Dizziness
In a dizziness workup, gather and document what the patient means by dizzy, episode timing and triggers, lying and standing blood pressure, a focused neurological and ear examination, and the red flags.
Head and nervous system: In these presentations, the history and a focused neurological examination carry most of the weight.
Key takeaways
- Write down what the patient means by dizzy, in their words.
- Record lying and standing blood pressure.
- Document the central neurological red flags, present or absent.
What this presentation is
Dizziness covers vertigo, presyncope, unsteadiness and vaguer symptoms. The timing and triggers of episodes usually narrow it more than the description does.
Most causes are benign, and a small number are central causes such as stroke that need urgent assessment.
Gather these sources first
- The referral and previous ENT, neurology or cardiology letters
- The medication list, especially blood pressure medicines
- ECG reports
- Complete blood count and glucose
- Audiogram results if done
Document these history questions
- What the patient means by dizzy
- Onset, duration of episodes and frequency
- Triggers such as head movement, standing or exertion
- Hearing loss, tinnitus and a feeling of fullness in the ear
- Headache, visual change, speech or swallowing difficulty
- Falls and near falls
- Recent medication changes
Record these findings
- Lying and standing blood pressure and heart rate
- Neurological examination including gait and coordination
- Eye movements and nystagmus
- Positional test results if performed
- Ear examination
Ask about these red flags
Record each one as present or absent. Your local pathway decides what happens when one is present.
- Double vision, slurred speech or difficulty swallowing
- New weakness or numbness
- Inability to walk or stand unaided
- Sudden severe headache
- Sudden hearing loss
- Syncope, chest pain or palpitations
Put these in the assessment draft
- The type of dizziness, with the history that supports it
- A differential between peripheral, central and cardiovascular causes
- The examination findings that bear on it
- The red flags asked about and the answers
- A plan with investigations, referral and safety-netting advice
How Workup Desk helps
Add the medication list, the ECG and earlier letters to the workspace. Ask which medicines in the sources lower blood pressure and when each was started.
Draft the assessment and edit it. The chat names the letter or report each answer comes from.
Frequently asked questions
Why ask what the patient means by dizzy?
The same word describes spinning, lightheadedness and unsteadiness, and each points to different causes. The patient's own description narrows the list.
General guidance on what to gather and document, not advice about any individual patient. Local guidelines and your clinical judgment govern.