[Dizziness from a neuro-otological viewpoint].

The symptom of vertigo can be due to many different causes. Differential diagnosis will be discussed primarily from a neuro-otologic point of view. Vertigo can be thought of as a subjective disturbance of the integration of different sensory inputs. The history and subjective characterisation of vertigo often provide enough information for initial differential diagnosis and recommendation for a specific evaluation. The evaluation includes simple tests of posture and gait, tests of ocular motility, and examination of nystagmus. Instability and nystagmus towards a specific direction point to a vestibular disorder, especially if the nystagmus is suppressed by optical fixation. The most common causes of a vestibular disorder are benign paroxysmal positional vertigo (BPPV), a sudden vestibular loss (or vestibular neuritis), and Ménière's disease. These three diseases are discussed briefly.