Why does it take so long to get a diagnosis?

By: Dr. Daniel Larson, MD
Southwest Ohio ENT Specialists

Clinicians and patients both struggle to find the source of dizziness. The largest challenge to make a diagnosis for dizziness is presenting symptomatology. People describe dizziness in many different ways. As described earlier the details of the symptoms are very important in getting to the diagnosis. The second challenge is that certain types of dizziness can be caused by multiple body systems. For example, the symptom of lightheadedness could be vascular, metabolic, psychiatric, or neurologic. Although the majority of vertigo develops from an inner ear insult other forms of dizziness may be more challenging. The third challenge is that there are no great diagnostic tests to definitively establish a diagnosis. Described later in this book you will learn about vestibular testing, however this testing is only a small portion of a dizziness evaluation. Without obtaining a thorough history, the testing independently is insufficient. The last major challenge when evaluating dizziness is that there is often no objective physical exam findings during the clinical visit. Your physician and vestibular physical therapist will perform a thorough physical exam that may be normal. Many of the conditions that cause dizziness can be known as silent diseases. That means that clinical evaluation, testing, and imaging can all be normal. Dizziness is a symptom that is real to you but is not observable by your doctor. This can be frustrating for patients and clinicians alike because everyone wants to see objective findings to help establish a diagnosis.

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