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Dizziness demystified
  1. Miriam S Welgampola,
  2. Allison S Young,
  3. Jacob M Pogson,
  4. Andrew P Bradshaw,
  5. G Michael Halmagyi
  1. Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia
  1. Correspondence to Dr G Michael Halmagyi, Institute of Clinical Neurosciences, Royal Prince Alfred Hospital, Central Clinical School, University of Sydney, Camperdown, New South Wales, Australia; gmh{at}icn.usyd.edu.au

Abstract

Four vestibular presentations caused by six different disorders constitute most of the neuro-otology cases seen in clinical practice. ‘Acute vestibular syndrome’ refers to a first-ever attack of acute, spontaneous, isolated vertigo and there are two common causes: vestibular neuritis / labyrinthitis and cerebellar infarction. Recurrent positional vertigo is most often caused by benign paroxysmal positional vertigo and less commonly is central in origin. Recurrent spontaneous vertigo has two common causes: Ménière's disease and vestibular migraine. Lastly, chronic vestibular insufficiency (imbalance) results from bilateral, or severe unilateral, peripheral vestibular impairment. These six disorders can often be diagnosed on the basis of history, examination, audiometry, and in some cases, basic vestibular function testing. Here we show that most common neuro-otological problems can be readily managed by general neurologists.

  • vertigo
  • benign positional vertigo
  • vestibular migraine
  • ménière's disease
  • vestibular neuritis
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Footnotes

  • Contributors MSW drafted and edited the text, created original figures and approved the final version of this manuscript. ASY edited the text, created original figures and approved the final version of this manuscript. JMP drafted and edited the text, created original figures and approved the final version of this manuscript. APB edited the text, created original figures and approved the final version of this manuscript. GMH drafted and edited the text and approved the final version of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned. Externally peer reviewed by Diego Kaski, London, UK.

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