The evaluation of a patient with dizziness

Dizziness is the quintessential symptom presentation in all of clinical medicine. It can stem from a disturbance in nearly any system of the body. Patient descriptions of the symptom are often vague and inconsistent, so careful probing is essential. The physical examination is performed by observing the patient at rest and following simple movements or bedside tests. In general, no special tools are required. The causes of dizziness range from benign to life-threatening disorders, and features that distinguish among these may be subtle. When diagnostic testing is considered, parsimony should be the rule. Identifying common peripheral vestibular disorders is a priority. Picking this "low hanging fruit" can be the key component to excluding more serious central causes of dizziness.