Symptoms of dizziness are very common, and they can be quite frustrating and debilitating. As the underlying presentation and etiology can be quite variable from patient to patient, deciphering the most appropriate evaluation steps can be a rather daunting task even for the experienced physician. The primary objectives of this review are to 1) present a relatively concise yet comprehensive overview of the multitude of signs, symptoms, and causes of different forms of dizziness, and 2) provide type-specific clinical and diagnostic guidelines for the evaluation and treatment of this complex condition. The diagnostic utility of various evaluation techniques and procedures, including audiometry, electronystagmography (ENG), vestibular evoked myogenic potential (VEMP), electrocochleography (ECOG), rotary chair testing, posturography, blood analyses, and radiographic imaging are reviewed for the workup of otogenic vertigo. The importance of professional referral to the appropriate medical subspecialist for the workup of neurogenic and cardiogenic dizziness is also discussed. Evaluation and treatment algorithms are integrated into the narrative to facilitate all discussions and for future reference.
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