Otology: Vertigo.

Area of Science:

• Neurology
• Otolaryngology

Background:

• Vertigo is increasingly understood by its triggers and timing, moving beyond simple symptom quality.
• This approach aids in distinguishing central from peripheral causes and classifying vertigo types: spontaneous episodic vestibular syndrome, triggered episodic vestibular syndrome, or acute vestibular syndrome.

Purpose of the Study:

• To outline a diagnostic and management strategy for vertigo based on triggers and timing.
• To emphasize the role of targeted physical examination in vertigo assessment.
• To provide guidance on pharmacological and interventional treatments for vertigo.

Main Methods:

• Classification of vertigo based on triggers and timing into distinct syndromes.
• Utilization of targeted physical examination for etiological delineation.
• Review of management strategies including vestibular rehabilitation, pharmacotherapy, and interventional procedures.

Main Results:

• The trigger and timing classification effectively distinguishes serious central from benign peripheral vertigo.
• Targeted physical examination is crucial for refining the diagnosis within classified vertigo categories.
• Neuroimaging and vestibular testing are not routinely indicated.

Conclusions:

• A systematic approach to vertigo evaluation using triggers and timing, coupled with targeted physical examination, is recommended.
• Vestibular rehabilitation is a primary treatment for vestibular hypofunction.
• Pharmacotherapy and interventional treatments are reserved for specific cases and symptom management.