The Spins: A Systematic Approach to Undifferentiated Vertigo
Sunday, May 18, 2025
10:30 AM – 11:30 AM
CE: 1.00 AAPA Category 1 CME
No relevant relationships with ineligible companies to disclose within the past 24 months.
Vertigo, or dizziness, is a common complaint in the primary care setting. The one-year prevalence of these complaints in the general population is approximately 5%, but approaches 30% in patients at least 60 years of age. While peripheral vestibular dysfunction is the most common cause of dizziness, it may be the initial presenting sign of a potentially devastating central cause such as cerebellar or brainstem stroke. The differentiation of these diagnoses can be daunting. A general understanding of the different presentations of central versus peripheral vertigo, historical context and timing, and physical exam findings, can facilitate a diagnosis. For example, prolonged and constant non-positional vertigo is unlikely to be benign paroxysmal positional vertigo, but the absence of ataxia or other neurologic findings makes it unlikely to be a stroke. Understanding the pathophysiology of the common causes of vertigo, along with a straightforward approach, can simplify management and referral decisions.
Learning Objectives:
At the conclusion of this session, participants should be able to:
Implement the use of timing and context in the patient history as a tool to differentiate the potential vertigo presentations
Discuss the pertinent physical exam techniques to identify and rule out potential causes of vertigo
Identify the most common etiologies associated with central and peripheral vertigo and their basic pathophysiology
Describe several common causes of vertigo including benign paroxysmal positional vertigo (BPPV), vestibular migraine, vestibular neuritis, and cerebrovascular accident
Expedite decisions with regard to management, and/or referral to a higher level of care in patients presenting with vertigo
