The diagnosis | Vertigo attacks

The diagnosis

As part of the anamnesis, the doctor can first obtain information about the occurrence of the vertigo. He will want to know when the dizziness attacks occur, the exact nature of the dizziness, what other symptoms occur and how the symptoms improve.Afterwards, various examinations are performed to help define the exact cause and type of vertigo. These tests include, for example, those that check the organ of balance.

With closed eyes, the patient should stand up straight. This test, known as the Romberg test, would be positive if the patient is unable to maintain balance and begins to sway. Subsequently, the pedaling test according to Unterberger can be performed.

The patient should tread on the spot. Sick patients turn by about 45 degrees, which means that the test is positive and shows an indication of disorder. Furthermore the index finger test can be carried out.

In this test the patient should lead his outstretched index finger with closed eyes to the tip of the nose. Hereby the coordination ability of the cerebellum is tested. Another important examination is done by rinsing the ears with cold and warm water.

During this procedure, involuntary rhythmic twitches of the eyes are checked, which are called nystagmus. The change in temperature in the ear irritates the organ of equilibrium and triggers the nystagmus, which normally occurs, for example, when turning quickly. During this examination, the patient wears a special pair of glasses, the Frenzel glasses, which allow a precise observation of the eyes and prevent disturbing influences such as fixing the eyes on a point in the surroundings.

The nystagmus can also be checked using the swivel chair. In this case, the patient sits on a chair that is turned in one direction for half a minute. Afterwards the test is performed in the opposite direction.

Both times the movements of the eyes are registered and compared with each other. A hearing test is also performed for further diagnostics. It can provide indications of various disorders of the middle or inner ear that can cause dizziness. In a vertigo outpatient clinic, a special consultation hour for the symptom dizziness, many different examinations can be carried out to find the focus and cause of the dizziness.