Vertigo is a difficult management problem in General Practice. Dr Benjamin Tsang will discuss this condition and help us to understand vertigo and what the patient may be dealing with. This is part one of this article. Read Part 2>>

Practice points

• The definition of “vertigo” is “an illusionary or false sense of movement when there is no true movement occurring”. In the acute setting, differentiating “vertigo” from “dizziness” is not important as there is no diagnostic discrimination value in doing so; in the acute setting, assume you are dealing with the same symptom.
• In all causes of acute persistent, spontaneous vertigo, any head movement will make the symptoms worse. In other words, head motion intolerance has no diagnostic discrimination value, as all causes of vertigo will have this clinical feature.
• Hearing loss, headache and/or neck pain accompanying dizziness are all red flags.
• In BPPV, there is usually a lateralising side, for example, otoconia entering the left posterior canal will have positionally-triggered vertigo when the head is positioned with the left ear