Dizziness and vertigo-NICE guidance summary

Refer to be seen within 2 weeks if they had -New onset blackout ( TLOC ) which are suggestive of epileptic seizures ie○ bitten tongue○ head turning to one side during TLOC○ no memory of abnormal behaviour seen before , during or after TLOC○ unusual posturing○ prolonged limb -jerking the guidance reminds that brief seizure like activity can often occur during uncomplicated faints○ confusion following the episode○ prodromal dejavu ( this is an intense sensation that what is happening for the 1st time has happened before ) or jamais vu ( a feeling of lack of familiarity that what should be familiar is happening for the 1st time )The following characteristics in the presentation should prompt you to consider a diagnosis other than epilepsy○ prodromal symptoms that previously stopped on sitting or lying down○ sweating before the episode○ prolonged standing that appeared to precipitate the TLoC○ pallor during the episode

Vasovagal syncope even with brief jerking of the limbs- does not require referral.

Consider a diagnosis of uncomplicated faint / uncomplicated vasovagal syncope if no features to support an alternative diagnosis features as 3 Ps which support a diagnosis of uncomplicated faint as1 posture - prolonged standing or similar episodes...