From personal experience of running a dedicated vertigo clinic for a decade now, it appears that when people experience dizziness for the first time, the experience is so terrifying that they are often short of vocabulary to describe the sensation they feel. This lack of clarity in symptom description often mislead inexperienced physicians into the wrong treatment.
Generally, the presenting complaint is always "I am feeling dizzy". Now the issue is this can mean several things to several people:
Feeling like blackout / lightheaded which may direct physician towards the cardiovascular system
Feeling like drunk while walking which may direct physician to the neurological system
Feeling as if the whole world is spinning or as if the subject is spinning which directs physician to the vestibular system
Feeling like seeing double which may direct clinician to the ophthalmology
And so on.
So when confronted with the dizzy patient, the challenge confronting clinician is what does the client mean by "I am feeling dizzy"
The interesting thing in ORL is that dizziness as a symptom, in most countries where English is a second language, is regarded as a block symptom which should not be accepted without probing for the details. It is similar to saying "I have catarrh" which can be taken to mean either 'I have stuffy nose', or 'I have blocked nose' or 'I have runny nose'
The interesting aspect is most GPs have little interest, training and understanding in diagnosis and management of the dizzy patient, but would nevertheless have commenced patients with dizziness on medications before referral to ORL surgeons.
It would be nice for GP clinicians to make sure they're on the same page with patients presenting with dizziness before commencement of treatment.
So when next you're experiencing dizziness, make sure you explicitly describe your symptom to your GP and that he understood these, before accepting treatments offered.
