Neurologist explains how to work-up dizziness...

I’m in the midst of a couple of months of constant dizziness and imbalance (among other things) which best I can determine is likely the result of chornic stress/taxation of the CNS.

My wife is in medicine and found some very interesting information. This is from a long time neurologis, and it’s a medical reference page for OTHER neuros to use when working up a patient.
He’s essentially an expert on dizziness and vertigo.

So, there is some jargon to work through. But the information contained within is fascintating and might shed some light on some some issues for those unsure of what they are going through or how they have been diagnosed/handled.

I pasted the things I found most interesting below, but there is a ton of info here… others may find other aspects much more useful.

Full link:
https://www.consultant360.com/article/dizziness-step-step-through-workup

A few exerpts…

Chronic nonspecific dizziness. In the final category, chronic nonspecific dizziness, the dizzy sensation is often a vague giddiness, which is typically protracted or continuous, varying in intensity, and often associated with periodic exacerbations. Although patients may develop anxiety and depressive symptoms in response to any type of dizziness and the associated fears of falling or injury, anxiety is a significant causal factor for many patients with this category of dizziness. Indeed, chronic nonspecific dizziness is often attributed to impaired central integration of sensory and motor signals in patients who have acute and chronic anxiety, although similar findings can be seen in patients with previous well-compensated vestibular lesions.8,9


In some cases, additional diagnostic tests will be required. These should be ordered selectively depending on the type of dizziness and suspected underlying etiologies. Unfortunately, studies have suggested that diagnostic testing is often ordered indiscriminately and that the frequency of ordering multiple expensive tests is increasing, particularly in emergency departments.23,24

Brain imaging should not be ordered routinely for dizziness complaints.9,25 The clinical value of CT scans for patients who present to the emergency department with dizziness is very low and appears to have declined over time.23 Patients who are more likely to have abnormal findings on head CT are those with severe headaches or some neurologic deficits in addition to dizziness, whereas those with isolated dizziness, lightheadedness, or monosymptomatic positional vertigo are very unlikely to have acute, life-threatening abnormalities.26 With MRI, in particular, structural abnormalities of the brain and neck are common and nonspecific, and routine MRI is unlikely to identify specific etiologies for dizziness.25

1 Like