Cause |
Clinical Features |
Management |
Benign Paroxysmal Positional Vertigo (BPPV) |
- Brief episodes of vertigo triggered by head movements
- No hearing loss or tinnitus
- Positive Dix-Hallpike maneuver
|
- Epley maneuver (canalith repositioning)
- Vestibular rehabilitation exercises
- Reassurance, as it often resolves spontaneously
|
Meniere’s Disease |
- Episodic vertigo, fluctuating hearing loss, tinnitus, and aural fullness
- Episodes last minutes to hours
- Usually unilateral symptoms
|
- Low-sodium diet and diuretics (e.g., hydrochlorothiazide)
- Betahistine and vestibular suppressants during acute episodes
- Intratympanic injections or surgery in refractory cases
|
Vestibular Neuritis |
- Sudden onset of severe vertigo lasting days to weeks
- No hearing loss or tinnitus
- Positive head-thrust test
|
- Vestibular rehabilitation exercises
- Short course of corticosteroids (in some cases)
- Anti-vertigo medications (e.g., meclizine) for symptom relief
|
Labyrinthitis |
- Vertigo with hearing loss and tinnitus
- Often follows an upper respiratory infection
|
- Antibiotics if bacterial infection is suspected
- Vestibular rehabilitation exercises
- Anti-vertigo medications for symptom control
|
Orthostatic Hypotension |
- Lightheadedness or dizziness upon standing
- May be related to dehydration, medications, or autonomic dysfunction
|
- Increase fluid and salt intake
- Avoid sudden postural changes
- Consider adjusting medications that contribute to hypotension
|
Anemia |
- Generalized weakness, fatigue, pallor, dizziness
- May be caused by blood loss, nutritional deficiencies, or chronic disease
|
- Treat underlying cause (e.g., iron supplementation for iron-deficiency anaemia)
- Transfusion in severe cases
|
Anxiety or Panic Disorder |
- Episodes of dizziness often associated with hyperventilation, palpitations, sweating
- May feel lightheaded or unsteady
|
- Cognitive-behavioral therapy (CBT)
- Anxiolytic medications (e.g., SSRIs)
- Breathing exercises to manage hyperventilation
|
Stroke or Transient Ischaemic Attack (TIA) |
- Sudden onset of dizziness, may be accompanied by other neurological deficits (e.g., weakness, numbness, slurred speech)
- Risk factors: hypertension, diabetes, smoking
|
- Emergency evaluation (CT/MRI to rule out stroke)
- Thrombolysis or anticoagulation if indicated
- Long-term management: antiplatelet therapy, control of risk factors (e.g., blood pressure, cholesterol)
|
Medication-Induced Dizziness |
- Common culprits: antihypertensives, sedatives, antidepressants, and antiepileptics
- Dizziness may be dose-related or occur with initiation of treatment
|
- Review and adjust medications
- Consider reducing dosage or switching medications
- Monitor for side effects when starting new medications
|