Practice 10-Minute Consultation

Funny turn

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d7465 (Published 05 December 2011) Cite this as: BMJ 2011;343:d7465
  1. Elaine Stephanie Leung, PhD candidate; general practitioner1,
  2. Monica Anne Hamilton-Bruce, principal medical scientist12,
  3. Nigel Stocks, professor and head3,
  4. Simon A Koblar, associate professor; senior consultant neurologist12
  1. 1Stroke Research Programme, University of Adelaide, Adelaide, South Australia 5005, Australia
  2. 2Department of Neurology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
  3. 3University of Adelaide, General Practice, Adelaide, South Australia, Australia
  1. Correspondence to: E S Leung elaine.leung{at}adelaide.edu.au
  • Accepted 7 October 2011

A 72 year old woman presents to your surgery complaining of “funny turns.” She describes two episodes over the last week when she felt dizzy and had difficulty walking. She did not collapse but felt very unsteady and needed to lean against a wall. She has a history of hypertension for which she is taking irbesartan.

What you should cover

The phrase “funny turn” is commonly used to describe a set of symptoms that presents a diagnostic challenge to the general practitioner. The potential diagnoses vary widely, and include neurological, cardiovascular, metabolic, vestibular, and psychological conditions.

Patients may complain of dizziness, and the assessment of these often vague symptoms in a 10-minute consultation is a challenge, with some of the potential diagnoses being medical emergencies.

A careful history from the patient and any witnesses is essential, as the history alone may provide the diagnosis or at least guide to the appropriate test or specialist. However, a reliable history cannot always be obtained and this article focuses on an …

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