Vestibular Disorders and Dizziness

Definitions and Classifications

The Barany Society defines vertigo as a false sensation of self-motion or a false sensation that the visual surroundings are spinning or flowing, representing true vestibular dysfunction, and dizziness as the sensation of disturbed or impaired spatial orientation without a false or distorted sense of motion 1
The American Academy of Otolaryngology-Head and Neck Surgery emphasizes that clinicians should focus on timing and triggers rather than the specific descriptor patients use, as patients have difficulty accurately describing symptom quality 3

The American College of Radiology recommends classifying presentations into four vestibular syndromes: triggered episodic vestibular syndrome, spontaneous episodic vestibular syndrome, acute vestibular syndrome, and chronic vestibular syndrome 3
For suspected vertigo, clinicians should ask specific questions to clarify, such as "Do you feel like you or the room is spinning?" and inquire about the duration of spinning episodes and associated otologic symptoms 1

The distinction between vertigo and non-vertiginous dizziness matters because vertigo indicates vestibular system pathology, while non-vertiginous dizziness suggests cardiovascular, metabolic, psychiatric, or other non-vestibular causes 1
Loss of consciousness is never a symptom of vestibular disorders like Ménière's disease, indicating a different etiology entirely 1, 6

Educate patients to clearly define their symptoms using specific terminology, such as spinning vs. lightheadedness vs. imbalance, to improve diagnostic accuracy in future encounters 1