Evaluation of "dizziness" in the neurology office

Dizziness is a common presenting symptom to a neurologist in the outpatient setting. Dizziness can occur as a result of a vestibular disorder involving the peripheral or central vestibular pathways or nonvestibular centers as the result of a disorder of balance, proprioceptive input, or autonomic nervous system dysfunction. A careful clinical history and examination along with ancillary testing can usually lead to determination of the underlying disorder and implementation of the appropriate treatment. The authors review the general approach to the dizzy patient in an office-based neurology practice, focusing on the clinical diagnostic features that may help to determine the etiology and treatment options for the dizzy patient.