Vertigo is a challenging symptom in general practice. With access to three tools – a focused history, eye examination and a management algorithm – a large proportion of vertiginous patients could be managed effectively by GPs. This practical guide seeks to increase the skills and confidence of frontline practitioners when managing vertigo.
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- A structured history (Tool 1) enables identification of the vestibular syndrome underlying vertigo symptoms. Vertigo can be subdivided into acute, episodic and chronic vestibular syndromes.
- An eye examination (Tool 2) identifies the aetiology of the syndrome. For example, is the episodic vestibular syndrome due to benign positional vertigo?
- A management plan (Tool 3) guides the practitioner in offering a treatment specific to the diagnosis.
- Acute vestibular syndromes are best assessed by a specialist.
- The most common episodic vestibular syndrome, benign paroxysmal positional vertigo, can easily be diagnosed and treated in general practice.
- The preferred treatment for chronic vestibular syndrome is vestibular rehabilitation.