The document discusses various types of vertigo, dizziness, and imbalance that patients may experience and how medical personnel should evaluate and classify these symptoms. It covers peripheral causes like benign paroxysmal positional vertigo (BPPV), vestibular neuronitis, labyrinthitis, and Meniere's disease. It also discusses central/neurological causes and compares features of peripheral vs. central vestibular lesions. Evaluation involves taking a history, physical exam including nystagmus tests, and potentially imaging or other tests.

1. Vertigo Professor Yasser Metwally

3. Development of vertigo Afferent Visual Proprioceptive Vestibular CNS Efferent Oculomotor Sceletal muscles Vegetative Dizziness

7. In case of vertigo No sponteous nystagmus Sponteous nystagmus Posture and balance control negative Posture and balance control positive Nausea vomiting Sweating, tachycardia Nausea, vomiting, sweating, anxiety GI disorder Chest pain Anxiety „ Harmonic” vestibular sy „ Dysharmonic” vestibular sy Internal medicine Angina, MI Loss of hearing, tinnitus Numbness, double vision, dysarthria Cardiology Psychiatry Vestibular neuronitis, Meniére disease Brainstem infarct Otology Neurology

12. Duration of vertigo Time Peripheral Central Seconds BPPV VB-TIA, aura of epilepsy Minutes perilymph fistula VB-TIA, aura of migraine (Half) hours Meni é re disease basilar migraine Days vestibular neuronitis labyrinthitis VB stroke Weeks, Month acustic neurinoma, drug toxicity multiple sclerosis cerebellar degenerations

14. Left Right HC HC AC AC PC PC + -

15. BPPV diagnosis: Dix-Hallpike manoeuvre