Assessment of dizziness in neurology

Dizziness and vertigo are common symptoms. In acute vertigo, expert clinical assessment is critically important in discerning stroke from non-stroke causes because the results of stroke-protocol brain magnetic resonance imaging, including diffusion-weighted imaging, can be falsely negative in the first 24 hours. It follows that acute medical services must have access to clinicians expert in assessing acute vertigo. Expertise in clinical examination and interpretation of the findings requires appropriate training, but here we outline the basic diagnostic and therapeutic approach to patients with dizziness. Appropriate early management of these conditions is part of the prevention of disabling chronic functional dizziness conditions. Furthermore, the availability of effective treatments for other vestibular disorders means it is always important to make an accurate diagnosis.