Referring for dizziness and balance complaints
Duizeligheid.nl is a specialised primary-care practice for the assessment and treatment of dizziness and balance complaints. The practice is part of Fysiotherapie Douma in Hilversum.
The practice includes physiotherapists who have specifically focused on assessment and treatment of disorders of the balance system.
Complaints for which referral may be useful
Referral may be useful for patients with complaints such as:
Patients with residual complaints after vestibular disorders such as vestibular neuritis or vestibular hypofunction may also benefit from vestibular rehabilitation.
Spinning vertigo
Suspected BPPV
Short attacks of rotational vertigo when turning over in bed, bending or looking up.
Instability when moving
Vestibular hypofunction
Dizziness and unsteadiness due to reduced function of one or both balance organs.
Complaints after acute dizziness
Residual complaints after vestibular neuritis
Persistent dizziness or instability after an acute loss of function of a balance organ.
Unsteady walking
Balance problems and fall risk
Difficulty maintaining balance, unsteady walking or an increased risk of falling.
Blurred vision when moving
Possible oscillopsia
A blurred or jerky image while walking or during quick head movements.
Fear of moving
Fear of movement and avoidance
Avoiding movements or activities for fear of dizziness, a new attack or loss of balance.
Persistent dizziness
Possible PPPD
Long-lasting dizziness or instability that increases when standing, moving or in visually busy environments.
Dizziness attacks
Possible vestibular migraine
Recurring attacks of dizziness, sometimes together with headache or sensitivity to light, sound and movement.
Complaints after brain injury
Dizziness after a concussion
Dizziness and balance complaints after a concussion or other non-congenital brain injury.
Systematic analysis during the first consultation
During the first consultation, a detailed history is taken in which the complaint pattern is analysed systematically. This includes use of a structured approach to dizziness complaints, such as the SO STONED principle.
Physical examination may also include:
- eye movements and nystagmus
- vestibulo-ocular reflex
- positional dizziness (BPPV)
- balance and gait pattern
- neck function
- blood pressure changes when standing up
If needed, assessment can be carried out with tools such as Frenzel goggles, Video Frenzel or Video Nystagmography (VNG).
Further assessment via GP or specialist
When the assessment shows indications of a possible neurological or other non-vestibular cause, it may be advised to arrange further assessment through the GP or specialist.
Booking and sharing information
Patients can contact the practice directly to make an appointment. Referral can also take place via ZorgDomein or via a referral given to the patient.
Where possible, we would like to receive additional information. This information can help to focus the assessment more effectively.
Referral letter
Via ZorgDomein or via the patient
A referral letter can help include the reason for referral and the clinical question clearly.
Previous diagnostics
Assessment already performed
Information about previous diagnostics can help make the assessment more targeted.
Audiogram, hearing test or medication
Additional information
An audiogram or hearing test and information about medication use may be relevant for the evaluation.
Reporting, collaboration and follow-up advice
After the assessment, a report is prepared with the findings of the assessment and any treatment plan or advice. If the referrer has a ZorgMail address, the report is sent back.
Reporting
After the assessment, a report is prepared with the findings and any treatment plan or advice.
Feedback to the referrer
If the referrer has a ZorgMail address, the report is sent back.
Collaboration
For dizziness complaints, collaboration with other disciplines may be important, such as GPs, ENT specialists, occupational therapists and psychologists.
Additional advice
In some situations, the consultation consists of diagnostics and advice towards the GP or specialist.
Coordination with other disciplines
For dizziness complaints, collaboration with other disciplines may be important. If needed, collaboration may include GPs, ENT specialists, occupational therapists and psychologists.
There is close collaboration with specialised ENT doctors at Bergman Clinics.
Supplementary insurance and first consultation
Physiotherapeutic assessment and treatment of dizziness complaints usually falls under supplementary insurance.
The first consultation may consist of an extensive assessment with reporting. When treatment is possible, a treatment pathway can be started. In some situations, the consultation consists of diagnostics and advice towards the GP or specialist.
Consultation or referral
For consultation or referral, the practice can be contacted. Patients can also register directly via the Duizeligheid.nl website.