Vertigo and dizziness : diagnosis, management, and hot topics

Abstract

Peripheral vestibular disorders can be diagnosed by characteristic nystagmus, whereas central vestibular disorders can be diagnosed by neurologic signs/symptoms other than vertigo/dizziness. Thus, in the differential diagnosis of vertigo/dizziness, both nystagmus and neurological symptoms should be examined. When a diagnosis of benign paroxysmal positional vertigo is made, the canalith repositioning maneuver should be attempted by all practitioners. Vertigo/dizziness usually dose not persist for a long period of time due to vestibular compensation. However, some of dizziness may persist because of collapsed vestibular compensation mechanism or central sensitization. In the treatment of dizziness, it is useful to know the mechanism of chronicity.