[Acute and episodic dizziness - diagnosis and treatment]

Dizziness is one of the most common, yet diagnostically challenging cardinal symptoms with a wide range of causes. It accounts for 2-8 % of all consultations in both the emergency room and in general practice. The extremely broad differential diagnosis, which covers numerous medical specialties, the often transient nature of the symptoms, and the difficulty for patients to put the experienced symptoms into words, often make the evaluation of dizziness challenging. A structured history and targeted clinical examination - particularly with a focus on duration, triggers and oculomotor signs (HINTS-plus) - are crucial. The priority is to quickly identify dangerous causes such as stroke or cardiac arrhythmias. Diagnostic tests should be targeted to avoid overdiagnosis. The treatment depends on the cause and should be based on guidelines.