Dizziness, vertigo, and presyncope: What's the difference?
Scott J. Saccomano is an assistant professor at the Herbert H Lehman College, Department of Nursing in Bronx, NY. The Nurse practitioner
12/2012; 37(12):46-52. DOI: 10.1097/01.NPR.0000422206.92550.5b
Dizziness is a general term used to express subjective patient complaints related to changes in sensation, movement, perception, or consciousness. There are four types of dizziness: vertigo, disequilibrium, presyncope/syncope, and dizziness as a result of psychological disturbances. Differentiating the type of dizziness will assist in the course of the evaluation.
Available from: Giovambattista De Sarro
- "Dizziness and vertigo are among the most common disorders in medicine, affecting approximately 20-30% of people in the general population. Dizziness is a general term used to express subjective complaints of the patients related to changes in sensation, movement, perception, or consciousness. Vertigo is a subtype of dizziness, defined as an illusion of movement caused by asymmetric involvement of the vestibular system. "
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ABSTRACT: Vertigo, dizziness, and nausea encompass a spectrum of balance-related symptoms caused by a variety of etiologies. Balance is affected by many systems: Proprioceptive pathways and visual, cerebellar, vestibulocochlear, and vascular / vasovagal systems. Vertigo is a subtype of dizziness, in which a subject, as a result to a dysfunction of the vestibular system, improperly experiments the perception of motion. The most useful clinical subdivision is to categorize vertigo into true vertigo and pseudovertigo, whereas from a pathophysiological point of view, vertigo can be classified into central, peripheral, and psychogenic. It is not easy to identify the cause of vertigo since the patients often are not able to precisely describe their symptoms. An impressive list of drugs may cause vertigo or dizziness.
The aim of the present study was to analyze the data extracted from the reporting cards of the ADRs (adverse drug reactions), received at our Pharmacovigilance Regional Center (Calabria, Italy) in 2012. In particular, the data concerning the occurrence of vertigo and dizziness, after taking certain classes of drugs, have been considered.
Our results show that, among the side-effects of different classes of drugs such as anti-convulsants, anti-hypertensives, antibiotics, anti-depressants, anti-psychotics, and anti-inflammatory, also vertigo or dizziness are included.
Spontaneous reports of vertigo or dizziness, as side-effect of certain drugs, received at our Pharmacovigilance Center, represented the 5% of all reports in 2012. Considering the high incidence of such an ADR for several drugs' classes, it can be speculated that under-reporting also affect vertigo and dizziness. Despite the fact that these ADRs might not represent a direct threaten for life, indirectly they can cause secondary damage to patients such as falls, fractures etc. Balance should be accurately monitored during drug use and particularly in fragile patients.
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ABSTRACT: Patients presenting to primary care with complaints of dizziness are common. Differentiating the cause of dizziness can be made easier by considering 4 main categories of dizziness: vertigo, presyncope/syncope, disequilibrium, and nonspecific symptoms. Differentials should immediately include the most common causes of dizziness, such as benign paroxysmal positional vertigo and orthostatic hypotension. Diagnostic tests should be ordered for patients who have abnormal findings on physical examination that may indicate a more serious cause of dizziness.
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