Giddiness is one of the important symptoms, one is dealing at least one case in a busy practice. Approach to studying the cause of giddiness is two ways. One is from above to below namely ruling out brain cause and then others as done by Neurologist whom most of our patients approach first. My approach to this vexing problem at times, is from below to above namely 1.Ruling out cardiac cause by taking ECG and X Ray chest and then if needed Echo. 2.Ruling out Cervical cause by taking cervical spine X Rays which is always rewarding.
3. Then think of investigating for brain cause namely Posterior circulation failure by doing MRI Brain with MRA and MRV. This way the patient will be better benefited by spending less and also not missing important cardiac cause which may be life saving. In my experience, most of the cases of giddiness are due to cervical causes namely 70% and 20% cardiac and…
