Approach to Vertigo

Abstract

Vertigo is a common symptom with a broad differential that ranges from benign (peripheral etiology) to life threatening (central etiology). This teaching script leads the reader through a systematic and diagnostically useful approach to evaluating a patient with vertigo. We emphasize the importance of taking a history focused on categorizing vertigo as episodic or continuous to narrow the differential diagnosis. We highlight the use of evidence-based eye movement examinations, including the Dix-Hallpike and the HINTS (Head Impulse, Nystagmus, Test of Skew) examinations, to aid in differentiating between benign and life-threatening etiologies.