Vertigo and dizziness
Sorting dizziness by timing and triggers, catching posterior circulation stroke in acute vestibular syndrome, and treating BPPV, vestibular neuritis, vestibular migraine, Ménière disease and PPPD.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Patients describe "dizziness" unreliably. Classify by timing and triggers, not by the word used (the TiTrATE approach: timing, triggers and a targeted examination).
- Acute vestibular syndrome (continuous vertigo for days): vestibular neuritis or posterior circulation stroke. A trained examiner's HINTS beats early MRI.
- Brief positional vertigo: BPPV, diagnosed with the Dix-Hallpike test and cured by the Epley manoeuvre, without imaging or drugs.
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Sources
- Therapeutic Guidelines: Neurology. VertigoAU/NZTherapeutic Guidelines Limited (eTG complete), current eTG edition (version not verified)
- Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg 2017;156(3 Suppl):S1-S47American Academy of Otolaryngology-Head and Neck Surgery Foundation, 2017
- Benign paroxysmal positional vertigo: diagnostic criteria. J Vestib Res 2015;25:105-17Bárány Society (Journal of Vestibular Research), 2015
- Acute unilateral vestibulopathy/vestibular neuritis: diagnostic criteria. J Vestib Res 2022;32:389-406Bárány Society (Journal of Vestibular Research), 2022
- Vestibular migraine: diagnostic criteria (update). J Vestib Res 2022;32:1-6Bárány Society and International Headache Society (Journal of Vestibular Research), 2022
- Diagnostic criteria for Menière's disease. J Vestib Res 2015;25:1-7Bárány Society (Journal of Vestibular Research), 2015
- Diagnostic criteria for persistent postural-perceptual dizziness (PPPD). J Vestib Res 2017;27:191-208Bárány Society (Journal of Vestibular Research), 2017
- Prevention of benign paroxysmal positional vertigo with vitamin D supplementation: a randomized trial. Neurology 2020;95(9):e1117-25Neurology (American Academy of Neurology), 2020
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy