vertigo

Last reviewed 07/2023

• vertigo is an hallucination of movement of the environment about the patient, or of the patient with respect to the environment (1) caused by disorders of the labyrinth or brainstem (2).
• vertigo is not synonymous with dizziness

• vertigo may be classified as:

• central - due to a disorder of the brainstem or the cerebellum
• peripheral - due to a disorder in the inner ear or the VIIIth cranial nerve

• most of the patients who complain about dizziness do not have true vertigo

• five community based studies on dizziness have indicated that around 30% of patients were found to have vertigo and this proportion increased to 56.4% when the study involved an older population (3)
• in a postal questionnaire study which included 2064 patients aged between 18 to 65, 7% described true vertigo in the previous year (2)
• a full time general practitioner can expect between 10-20 patients with vertigo in 1 year (2)

Notes:

• dizziness is a non specific term which can be categorised into four different subtypes according to symptoms described by the patients:

• vertigo
• presyncope: the feeling of impending faint, caused by reduced total cerebral perfusion
• disequilibrium: feeling of unsteadiness or imbalance when standing
• light-headedness: also known as giddiness or wooziness (4)

Reference:

• (1) Ronald H. Labuguen. Initial Evaluation of Vertigo. Am Fam Physician 2006;73:244-51, 254
• (2) Barraclough K, Bronstein A. Vertigo. BMJ. 2009;339:b3493
• (3) Hanley K, O'Dowd T, Considine N. A systematic review of vertigo in primary care. Br J Gen Pract. 2001;51(469):666-71
• (4) Kuo CH, Pang L, Chang R. Vertigo - part 1 - assessment in general practice. Aust Fam Physician. 2008;37(5):341-7