausea and vomit Gait instability Increased risk of falling on the affected side Nystagmus Oscillopsia Usually develops over several hours Mild symptoms mat persist for weeks or even months Meiner’s disease (distension of the bony labyrinth by endolymph equally called endolymphatic hydrops -> may be caused by allergies, autoimmune, head injury, migraines, headaches or viral infections_ Vertigo tinnitus Ear pressure Imbalance Fluctuating hearing loss Iatrogenic toxicity Benign paroxysmal positioned vertigo Episodic vertigo caused by certain changes in the positioning of the head. Sudden/paroxysmal and recurrent episodes Lasts for several seconds (less than a minute). Triggered by certain head movements Nystagmus Risk of falls and subsequent injury. Nausea and vomit Multiple sclerosis Fatigue Headache Optic neuritis (inflammatory of the optic nerve) -> subacute changes to vision, reduced visual acuity, dyschromatopsia, visual field defects, retrobulbar pain that increases with eye movements, usually monocular Ptosis Weak upper extremities. Demyelination of spinal cord tracts -> UMNL -> weakness, spactisty , numbness, positive Babinski, impaired gait Loss of tract features -> spinothalamic, DCLM etc. Acoustic neuroma Congestive heart failure Cough Fatigue Palpitations SOB Abdominal distension Orthopnoea Hypotension Nausea Fatigue Vision changes Aortic stenosis Chest pain Loss of consciousness Dehydration AF Fatigue Chest pain Palpitations SOB Iron deficiency anaemia Pallor Fatigue Bleeding Chest pain Vomit SOB Altered bowel habits ACS