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17 results

Dizziness
  • A Practical Approach to Diagnosis and Management
  • 2nd edition
  • Adolfo Bronstein, Thomas Lempert
  • Published online:
    01 March 2017
    Print publication:
    02 March 2017
  • Dizzy patients are notoriously difficult to diagnose as doctors require knowledge spanning several subspecialties, including neurology, otolaryngology, internal medicine and psychiatry. This updated second edition integrates the essential information from these fields, providing advice that is both practical and accessible. Beginning with two jargon-free chapters on anatomy, physiology and examination techniques, the book follows a coherent structure organized according to clinical presentations, such as recurrent vertigo, positional vertigo and chronic dizziness. Each chapter is summarized with a table showing diagnoses and their key features, ensuring that the relevant differential diagnoses are readily available. Access to more than sixty online video clips is included, illustrating bedside findings from pathological nystagmus to specific balance problems. With practical advice offered for a range of difficult clinical situations, this comprehensive guide will enable any doctor to feel confident when confronted with dizzy patients.

  • Chapter 3 - Syncope

  • Edited by Bettina Schmitz, Barbara Tettenborn, Johannes Gutenberg Universität Mainz, Germany, Donald L. Schomer, Harvard University, Massachusetts
  • Book:
    The Paroxysmal Disorders
    Published online:
    06 December 2010
    Print publication:
    09 September 2010, pp 14-27

  • Summary

    This chapter describes the clinical characteristics of syncope and its distinction from generalized tonic-clonic seizures, which cause the most difficulties in daily clinical practice. The high variability of frequencies at which convulsions in syncope were observed is explained by their highly variable presentation. The most important criterion to differentiate syncopal and epileptic convulsions is their specific phenomenology. Presyncope is the prodromal stage of syncope in which there is only a less pronounced hypoperfusion of the brain and therefore no complete loss of consciousness. Syncope can also appear after eating a carbohydrate-rich meal, particularly in elderly patients. Syncope associated with migraine is particularly frequent in basilar migraine. This form of migraine occurs mostly in adolescent girls and young women. The initial evaluation of a patient presenting after loss of consciousness includes a thorough history, a physical examination, supine and upright measurement of blood pressure and pulse rate, and an electrocardiogram (ECG).