DCoE Releases Clinical Support Tools to Treat Dizziness Symptoms

By Corina Notyce, DCoE Strategic Communications

While most patients with mild traumatic brain injury (mTBI), also known as concussion, completely recover within days to weeks, some individuals experience persistent symptoms such as dizziness. Dizziness is a common symptom following mTBI and if left unresolved or untreated, can have a significant impact on a service member’s quality of life.

Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) developed “Assessment and Management of Dizziness Associated with Mild Traumatic Brain Injury Reference Card and Clinical Recommendation” to give primary care providers a quick and easy way to help evaluate and manage dizziness symptoms in patients who have been diagnosed with mTBI.

“Usually dizziness associated with mild TBI resolves within seven days,” said U.S. Public Health Service Capt. Rita Shapiro, chief of clinical practice guidelines for DCoE TBI directorate. “However, approximately 20 percent of patients can present with chronic or recurring episodes of dizziness symptoms that require additional examination by a provider to determine the cause and make appropriate referrals.”

There are three basic types of dizziness:

■Vertigo: a false sense of motion

■Disequilibrium: being off-balance or unsteady while standing or attempting to walk

■Lightheadedness: feeling faint or other vague sensations such as disconnect with environment

The reference card and clinical recommendation provides differentiation between the different types of dizziness, so providers can accurately categorize a patient’s symptoms and provide a focused assessment.

“When someone is regularly experiencing dizziness symptoms it can make daily activities challenging and for severe cases, almost impossible,” said Shapiro.

The clinical recommendation includes information on red flags that require urgent referral to appropriate specialists, medication side effects, patient management and referral options. According to Shapiro, this resource allows providers to get detailed information and reasoning behind each step in the algorithm card.

The reference card provides a listing of focused diagnostic tests and specific comorbid conditions (e.g., migraines, sleep disorders, psychological disorders and visual disturbances) which should be explored based upon a patient’s symptoms. It is intended for use by primary care providers and can be carried in their pocket for quick reference on the job.

Additionally, training slides corresponding to the clinical recommendation and the reference card are available for providers.

To request hard copies of the “Assessment and Management of Dizziness Associated with Mild TBI Reference Card and Clinical Recommendation,” contact DCoE at DCoEProducts@tma.osd.mil. To download these tools and other TBI resources, visit the Health Professionals section of the DCoE website.

DCoE recently released a clinical recommendation and reference card for neuroendocrine dysfunction screening following mild TBI, and will be releasing similar tools focused on the evaluation and management of prolonged visual disturbances associated with mild TBI next.