TY - JOUR T1 - Diagnosis and management of vertigo JF - Clinical Medicine JO - Clin Med SP - 159 LP - 165 DO - 10.7861/clinmedicine.5-2-159 VL - 5 IS - 2 AU - GM Halmagyi Y1 - 2005/03/01 UR - http://www.rcpjournals.org/content/5/2/159.abstract N2 - 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. ER -