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Diagnostic clues

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • vertigo can have multiple simultaneous causes (especially in old age)
    • the diagnosis can be vague
  • there are features in the history and the examination which help with the diagnosis of vertigo
  • clues to diagnosis of causative lesion include (1):
    • duration of vertiginous episodes
    • presence or absence of auditory symptoms
  • the physical examination should include (1):
    • measurements of orthostatic vital signs ( blood pressure and pulse)
    • otoscopy
    • neurological examination
      • cranial nerves
      • Dix-Hallpike manoeuvre
        • helps differentiate peripheral from central vertigo
      • Unterberger's stepping test
  • laboratory tests (1):
    • usually not indicated
    • if hearing loss is present
      • audiometric tests may be necessary to differentiate vestibular lesions from retro-cochlear lesions (e.g., acoustic neuroma)
    • brain imaging
      • done if a tumour or cerebrovascular accident is suspected


  1. Swartz R.Treatment of Vertigo.American Family Physician 2005; 71(6)

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