Neurology. 3: Dizziness

The differential diagnosis of dizziness includes vertigo as well as numerous other causes of faintness or lightheadedness. Vertigo is a common symptom that has diverse causes. Because of uncertainties about the diagnosis, many patients are treated symptomatically without a specific diagnosis being made. Most patients have benign, peripheral (otological) causes for their symptoms. Patients with potentially serious central (neurological) problems are usually identified on history and examination. Many common causes of vertigo, such as benign positional vertigo and migraine, can be successfully diagnosed and treated without expensive investigations or referral. Exercise therapy, rather than vestibular suppressant medication, should be the mainstay of treatment for patients with chronic vertigo due to "uncompensated" vestibular lesions.