Do you experience a hearing change or other neurologic symptoms, like diplopia?
If the answer is yes, suspect vertigo. A negative is not helpful. • Is your dizziness accompanied by nausea and/or vomiting? These symptoms are common with vertigo, less so with other dizziness. • Is your dizziness constant or transient? Constant dizziness over a period of months or years is never vertigo. Even vertigo resulting from a permanent vestibular lesion, though initially constant, will fade over the course of a few weeks due to adaptation. Make sure, though, that the patient understands the question. Some people with benign paroxysmal positional vertigo (BPPV) claim that they are constantly dizzy; they actually mean that they are constantly at risk of provoking the episodic vertigo by assuming certain head positions. Also, be careful in your consideration of certain symptoms. For instance, panic and fear don’t automatically mean a panic attack rather than vertigo. Vertigo itself is a frightening experience. Neither does hyperventilation-induced dizziness necessarily mean pres
