Dizziness is one of the most common complaints in general practice. Distinguishing benign from serious causes is critical.
Types of dizziness
BPPV (benign paroxysmal positional vertigo): seconds-long spinning on head movement — most common, treatable
Vestibular neuritis: constant rotational vertigo for days, severe nausea, viral
Ménière's disease: episodic vertigo with hearing loss and tinnitus
Orthostatic: lightheadedness on standing
Cardiac: palpitations, heart-rhythm disorders
Central (stroke): vertigo + neurological deficit — emergency
Call 112 for vertigo PLUS any of:
Double vision
Facial weakness, arm weakness, speech difficulty (FAST)
Severe headache or neck pain
Difficulty walking
Sudden hearing loss
What DoktorAkut can do on site
Structured clinical examination (HINTS test to differentiate peripheral from central vertigo)
Blood pressure, orthostatic measurement
ECG (cardiac causes)
Dix-Hallpike test for BPPV
Epley manoeuvre for BPPV — often resolves the problem in a single visit
Antiemetic (metoclopramide) IV if severe nausea
Short-course vestibular sedatives (dimenhydrinate) — limited use as they delay compensation
Referral to ENT or neurology if complex or central cause suspected
FAQ
Can BPPV really be cured in one visit?
Often yes. The Epley manoeuvre resolves BPPV in 80 %+ of cases on first attempt.
Is dizziness a stroke symptom?
It can be. Isolated dizziness without neurological deficit is rarely stroke. But dizziness + any focal deficit (double vision, weakness, speech change) = call 112.