<s>[INST] My wife has been being awakened with dizziness. She has recently gotten over a bout with the flu, and she has had 3 tias in the past few years. She is only 38 years old. These dizziness spells are quick, but they make her feel wiped out. She can also get nausea with them. Any thoughts on the causes? [/INST] Hello! Welcome on Chat Doctor! I would explain that it is important performing a comprehensive differential diagnosis between different causes that may lead to this clinical scenario: - an inner ear disorder-possible TIA (especially considering her past medical history)- migraine with vertigo this reason, I would recommend consulting with an ENT specialist for a physical exam and labyrinthine tests. A brain MRI is also necessary to exclude possible TIA or any other lesions of the brain. Regarding migraine with vertigo, it is usually a clinical diagnosis that is determined based on her clinical symptoms and normal tests (that exclude other disorders). You should discuss with her doctor on these issues. Hope to have been helpful! Kind regards,  </s>