INTEGRATED DIAGNOSTIC APPROACH TO DIZZINESS

Abstract

Dizziness is one of the most frequent neurological and otoneurological complaints worldwide, affecting nearly one-third of the adult population at least once in their lifetime. Diagnostic difficulties arise from the symptom’s multifactorial etiology, overlapping clinical characteristics, and the necessity to differentiate between peripheral vestibular disorders, central neurological causes, cardiovascular instability, and functional or psychogenic conditions. Benign paroxysmal positional dizziness (BPPD) remains the most prevalent peripheral cause of vertigo and is commonly underdiagnosed despite its characteristic positional nature and high responsiveness to therapeutic maneuvers.

This article aims to systematize modern diagnostic approaches to dizziness, focusing on the clinical relevance of vestibulo-ocular reflex (VOR) assessment and positional testing for accurate identification of BPPD and differentiation from other vestibular pathologies. 

An integrated diagnostic strategy that incorporates both VOR assessment and positional maneuvers represents the most effective clinical pathway for evaluating dizziness. Standardizing this approach internationally may enhance early detection of BPPD and other vestibular disorders, improving patient outcomes and reducing healthcare burden.