| 🪨 Benign Paroxysmal Positional Vertigo (BPPV) |
- Brief (<1 min) vertigo triggered by head movement
- No hearing loss or tinnitus
- Positional nystagmus; + Dix–Hallpike
|
- 🔄 Epley manoeuvre (first-line)
- Vestibular exercises
- Reassurance (benign, self-limiting)
|
| 🌊 Ménière’s Disease |
- Episodic vertigo (minutes–hours)
- Fluctuating hearing loss
- Tinnitus + aural fullness
- Usually unilateral
|
- 🥗 Low-salt diet
- 💊 Betahistine ± diuretics
- ENT referral if refractory
|
| 🦠 Vestibular Neuritis |
- Acute, severe vertigo lasting days
- No hearing loss
- Positive head-impulse test
|
- Early mobilisation + vestibular rehab
- Short-term vestibular suppressants only
- Consider steroids (early phase)
|
| 👂 Labyrinthitis |
- Vertigo with hearing loss
- Tinnitus common
- Often post-viral
|
- Supportive ± antibiotics if bacterial
- Vestibular rehabilitation
- Audiology follow-up
|
| ⬆️⬇️ Orthostatic Hypotension |
- Dizziness on standing
- Postural BP drop
- Medication or dehydration related
|
- Hydration + slow postural change
- Review antihypertensives
- Compression stockings if needed
|
| 🩸 Anaemia |
- Fatigue, pallor, exertional dizziness
- Often chronic
|
- Treat underlying cause
- Iron/B12/folate replacement
- Transfusion if severe
|
| 😰 Anxiety / Panic Disorder |
- Light-headedness, “floating” sensation
- Hyperventilation, palpitations
- Normal neuro exam
|
- CBT and reassurance
- Breathing techniques
- SSRIs if persistent
|
| 🧠 Stroke / TIA (Central Vertigo) |
- Sudden onset dizziness
- Ataxia, diplopia, dysarthria
- Normal head-impulse test
|
- 🚨 Emergency neuroimaging
- Stroke pathway (thrombolysis if eligible)
- Secondary prevention
|
| 💊 Medication-Induced |
- Temporal link to new drugs
- Sedatives, antihypertensives, antiepileptics
|
- Medication review
- Dose reduction or alternative
- Patient counselling
|
