A practical work-up for vertigo.

Specific elements in the history and physical examination direct the work-up of the "dizzy" patient toward or away from a vestibular disorder. When a disorder of this type is suspected, the differential diagnosis includes benign positional vertigo, vestibular neuritis, vertebrobasilar insufficiency, migraine, and endolymphatic hydrops, which is the pathologic condition thought to underlie Meniere's disease. Anxiety is well recognized as a potential component of vestibular abnormalities or as the primary problem.