Feature Article

Three tools for managing vertigo in the frontline

VINCENT A. VAN VUGT, ALLISON S. YOUNG, ANDREW P. BRADSHAW, BENJAMIN NHAM, MARGOT WOODS, MIRIAM S. WELGAMPOLA

Figures

© carlosbezz/istockphoto.com
© carlosbezz/istockphoto.com

Abstract

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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Key Points

  • 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.

Figures

© carlosbezz/istockphoto.com
© carlosbezz/istockphoto.com