Great video! For years, I began my histories with, "What do you mean by dizzy?" For a brief time, I alphabetized the responses in a spreadsheet and collected over 435 different descriptions! I never imagined there would be that many descriptions. In my world (outpatient physical therapy), clients often use the word lightheaded to describe off balance and occasionally to describe what they feel in the positive Dix Hallpike test position. I find lightheaded rarely means presyncope (again...in outpatient PT). I now explore triggers and timing first and use descriptions to categorize the different sensations that may have different causes and require different types of therapy.
@PeterJohns
5 жыл бұрын
Exactly! When I ask junior learners how they assess dizzy patients, they often start with, "First I would ask what they mean by dizzy" and then I show them this woman's history and blow their minds.
@michaelkim3704
5 жыл бұрын
you make things so clear that you make my heart beat faster in excitement to learn more. thank you so much
@rumit9946
4 жыл бұрын
I can't like this video enough
@harishchandergoel5159
2 жыл бұрын
Nice
@wanderingowl4874
5 жыл бұрын
Wow, great content! Thanks!
@jacklee9252
4 жыл бұрын
I understand that qualitative description of dizziness is generally not accurate and therefore the "old" approach separating dizziness into vertigo, disequilibrium, syncope and "non specific dizziness" is not the best method out here. I was looking through the titrate paper and cant seem to find where the "disequilibrium" group of etiologies are categorized under the t-AVS, t-EVS, s-EVS, s-AVS division system. I.e parkinsons, peripheral neuropathy etc. How would these "disequilibrium" patients present? Thank you.
@PeterJohns
4 жыл бұрын
This is why I do not talk about t-AVS, s-EVS, t-EV. That's because AVS is where the differential is (mostly) posterior circulation stroke and vestibular neuritis. I think the other syndrome only confuses people, rather than make it clearer. Interestingly, a new syndrome has been described by Machner pubmed.ncbi.nlm.nih.gov/32462345/. Acute imbalance syndrome, (AIS) where the patient has acute imbalance, but not nystagmus. A third of these patients will have an acute brain lesion on delayed MRI (mostly stroke) If you look at those with AIS and an ABCD2 score 4 or over, the percentage goes to 50%.
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