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Vertigo is defined as the sensation of self-motion when no motion is occurring. Vestibular disorders are conditions that affect the vestibular sensory organs in the inner ear or the cerebellum and brainstem and the connections between them.

Some patients have difficulty describing the sensation of vertigo.1 Dizziness is a nonspecific word patients use quite often to describe the vertigo they experience when suffering from a vestibular disorder. Although asking about the quality of dizziness that the patient is experiencing may be helpful in many cases, overreliance on the description may lead to misdiagnosis.

To add to the confusion, dizziness is also used by some patients to describe the symptoms of presyncope, imbalance, light-headedness, and other sensations. In the initial evaluation of a patient presenting with dizziness, the clinician must keep this broader differential diagnosis in mind. Fortunately, the nonvestibular causes of dizziness can be suspected and appropriate investigations selected based on the context of the patient’s presentation.

Vertigo can be a diagnostic challenge for emergency physicians. One reason is because it has many potential causes (Table 170-1).

TABLE 170-1Peripheral and Central Causes of Vertigo

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