Diagnosing between dizziness and light headedness is your first
priority.
1) Lightheadedness is usually associated with vascular compromise; however it
can also be a part diabetic disorder, thyroid dysfunction, exocrine or
endocrine hormone imbalance, medication dosage or redundancy in prescription,
etc., Check blood pressure in supine, sitting, standing and or activity which
provokes symptoms. And of course thoroughly review chart and take good
history notes.
2) Dizziness on the other hand can be provoked due to medication (see above),
vestibular apparatus dysfunction (check sensation, proprioception, vision),
cranial nerve dysfunction, cortical and cerebellar disease, etc., It is also
very important to review history.
To provoke vestibular mechanism Try Halpike maneuver, saccades, target
tracking with eyes fixed; target moving; person moving head on trunk while
walking. Look for nystagmus, Essentially try to compromise persons balance
integrity. Our balance "reference system" or coordinates are head flexion of
approximately 30 degrees into sagital plane.
Respectfully,
Nick El Baridi, PT
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