Acute Onset Dizziness

Description of Symptoms

Patient's description of symptoms

Timing

Symptom onset

Onset to maximal symptom intensity

Duration of dizziness

Prior diagnosis of transient ischemic attack, stroke, vertebrobasilar insufficiency, migraine, seizures, benign paroxysmal positional vertigo, vestibular neuritis, concussion, Meniere’s disease, or orthostatic hypotension

Triggers & Associated Signs and Symptoms

Bedside Exam Techniques to Consider

Dizziness is episodic and triggered only by head/position changes (benign paroxysmal positional vertigo, orthostatic hypotension or postural orthostatic tachycardia syndrome – consider Dix-Hallpike/Epley maneuver and checking orthostatic vitals)

Positive orthostatic hypotension: reduction of in systolic blood pressure (SBP) of >20 mm Hg OR a reduction of in diastolic blood pressure (DBP) >10 mm Hg

Postural Orthostatic Tachycardia Syndrome (POTS): sustained heart rate increase of 30 beats per minute (bpm) or more, or over 120 bpm, within the first 10 minutes of standing, in the absence of orthostatic hypotension

Description of Symptoms

Timing

Triggers & Associated Signs and Symptoms

Bedside Exam Techniques to Consider

Diagnostic Evaluation