Dizziness: The Right Questions to Ask and Tests to Order

PROGRAM DESCRIPTION: How can we most effectively evaluate patients with dizziness within the confines of modern practice? During this panel presentation, sponsored by the Otology Neurotology Education Committee, experts in vestibular diagnosis will discuss how to integrate best evidence with clinical experience to efficiently formulate a differential diagnosis for any patient with dizziness. By working through illustrative cases, we will present the key questions – focused on timing, triggers, and associated symptoms – that elicit the pertinent history and minimize vague reporting. We will also review the highest yield physical exam elements that warrant incorporation into daily practice using video clips to illustrate technical pearls and findings. With this diagnostic framework established, we will guide clinicians in determining what tests to order, if any, by defining the specific questions that can and cannot be answered with the current array of audio-vestibular tests and imaging. We will incorporate audience response to maximize engagement at various stages of clinical decision making. We aim to provide an approach that clinicians can readily implement to make correct diagnoses in a timely fashion, thus expediting initiation of therapy and improving patient outcomes.

OUTCOME OBJECTIVE 1: Efficiently gather an informative case history for a patient with dizziness

OUTCOME OBJECTIVE 2: Formulate a differential diagnosis for dizziness based on timing, triggers, and associated symptoms

OUTCOME OBJECTIVE 3: Select appropriate diagnostic tests that yield information necessary for patient management

BACKGROUND STATEMENT: There is a need for clinicians to implement evidence-based, efficient, and cost-effective approaches for dizziness evaluation. We will focus on presentations most commonly encountered by comprehensive otolaryngologists, highlighting key peripheral and central vestibular disorders.