Table 1: Classification of Dizziness

Type Features Etiology
1. Vertigo Rotary or tilting sensation
Episodic
Possible associations:
       nystagmus
       oscillopsia
Vegetative symptoms:
       nausea
       Vomiting
       Pallor
       diaphoresis
Labyrinthiasis (often viral)
BPPVa (canalithiasis, cupulolithiasis)
Labyrinthine ischemia (posterior circulation stroke)
Endolymphatic hydrops (e.g. Meniere disease)
Ototoxicity (if damage asymmetric)
Trauma
Central vestibular connections (about 10% of cases)
2. Presyncope Sensation of impending loss of consciousness
Gradual onset (except if cardiac)
Resolution with recumbency (except if cardiac)
Associations:
       generalized weakness
       visual dimming
Vegetative symptoms (as with vertigo)
Dehydration
Orthostasis
Vasovagal phenomena
       Sympatholytic drug therapy (alpha blockade)
Primary autonomic insufficiency
3. Dysequilibrium Unsteadiness while standing or walking
Exacerbated by poor lighting if sensory
Proprioceptive deficit (e.g. peripheral neuropathy)
Visuo-vestibular mismatch (e.g. use of optical devices)
Compensated unilateral or balanced bilateral
vestibulopathy
Dementia
Central motor disorders (stroke, Parkinson disease)
Musculoskeletal disorders (e.g. DJDb, myopathies)
Neuromuscular junction disorders (MGc, L-ESd)
4. Psychogenic Vague sensation of giddiness or dissociation
Protracted or continuous with periodic flaresTrigger
often identifiable (crowds, confined spaces)
May be induced by hyperventilation
Associations:
      anxiety (acute or chronic)
       "light-headedness"
       "heavy-headedness"
       "wooziness"
Anxiety disorder
Mood disorder

a: Benign paroxysmal positional vertigo; b: Degenerative joint disease; c: myasthenia gravis; d: Lambert-Eaton syndrome