Unravelling Dizziness: A Practical Diagnostic Guide for Primary Care

Objective: To provide general practitioners (GPs) with a concise, evidence-based framework for diagnosing and managing dizziness inprimary care. Methods: A narrative review was conducted, synthesizing literature from PubMed and Google Scholar (2000–2025) on dizziness, vertigo, and vestibular disorders. Results: Dizziness, encompassing vertigo, disequilibrium, presyncope, and lightheadedness, affects 3%–10% of the population annually. Vertiginous dizziness often stems from peripheral vestibular disorders (e.g., benign paroxysmal positional vertigo [BPPV],Meniere’s disease) but may indicate central nervous system (CNS) pathology requiring urgent action. Nonvertiginous dizziness arises from cardiovascular, metabolic, or psychiatric causes. A systematic approach involving history (duration, triggers, red-flag signs), clinical examination (nystagmus, head impulse test), and targeted investigations (audiometry, MRI) enables accurate diagnosis. Management includes repositioning manoeuvres for BPPV, diuretics for Meniere’s disease, and urgent referral for CNS causes. Conclusion: This framework enhances GP confidence in distinguishing dizziness causes, ensuring timely intervention and referral to optimize patient outcomes.