[The "difficult" patient-Vestibular testing under difficult conditions : Part 1: History taking and clinical neurotological examination]. / Der "schwierige" Patient ­ Vestibularisdiagnostik unter erschwerten Bedingungen : Teil 1: Anamnese und klinisch-neurootologische Untersuchung.

ABSTRACT

Patients presenting with vertigo or dizziness may pose a real challenge for the clinical otorhinolaryngologist. This series of articles covers different aspects of the "difficult" dizzy patient. The first part is dedicated to pearls and pitfalls in history taking and clinical neurotological examination. It suggests possible solutions for challenging situations in history taking, such as definition of the expectations and aims, patients presenting with a long-winded history, patients' description of the symptom "vertigo", multiple vestibular syndromes in one patient, discrepancy between subjective symptoms and objective vestibular findings, cognitive bias and dealing with emotions. Furthermore, it offers practically oriented tips for the neurotological examination of patients with problems of the cervical spine, oculomotor disorders and anxiety.