Complaints of dizziness, vertigo or imbalance, the symptoms may be the result of vestibular disease, neurological, vascular, orthopedic and psychological. As such, it is not always clear which specialty is the subject of a court. In the era of cost consciousness and efficiency, the doctor important decisions about the appropriateness and the cost of diagnostic procedures and referrals to specialists do.
Patients complain of dizzinessor without objective signs imbalance, lack of a clear direction for diagnosis, are often used for MRI / CT imaging studies to rule out the possibility of brain damage. The economics of this decision deserves scrutiny, since the yield of these studies, very low, while the diagnostic yield corresponding physical examination in the doctor's office is very high. "Disturbances are common, and brain tumors are rare." Before testingsuch as magnetic resonance, are issues that need to consider the likelihood that MRI will provide all diagnostic information, and whether the sensitivity of diagnostic tests more useful to be less expensive to run first. In our office, the objective of examining the initial site of the probable cause of the symptoms of the patient to be determined.
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A directed history and physical examination, detailed neurological diagnosis allows the most sophisticated and successful treatment. Unfortunately, inthis day of managed care providers have many succumb to time constraints prohibiting extensive investigations, referrals to specialists require. Currently, 50% of patients seen in primary care do not receive a diagnosis for their complaints of dizziness, but 70% receive a prescription for Meclizine (Antivert). Meclizine has not been shown to be effective and appropriate in the treatment of chronic imbalance, vertigo or imbalance. Sometimes it is effective in reducingNausea associated with dizziness / spinning in some forms of chronic head spin, but is not curative in any way, and it often disrupts the natural recovery issues further deterioration. E 'should be specified at this time, do not want you to contact a specialist consultation with me in my office.
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