Dizziness in the Outpatient Care Setting

Terry D. Fife, MD, FAAN Selected Topics in Outpatient Neurology p. 359-395 April 2017, Vol.23, No.2 doi: 10.1212/CON.0000000000000450
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Purpose of Review: This article summarizes an approach to evaluating dizziness for the general neurologist and reviews common and important causes of dizziness and vertigo.

Recent Findings: Improved methods of diagnosing patients with vertigo and dizziness have been evolving, including additional diagnostic criteria and characterization of some common conditions that cause dizziness (eg, vestibular migraine, benign paroxysmal positional vertigo, chronic subjective dizziness). Other uncommon causes of dizziness (eg, superior canal dehiscence syndrome, episodic ataxia type 2) have also been better clarified. Distinguishing between central and peripheral causes of vertigo can be accomplished reliably through history and examination, but imaging techniques have further added to accuracy. What has not changed is the necessity of obtaining a basic history of the patient’s symptoms to narrow the list of possible causes.

Summary: Dizziness and vertigo are extremely common symptoms that also affect function at home and at work. Improvements in the diagnosis and management of the syndromes that cause dizziness and vertigo will enhance patient care and cost efficiencies in a health care system with limited resources. Clinicians who evaluate patients with dizziness will serve their patient population well by continuing to manage patients with well-focused workup and attentive care.

Address correspondence to Dr Terry D. Fife, Barrow Neurological Institute, 240 West Thomas Rd, Suite 301, Phoenix, AZ 85013, [email protected].

Relationship Disclosure: Dr Fife serves on the editorial boards of Barrow Quarterly and Neurology.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Fife discusses the unlabeled/investigational use of acetazolamide, venlafaxine, and zonisamide for the treatment of vestibular migraine.

Copyright © 2017 by the American Academy of Neurology.