Dizziness classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Debduti Mukhopadhyay, M.B.B.S[2] Fatimo Biobaku M.B.B.S [3] Norina Usman, M.B.B.S[4]

Based on the symptoms, dizziness may be classified into vertigo, presyncope, disequilibrium, lightheadedness. Vertigo can further be classified into timing and trigger as well as based on the area of pathology such as central and/ or peripheral.

Dizziness may be classified into subtypes based on the symptoms^[1]:

One way to classify dizziness and vertigo is based on the timing and trigger as follows:^[3]

• New episodic:
  • With triggers:
    • Triggered episodic vestibular syndrome (e.g., positional vertigo from BPPV)
  • Without triggers:
    • Spontaneous episodic vestibular syndrome (e.g., arrhythmia from cardiac causes)

-New continuous:
  - Post-exposure acute vestibular syndrome (e.g., after gentamicin)
  - Spontaneous acute vestibular syndrome (e.g., stroke of posterior fossa)

-Chronic, persistent:
  - Chronic vestibular syndrome (unilateral vestibular loss, present with head movement)
  - Spontaneous chronic vestibular syndrome (associated with degeneration of cerebellum)

Vertigo can be further classified into peripheral and central based on the area of pathology (explained further under the pathophysiology section): ^[4][5]

-Central:
  -Ischemia or infarction of the brainstem
  -Vertebrobasilar insuffiency
  -Demyelination syndromes like multiple sclerosis
  -Space occupying lesions (both benign and malignant)
  -Arnold-Chiari malformation
  -Vestibular migraine

-Peripheral:
  -Benign Paroxysmal Positional Vertigo (BPPV)
  -Cogan syndrome (autoimmune condition that affects eyes and inner ears)
  -Acoustic neuroma
  -Herpes zoster
  -Labyrynthitis
  -Vestibular neuritis
  -Medication toxicity (e.g., aminoglycosides, etc)
  -Perilymphatic fistula

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