Begin with the Basics
A thorough history and physical is still the best way to begin assessing a patient’s dizziness. In fact, a thorough history is “the most crucial part in figuring out what might be causing someone’s dizziness,” said Meredith E. Adams, MD, assistant professor of otolaryngology at the University of Minnesota in Minneapolis. So take your time and ask patients specific questions to elicit details about their dizziness. Many patients are eager to discuss their current symptoms, but also ask them when, where, and how the dizziness first began.
The information you receive will help you determine what tests to order. Many patients will still require an audiogram and/or imaging study. And, despite the availability of newer tests, electronystamography (ENG) or videonystagmography (VNG) remain mainstays of vestibular assessment.
“Videonystagmography gives you ear-specific information,” Dr. Adams said. “We also have a lot of data on it in different clinical disease states, so we know the most about its results in different diseases.”