Dizziness, falling, and fainting: differential diagnosis in the aged (Part I)

Lack of awareness of benign positional vertigo is a common cause of misdiagnosis of dizziness. Patients complain of brief bouts of vertigo, specifically provoked by turning the head or by arising in the morning. The Bárány's test reproduces characteristic vertigo and nystagmus. Postural hypotension, by far the most common cause of recurrent dizziness and falls in the elderly, is especially notable on arising after prolonged bedrest. Vasoactive drugs are the most common culprits, typically antihypertensive agents, vasodilators used for angina, and tricyclic antidepressants.