The neurologic aspects of vertigo: analysis of 400 cases

Of almost 8,000 patients referred for neurological consultation, 6.1 per cent had "dizziness" as a presenting complaint. Dizziness is a nonspecific complaint, used loosely to describe funny feelings in the head or lightheadedness by anxious or depressed patients; or it may mean vertigo-a hallucination of movement of self or surroundings in horizontal, rotatory or vertical direction. An analysis of 400 cases showed the complaint "dizziness" to be functional in about 25 per cent of patients. The cause in the remaining cases varied from epilepsy from cortical lesions, to lesion of the brain stem, such as tumors, vascular insufficiency, and multiple sclerosis, or to the peripheral neurone from Meniere's disease, and vestibular neuritis. Leading the patient out in a description of the kind of dizziness he feels may give clues that will help differentiate between true vertigo and functional disorder, particularly when considered against the information that is obtained in neurological examination.

The practical management of dizziness

THE PROBLEM OF DIZZINESS IS GREATLY SIMPLIFIED IF: (1) A definite routine is followed in the history taking and the steps of the examination; (2) the examination is done in two stages; and (3) a simple classification is used in cases of dizziness of vestibular origin whereby three groups are distinguished on the basis of localization of the origin. The etiologic diagnosis is thereby narrowed down to a relatively few possibilities.The treatment consists of measures to relieve the symptoms and to reverse the underlying disease which produced the symptoms.