PT  - JOURNAL ARTICLE
AU  - GM Halmagyi
TI  - Diagnosis and management of vertigo
AID  - 10.7861/clinmedicine.5-2-159
DP  - 2005 Mar 01
TA  - Clinical Medicine
PG  - 159--165
VI  - 5
IP  - 2
4099  - http://www.rcpjournals.org/content/5/2/159.short
4100  - http://www.rcpjournals.org/content/5/2/159.full
SO  - Clin Med2005 Mar 01; 5
AB  - Vertigo is an illusion of rotation due to a disorder of the vestibular system, almost always peripheral. In the history it must be distinguished from pre-syncope, seizures and panic attacks. A single attack of acute, isolated spontaneous vertigo lasting a day or more is due either to vestibular neuritis or cerebellar infarction; distinguishing between the two requires mastery of the head impulse test. Recurrent vertigo is mostly due to benign paroxysmal positioning vertigo (BPPV), Menière's disease or migraine. With a good history, a positional test, an audiogram and a caloric test, it is usually possible to distinguish between these. BPPV is the single most common cause of recurrent vertigo and can usually be cured immediately with a particle repositioning manoeuvre. Posterior circulation ischaemia very rarely causes isolated vertigo attacks and when it does the attacks are brief and frequent and the history is short.