Dear Patient:

You can help your doctor get more insight into how your medical condition is progressing by regularly making entries in the Dizziness
Diary. These entries are very helpful for the diagnosis and treatment of your illness.

Please enter the following information to describe each attack of dizziness that you experience:

Type
P= postural vertigo (a feeling of unsteadiness,      as if on a ship)
R = rotatory vertigo (a feeling of spinning, as if       on a merry-go-round))
G = gait unsteadiness
L = lightheadedness, giddiness

Trigger of the attacks
1 head movement
2 change in head position
3 standing up from sitting position
4 walking
5 visual stimuli
6 certain specific situations
7 cough, sneeze
8 other

Accompanying conditions
A nausea
B vomiting
C diplopic images
D other vision disorders
E falling
F headache
G hearing disturbances
H tinnitus
I feeling of pressure in ears
L light sensitivity or sensitivity to noise
M other

own therapy
1 positional maneuvers
2 physiotherapeutic exercises
3 rest
4 medication for nausea
5 pain pills
6 other

Important additional information
(blood glucose level, blood pressure, etc.)
other