Vertigo overview

Vertigo Microchapters
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Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Vertigo from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Historical Perspective

• Vertigo is derived from the Latin words vertigin and vertere which means "a whirling or spinning movement," and "to turn", respectively.

Classification

• Vertigo is classified on the basis of the location of dysfunction into:
  • Peripheral: Lesion in the inner ear or vestibulocochlear nerve.
  • Central: Lesion in brainstem or cerebellum.
• It can also be classified on the basis of its time course or duration:
  • Lasting a day or longer
  • Lasting minutes to hours
  • Lasting seconds

Causes

• Common causes of vertigo:
  • Peripheral: Benign paroxysmal positional vertigo (BPPV), Ménière's disease, acute labyrinthitis, vestibular neuritis, Herpes zoster oticus(Ramsay Hunt syndrome).
  • Central: Ischemic/hemorrhagic stroke in the cerebellum or brainstem, tumor in cerebellopontine angle, vestibular migraine.
  • Drug induced
  • Psychological Vertigo

Differentiating Vertigo from other Diseases

• Vertigo is a type of dizziness therefore it must be differentiated from other diseases that cause imbalance, dizziness, and lightheadedness.

Epidemiology and Demographics

• Among the patient who presents with dizziness in the primary care setting, fifty-four percent have vertigo upon investigation.

Risk Factors

• There are no established risk factors for vertigo, as it is a symptom of an underlying disease.
• However, vertigo can be prevented in some cases by controlling risk factors for the underlying cause.

Screening

• There is insufficient evidence to recommend routine screening for vertigo.

Diagnosis

Diagnostic Study of Choice

• There are no established criteria for the diagnosis of vertigo. Associated signs and symptoms should be identified to reach the underlying cause of vertigo.

History and Symptoms

• It is important to differentiate between other causes of dizziness before evaluating for the cause of vertigo. True vertigo is described as the room spinning around the patient.
• Once true vertigo is established next step is to identify if the origin of dysfunction is central or peripheral.

Physical Examination

Laboratory Findings

• There are no diagnostic laboratory findings associated with vertigo.

Electrocardiogram

• There are no ECG findings associated with vertigo.
• ECG monitoring may be indicated if the cause of dizziness is uncertain.

X-ray

• There are no x-ray findings associated with vertigo.

Echocardiography or Ultrasound

• There are no echocardiography/ultrasound findings associated with vertigo.

CT scan

• CT scan is not the first-line imaging preferred to determine the underlying cause of central vertigo.

MRI

• An MRI is the first-line imaging if the cause of vertigo is suspected to be central in origin.

Other Imaging Findings

Other Diagnostic Studies