Wind exposure Infections • • Rotational stimulation Medications • • Flying • Driving • Pressure changes • Changes in specific gravity • Alcohol-induced vertigo • Is it vertigo? Yes • Rotatory • Vestibular neuritis BPPV Meniere’s disease Vestibular migraine Sensation of boat • Bilateral vestibulopathy No • Dizziness Duration Seconds to minutes • BPPV Vestibular paroxysmia Minutes to hours • Meniere’s disease Vestibular migraine Hours to days • Vestibular neuritis Varies • Fistula SSCD Precipitating/exacerbating factors Present in rest • Vestibular neuritis Worse when walking • Bilateral vestibulopathy Precipitated by turning the head to the left and • Vestibular paroxysmia Turning in bed to one side • BPPV Coughing/pressing/sounds • Fistula SSCD Social or environmental condition • Phobic postural vertigo Accompanying symptoms Inner ear • Tinnitus, hearing loss, aural fullness Central nervous system • Diplopia, dysphagia, sensory disturbances, dysarthria, paralysis of arms or legs
• Wind exposure • Rotational stimulation • Flying • Driving • Pressure changes • Changes in specific gravity • Alcohol-induced vertigo • Infections • Medications Is it vertigo? • Yes • Rotatory Vestibular neuritis BPPV Meniere’s disease Vestibular migraine • Sensation of boat Bilateral vestibulopathy • No Dizziness Duration • Seconds to minutes BPPV Vestibular paroxysmia • Minutes to hours Meniere’s disease Vestibular migraine • Hours to days Vestibular neuritis • Varies Fistula SSCD Precipitating/exacerbating factors • Present in rest Vestibular neuritis • Worse when walking Bilateral vestibulopathy • Precipitated by turning the head to the left and Vestibular paroxysmia • Turning in bed to one side BPPV • Coughing/pressing/sounds Fistula SSCD • Social or environmental condition Phobic postural vertigo Accompanying symptoms • Inner ear Tinnitus, hearing loss, aural fullness • Central nervous system Diplopia, dysphagia, sensory disturbances, dysarthria, paralysis of arms or legs