Home   |   View Cart   |   LogIn   |   Sitemap    |   Bookmark this site     Welcome, This is a community resource project for people seeking help for balance or dizzy problems and professionals who can provide it.     Self Assessment USER INSTRUCTIONS The self-assessment questions have only been provided to guide you to more specific information, education, and resources. The self assessment questions are not a substitute for the examination, diagnosis, or treatment by a medical professional, nor is the information provided a substitute for the medical advice of a qualified healthcare professional. Answer the follow questions as accurately as possible; answer none of the above if the answers do not apply to you.   Q1: Which of the following answers most accurately describes the times you experience your symptoms of dizziness?   I experience lightheadedness when I change positions.   I get vertigo (see the room spinning) when I change positions   I have a constant sensation of dizziness no matter what position I'm in.   I only feel dizzy when I'm walking or standing   I feel a sense of dizziness the more I'm up and moving around, but when I lie down or support my head I feel fine.   I only feel dizzy with strenuous activities such as bearing down or lifting heavy objects   I feel dizzy when I hear loud sounds   None of the above     Q2: How would you best describe your symptoms?   I have episodes where I see the room spinning for seconds to minutes   I have episodes where I see the room spinning for minutes to hours   I feel like I'm spinning, but I never see anything in the room spinning   I am unsteady when I'm standing or walking, but otherwise I feel fine   I experience pressure at the base of my skull that makes me feel dizzy   I have episodes where I feel as though I'm going to pass out or faint   I constantly feel like I am rocking on a boat   None of the above describes my symptoms     Q3: If you have experienced or continue to experience true vertigo (where you actually see the room spinning), how long does or did the vertigo last?   Seconds to minutes   More than 3 but less than 20 minutes   Greater than 20 minutes   Hours to less than 1 day   1-3 Days   I haven't experienced true vertigo.     Q4: How many times have you experienced true vertigo (where you actually see the room spinning)?   Only one time, lasting for seconds to minutes   Only one time, but it lasted several days   Multiple times, lasting for seconds to minutes   Multiple times, lasting greater than 20 minutes   I have never experienced true vertigo     Q5: When you experience dizziness (lightheadedness, fogginess, spaciness, haziness?), how long does this last?   Seconds to a minute   Minutes   Hours   Days   I have a constant sensation of dizziness     Q6: Do you normally experience any of the following when you experience vertigo or dizziness?   Hearing loss and tinnitus   Neck pain, headache, or pressure in the head or neck   Numbness, tingling, ataxia, or loss of strength and coordination   Sensitivity to light or sound   Neck pain, headaches, and sensitivity to light and sound   I don't experience any of the above     Q7: Which of the following most accurately describes your symptoms?   I only experience brief symptoms when I change positions such as lying down, sitting up, a rolling over, bending forward, or looking up   My symptoms are worse when I go grocery shopping or when I am in busy environment such as a mall, store, family function, athletic event   My symptoms can last for hours and are worse when I keep my head turned, work on my computer, or read for long periods of time   My symptoms can come on suddenly without warning, even if I am just sitting without moving   My symptoms can come on suddenly but I usually have a warning such as; tinnitus (ringing), pressure or blocking in my ears, or a sensation of dizziness   I experience symptoms when I sneeze, strain, blow my nose, or lift heavy objects   I experience symptoms when I hear loud noises, sneeze, blow my nose, or lift heavy objects   None of the above statements describes my symptoms     Q8: Which best describes you:   I have a history of migraines (visual or headache)   I have a history of strokes and/or transient ischemic attacks (TIAs)   I have a heart condition   I have fibromyalgia   I have undergone neck surgery   I have neuropathy   None of the above     Q9: Which most accurately describes your symptoms?   My hearing fluctuates (I seem to lose some of my hearing but then it comes back).   I started experiencing my symptoms only after going on a cruise or long flight.   Before I experience vertigo or dizziness, I have visual disturbances such as wavy lines, spots, flashing lights, or other odd sensations   I feel like I can hear everything too loudly, even my own voice is too loud.   I experienced a "pop" in my ear before I started experiencing symptoms of vertigo and dizziness   None of the above     Q10: If you experience a sensation of disequilibrium (feeling off-balance) is this sensation:   Constant   Induced by quick movements   Induced by changing positions   Worse in the dark her uneven surfaces   I don't experience disequilibrium     Q11: Which of the following best describes your symptoms?   I can hear my own heart beating and/or my joints moving and/or my eyes moving   I feel a sense of fullness or pressure in my ears.   I feel like I am rocking on a boat   I feel like my world is bouncing up and down   I feel like my eyes wont focus, especially when I move my head   None of the above     Q12: Which one of the following makes your symptoms of dizziness feel the worst?   When I lie down or roll over in bed.   When I walk on uneven surfaces; grass, sand, gravel, ramps, hills.   When I use a computer, read, or perform activities with my arms for too long   When I go grocery shopping or to a store.   When I am worried about something or under stress   None of the above     Q13: Which of the following is most consistent with your condition?   I have lost my coordination and have difficulty performing simple tasks such as buttoning my clothes, writing, or walking   I experienced a sudden onset of vertigo lasting 1-2 days followed by dizziness, and I have lost hearing in one ear.   I experienced a sudden onset of vertigo lasting 1-2 days followed by dizziness, but my hearing has not changed.   I occasionally experience lightheadedness and feel as though my heart is racing   I feel like I am constantly walking on foam or thick carpeting.   None of the above.     Q14: Which of the following, if any, best describes you?   My hearing fluctuates, and has progressively decreased   My hearing fluctuates, especially when I am dizzy   I have progressive hearing loss associated with my dizziness   I had sudden hearing loss associated with my dizziness   I hear things more intensely than I used to, everything seems too loud   My hearing has not changed     Q15: Do you or have you experienced any of the following?   Difficulty getting moving, as though you are frozen or rigid   Loss of mobility in one of your arms or a legs   Double vision   Panic or anxiety attacks   Burning in your feet or legs   I don't experience or haven't experienced any of the above

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