Evaluation and outcome of the dizzy patient

One hundred twenty-one patients were identified who presented to an emergency room with the complaint of dizziness. Peripheral vestibular disease (24 percent of patients) was the most common cause of dizziness, but the cause remained unknown at follow-up after six months in 37 percent of the patients. The history and physicial examination were sufficient for diagnosis in 83 percent of patients in whom a diagnosis could be made. Diagnostic tests, such as complete blood counts (four patients) and chest roentgenograms (four patients), provided crucial information in some cases. At the time of follow-up, 7 percent of patients had suffered either major morbidity or had died as a result of the cause of the index episode of dizziness. Patients with an initial diagnosis of anemia, stroke, or diabetes represented a high-risk (50 percent) group for a poor outcome. However, patients who were aged under 50 years or whose dizziness was due to peripheral vestibular disease, vasovagal or psychogenic cause, drugs, or infection formed a low-risk (2 percent) group.