From the Research
Complete Blood Count (CBC) and Basic Metabolic Panel (BMP) are not typically ordered for patients with vertigo and falls as a first-line diagnostic approach, according to the most recent and highest quality study 1. When evaluating a patient with vertigo and falls, the primary focus is on determining whether the etiology is peripheral or central, as central etiologies often require urgent treatment. The HINTS (head-impulse, nystagmus, test of skew) examination can help distinguish peripheral from central etiologies 2. However, in some cases, a CBC and BMP may be ordered to rule out underlying conditions that could be contributing to the patient's symptoms, such as anemia, infections, or electrolyte imbalances. For example, abnormalities like hyponatremia (low sodium), hypokalemia (low potassium), or hypoglycemia (low blood sugar) can directly cause or worsen vertigo symptoms and increase fall risk 3. Additionally, a CBC can help detect anemia, infections, or blood disorders that can contribute to dizziness and balance problems, while a BMP can evaluate kidney function, electrolyte levels, and glucose status, all of which can impact neurological function when imbalanced 4, 5. But, the most recent study 1 suggests that laboratory testing and imaging are not required and are usually not helpful in the initial evaluation of vertigo, and the focus should be on the physical examination and the HINTS examination to determine the underlying cause of the patient's symptoms.