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Mystery Diagnosis: Dizziness

Mystery Diagnosis: What Causes Dizziness?

By
Rob Lamberts, MD,
June 22, 2010
Episode #052

Page 1 of 2

Since my last mystery diagnosis article (How Do Doctors Solve Medical Mysteries?) was one of my most popular, I thought it would be appropriate to do another mystery diagnosis. 

Mystery Diagnosis: Dizziness

The star of today’s show is Mary, a 30 year-old woman who comes to the office with a complaint of dizziness.

The first step in figuring out the cause of the dizziness is to decide just what Mary means by dizziness.

Different Types of Dizziness

There are several different symptoms that people can refer to as dizziness:

Feeling the room spinning: The sensation of the room spinning is the most common symptom described as dizziness. The medical term for this sensation is vertigo, which also happens to be the name of a great movie starring Jimmy Stewart.

Feeling light-headed: Light-headedness, or the sensation of almost passing out, is also commonly called dizziness. Most people have felt this when they have stood up too quickly. 

Feeling woozy: A woozy or drunk feeling is also referred to as dizziness. Medications, mind-altering substances, and certain medical conditions like diabetes can cause this symptom. 

Feeling excessively tired: Sometimes people who are excessively fatigued also say they are dizzy as well. I think they do this just to make my job harder.

So what symptom is Mary having? She says that she gets light-headed and almost passes out, so I write the chief complaint: light-headedness.

As I explained in the last mystery diagnosis article, the next step is to hear the story of the light-headedness. That is known as the history of present illness, and is perhaps the most important part of the entire visit when it comes to making a quick and accurate diagnosis. 

History of Present Illness

The key to making an accurate diagnosis is for the patient to give good information and for the doctor to listen carefully.

Mary explains that her dizziness has actually gone on for several years, but over the past few months it has gotten more frequent. It used to be mild, but now has even made her pass out twice. At first she had these episodes of dizziness every few months, but now she’s getting them every day, often several times a day. Between the episodes she’s perfectly fine. The episodes aren’t brought on by standing quickly, and they don’t seem to be associated with meals, but they seem worse in the morning. The two times she passed out occured when she got up during the night to use the bathroom.

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