An algorithm for differentiating the most common causes of vertigo and dizziness in the primary care Review article
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Published:
Dec 31, 2024
Keywords:
dizziness, vertigo, differential diagnosis, algorithm, VOR, HINTS
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Abstract
Dizziness and vertigo are common conditions in primary care, with diagnosis often challenging due to the subjective nature of symptoms and overlapping features of vestibular syndromes. To facilitate diagnosis, a dedicated algorithm has been developed to identify the most common causes, their symptoms, and situations requiring specialist consultation or hospitalization. Key diagnostic elements include a detailed medical history, assessment of the vestibulo-ocular reflex, evaluation of nystagmus, and detection of skew deviation within the HINTS protocol. In cases of suspected benign paroxysmal positional vertigo, the algorithm outlines specific diagnostic and therapeutic steps.
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How to Cite
Bojanowski, S., Mielańczuk-Lubecka, B., Kania, J., & Domitrz, I. (2024). An algorithm for differentiating the most common causes of vertigo and dizziness in the primary care. Medycyna Faktow (J EBM), 17(4(65), 440-445. https://doi.org/10.24292/01.MF.0424.01
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References
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2. Lopez-Escamez JA, Carey J, Chung WH et al. Diagnostic criteria for Menière’s disease. J Vestib Res. 2015; 25(1): 1-7.
3. von Brevern M, Bertholon P, Brandt Th et al. Benign paroxysmal positional vertigo: Diagnostic criteria. J Vestib Res. 2015; 25(3-4): 105-17.
4. Strupp M, Lopez-Escamez JA, Kim JS et al. Vestibular paroxysmia: Diagnostic criteria. J Vestib Res. 2016; 26(5-6): 409-15.
5. Staab JP, Eckhardt-Henn A, Horii A et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society. J Vestib Res. 2017; 27(4): 191-208.
6. Strupp M, Kim JS, Murofushi T et al. Diagnostic criteria Consensus document of the Classification Committee of the Bárány Society. J Vestib Res. 2017; 27(4): 177-89.
7. Eggers S, Bisdorff A, von Brevern M et al. Classification of vestibular signs and examination techniques: Nystagmus and nystagmus-like movements. J Vestib Res. 2019; 29(2-3): 57-87.
8. Kim HA, Bisdorff A, Bronstein A et al. Hemodynamic orthostatic dizziness/vertigo: Diagnostic criteria. J Vestib Res. 2019; 29(2-3): 45-56.
9. Agrawal Y, Van de Berg R, Wuyts F et al. Presbyvestibulopathy: Diagnostic criteria Consensus document of the classification committee of the Bárány Society. J Vestib Res. 2019; 29(4): 161-70.
10. Cha YH, Baloh R, Cho C et al. Mal de débarquement syndrome diagnostic criteria: Consensus document of the Classification Committee of the Bárány Society. J Vestib Res. 2020; 30(5): 285-93.
11. Cha YH, Golding J, Keshavarz B et al. Motion sickness diagnostic criteria: Consensus Document of the Classification Committee of the Bárány Society. J Vestib Res. 2021; 31(5): 327-44.
12. Lempert Th, Olesen J, Furman J et al. Vestibular migraine: Diagnostic criteria (Update). J Vestib Res. 2022; 32(1): 1-6.
13. Kim JS, Newman-Toker D, Kerber K et al. Vascular vertigo and dizziness: Diagnostic criteria. J Vestib Res. 2022; 32(3): 205-22.
14. Strupp M, Bisdorff A, Furman J et al. Acute unilateral vestibulopathy/vestibular neuritis: Diagnostic criteria. J Vestib Res. 2022; 32(5): 389-406.
15. Mielańczuk-Lubecka B, Bojanowski S, Krzysztoń K et al. Zawroty głowy w praktyce neurologa i fizjoterapeuty — interdyscyplinarne spojrzenie na diagnostykę i leczenie. Praktyczna fizjoterapia i rehabilitacja. 2024; 152: 1-14.
16. Berkowicz T, Domitrz I, Kalinowska‑Łyszczarz A et al. Rekomendacje postępowania w zawrotach głowy w praktyce ambulatoryjnej. Neurologia Praktyczna. 2013; 5(74): 8-16.
17. Bhandari A, Bhandari R, Kingma H et al. Proposal of a standardized testing protocol for BPPV: using 3D stimulations for insights into otolith movement during positional tests. XXXII Bárány Society Meeting 2024.