Dizziness: State of the Science

Abstract

Dizziness is prevalent in all adult populations, causing considerable morbidity and utilization of health services. In the community, the prevalence of dizziness ranges from 1.8% in young adults to more than 30% in the elderly. In the primary care setting, dizziness increases in frequency as a presenting complaint; as many as 7% of elderly patients present with this symptom. Classification of dizziness by subtype (vertigo, presyncope, disequilibrium, and other) assists in the differential diagnosis. Various disease entities may cause dizziness, and the reported frequency of specific diagnoses varies widely, depending on setting, patient age, and investigator bias. Life-threatening illnesses are rare in patients with dizziness, but many have serious functional impairment. Dizziness can be difficult to diagnose, particularly in elderly persons, in whom it often represents dysfunction in more than one body system. Given the relatively underdeveloped state of the empirical literature on dizziness, investigators would benefit from use of consistent criteria to describe dizziness symptoms and establish diagnoses. Investigation of the effects of testing and treatment should focus on diagnoses that are life threatening or lead to significant morbidity. In the elderly, a function-oriented approach should be studied and compared with current diagnosis-focused strategies. Alternative therapies for chronic and recurrent dizziness also merit investigation.

Occupational disability caused by dizziness and vertigo: a register-based prospective study

“…1 This classification was introduced 35 years ago and is still in use. 2,3 Vertigo indicates vestibular disorder: benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Ménière's disease, and has constituted 30% of cases in previous studies.…”

Disconnect Between Charted Vestibular Diagnoses and Emergency Department Management Decisions: A Cross‐sectional Analysis From a Nationally Representative Sample

“…2,3 The most common peripheral vestibular disorders are benign paroxysmal positional vertigo (BPPV) and acute peripheral vestibulopathy (APV). 4 BPPV results from the accumulation of mobile crystalline debris (canaliths) within the semicircular canals. 5 APV is a generic term referring to any of three related pathoanatomic diagnoses: labyrinthitis (labyrinthine inflammation), vestibular neuritis (vestibular nerve inflammation), and vestibular neuronitis (vestibular ganglion inflammation), all possibly linked to herpetic infections.…”

Childhood otitis media is associated with dizziness in adulthood: the HUNT cohort study

“…Dizziness is often defined as the sum of vertigo (illusion of movement of oneself or the environment), disequilibrium (a sensation of imbalance and/or postural instability), presyncope (feeling faint or light-headed) and "other types of dizziness" [13]. Dizziness is a common symptom associated with extensive handicap and psychological morbidity [14].…”