Symptoms of vertigo in general practice: a prospective study of diagnosis.

BACKGROUND There is little published evidence of the general practice experience of the diagnostic outcomes when symptoms of vertigo present. What research there is has been dominated by specialist centres. This gives a skewed view of the prevalence of the causes of such symptoms. AIM To describe the likely diagnosis of symptoms of vertigo. DESIGN OF STUDY Prospective cohort study METHODS Thirteen GPs were recruited and trained to clinically assess and follow up all patients presenting with symptoms of vertigo over a six-month period Age-sex data were simultaneously gathered on those who consulted with non-vertiginous dizziness. RESULTS The main diagnoses assigned by the GPs in 70 patients were benign positional vertigo, acute vestibular neuronitis and Ménière's disease, which together accounted for 93% (95% confidence interval = 71% to 100%) of patients' symptoms. Ninety-one per cent of patients were managed in general practice and 60% received a prescription for a vestibular sedative. CONCLUSION This study suggests that presentations of symptoms of vertigo can be clinically diagnosed in most cases. The diagnoses recorded by GPs differ in proportion to those in specialist centres, with a larger number of patients suffering from benign positional vertigo and acute vestibular neuronitis in general practice, in contrast with specialist centres, which see more patients with Ménière's disease.