Pathologies

Common vestibular causes of dizziness are explained with an emphasis on assessment, diagnosis, and how the location of dysfunction affects management. A key idea is distinguishing an active pathology from the original trigger, since the cause may have resolved by the time the patient is assessed. The approach also stays patient-centred by focusing on symptoms, functional limits, and goals. The main triggers reviewed are BPPV, unilateral and bilateral vestibular hypofunction, vestibular migraine, Menière’s disease, acoustic neuroma, and ischaemic causes. BPPV is presented as the most common cause, caused by displaced otoconia entering a semicircular canal and producing brief, position-triggered vertigo with characteristic nystagmus. Diagnosis and treatment methods such as Dix-Hallpike and repositioning manoeuvres are outlined. Vestibular neuronitis is described as a sudden peripheral hypofunction, often viral, causing prolonged dizziness and requiring vestibular rehabilitation, with possible benefit from early steroids. Menière’s disease and vestibular migraine are compared as episodic conditions lasting hours, with hearing loss distinguishing Menière’s. Ischaemic vertigo is discussed as less common but important, especially when accompanied by central neurological signs. Duration and pattern of symptoms are highlighted as useful diagnostic clues.