Dizziness

Dizziness and vertigo are common symptoms. In the acute setting, it is most important to make an accurate diagnosis, particularly to distinguish peripheral from central causes of vertigo and to determine which patients require urgent neuro-imaging for suspected stroke. Although the history and physical examination usually yield the diagnosis, on occasion there is diagnostic ambiguity and the clinician must have to hand a list of likely diagnoses in order to decide rationally which specific investigations (e.g. brain imaging) are required. This article outlines the diagnostic approach to common and important conditions that present with acute dizziness, and their management.