Dizziness - Diagnosis and prevention

How is it diagnosed?

An in-depth medical history of the patient followed by an instrumented enquiry is a pivotal time that allows a correct diagnosis.

• Assembling the history through five foundamental elements, which are the key-tools to frame a specific condition:
  1. Outlook mode, acute or chronic
  2. Co-existing of symptoms and neurological signs.
  3. Co-existing of audiological signs.
  4. Outbreak through motion.
  5. Evolution in time
• Objective examination
  1. Auricolar inspection
  2. Otoscopy
  3. Search for spontaneous nystagmus (rhythmic and involuntary movement of eyeballs)
  4. Search for muscle tone asymmetries (ability to keep a standing position, with eyes both closed and open).
• Instrumented examinations: CAT (computed axial tomography) and NMR (nuclear magnetic resonance)

How to behave in case of dizziness

• During the acute phase of the disorder the patient must stand still with eyes closed, in a poorly lit environment.
• As soon as the symptomatology improves, it is fundamental to get up from bed and move as much as possible. The patient must be helped to walk; during this stage it's important to stimulate the balance systems which are “restoring”. After having beeing in bed for a long time, recovery takes longer.
• Avoid driving vehicules unless a specialist gives his/her consent. This is due to the fact that, during the recovery, there are times when suddenly, for some seconds, the disease steps back in: such an event would be fatal while driving.
• Avoid staircases. The balancing system isn't too reliable for several weeks, and there may be risk of mishaps.

Prevention

There are some expedients that one can stick to in order to reduce the symptomatology:

• Avoid sudden changes of position.
• Avoid quick movements of the head (especially turning or rotating).
• Quit or cut down on substances that reduce the blood flow, like tobacco, alcohol, caffeine and salt.
• Reduce the stress as much as possible, and avoid the exposure to allergenic substances.
• Take sufficient fluids.
• Cure infections, including the ear ones, cold, flu, congestion of paranasal sinuses and other respiratory infections.