Spatial disorientation may be expressed by the patient as dizziness, vertigo or feeling ‘light-headed’. True vertigo, however, is not experienced as a sensation of movement but as tilting or sloping of the environment, often characterised as the room spinning around them.

Causes

Episodic

  • ●

    Ménière’s disease *

  • ●

    Benign paroxysmal positional vertigo (BPPV)

  • ●

    Arrhythmia

  • ●

    Postural hypotension

  • ●

    Migraine/Vestibular migraine

  • ●

    Hyperventilation

  • ●

    Drugs (antihypertensives, antidepressants)

  • ●

    Hypoglycaemia

  • ●

    Posterior circulation TIAs

  • ●

    Anxiety

  • ●

    Seizures (partial)

  • ●

    Carbon monoxide poisoning (e.g. faulty heating)

  • ●

    Persistent postural-perceptual dizziness (PPPD)

Constant

Acute onset

  • ●

    Labyrinthitis *

  • ●

    Vestibular neuronitis

  • ●

    Acute alcohol or recreational drug intoxication

  • ●

    Head injuries *

  • ●

    Posterior circulation CVA

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