From the Guidelines
Dizziness and vertigo are two distinct sensations, with vertigo being a specific type of dizziness characterized by a false sensation of spinning or movement, whereas dizziness is a more general feeling of lightheadedness or unsteadiness. The key difference between the two lies in the presence or absence of a rotational component, with vertigo involving a sense of rotation or spinning, and dizziness being more vague and general 1.
Causes of Dizziness and Vertigo
Some common causes of vertigo include inner ear problems such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Meniere's disease 1. On the other hand, dizziness can result from various causes including low blood pressure, dehydration, anxiety, or medication side effects.
Importance of Accurate Diagnosis
Understanding the difference between dizziness and vertigo is crucial because treatment approaches vary significantly depending on the underlying cause 1. For example, vertigo from BPPV might be treated with specific head positioning maneuvers like the Epley maneuver, while general dizziness from low blood pressure might require hydration and lifestyle modifications.
Clinical Evaluation
A thorough clinical evaluation, including a detailed history and physical examination, is essential to establish an accurate diagnosis 1. The Barany Society defines vertigo as a false sensation of self-motion and a false sensation that the visual surrounding is spinning or flowing, while dizziness is defined as the sensation of disturbed or impaired spatial orientation without a false or distorted sense of motion 1. Clinicians should ask patients specific questions about their symptoms, including the nature of the onset, duration, and concurrent symptoms, to determine whether they are experiencing vertigo or dizziness 1.
From the Research
Difference Between Dizziness and Vertigo
- Dizziness and vertigo are common presenting symptoms in acute care settings 2
- The distinction between dizziness and vertigo is often imprecise, with patients having difficulty describing the quality of their symptoms 3
- However, patients can more consistently identify the timing and triggers of their symptoms, which can help in evaluation and management 3
Characteristics of Dizziness and Vertigo
- Dizziness can be characterized as continuous or episodic, with episodic symptoms being further classified as triggered or spontaneous 2
- Vertigo is often described as a debilitating disease that can be triggered by head motion or other factors 4
- Episodic vertigo triggered by head motion may be due to benign paroxysmal positional vertigo, while vertigo with unilateral hearing loss suggests Meniere disease 3
Evaluation and Management
- Evaluation of dizziness and vertigo focuses on determining whether the etiology is peripheral or central, with peripheral etiologies being usually benign and central etiologies often requiring urgent treatment 3
- The HINTS (head-impulse, nystagmus, test of skew) examination can help distinguish peripheral from central etiologies 3
- Treatment of vertigo depends on the underlying cause, with options including vestibular suppressant medications, vestibular rehabilitation, and procedures such as the Epley maneuver for benign paroxysmal positional vertigo 4, 3