The following symptoms and complaints may occur along with Vertigo (vertigo):
Leading symptom
- Vertigo
Associated symptoms
- Nausea (nausea)/vomiting
- Nystagmus – involuntary but rapid rhythmic eye movements.
- Positional instability
- Gait ataxia (gait disorders)
- Hearing loss / tinnitus (ringing in the ears)
Common causes of dizziness in old age
Disease | Symptoms |
Benign paroxysmal positional vertigo (BPLS)(synonym: benign peripheral paroxysmal positional vertigo, BPPV). |
|
Bilateral vestibulopathy (BV)(complete or incomplete). |
* Increase in the dark and on uneven ground. |
Meniere’s disease |
Leading symptoms (Meniere’s triad)
* Dizziness usually lasts minutes (> 20 min.) to 12 hours and repeats at irregular intervals. |
Orthostatic vertigo |
|
Central vertigo |
Note: Gaze direction nystagmus and vertical deviation of the axis of both eyes are present only in brainstem infarction. |
Note: In elderly patients with chronic vertigo, there is often a combination of central and peripheral causes with accompanying psychological factors.
Warning signs (red flags)
- Anamnestic information:
- Chronic alcohol consumption
- Otitis media (inflammation of the middle ear), acute and chronic.
- Visual, speech and swallowing disorders or other neurological deficits.
- In patients aged 20 to 40 years with episodic dizziness and vague neurologic symptoms → think of: Multiple sclerosis (MS)
- Gaze direction nystagmus and/or vertical deviation of the axis of both eyes → think of: Brainstem infarction
- Gait ataxia → think of: Transient ischemic attack (TIA) or apoplexy (stroke).
- Syncope (brief loss of consciousness due to reduced blood flow to the brain, usually accompanied by loss of muscle tone).
- Sudden hearing loss (within 72 hours) or progressive (rapidly progressing) symptomatology
- With /without sudden hearing loss (sudden onset, unilateral, near-total hearing loss) → think of: Acoustic neuroma