Abstract

Background.Although dizziness is a common symptom in both primary care and referral practices, the relative frequency of various causes has not been well delineated. Methods.A MEDLINE search identified 12 articles containing original data on the etiology of dizziness in consecutive patients. Study sites included primary care offices (n = 2), emergency room (n = 4), and referral clinics (n = 6). Each study's strength of design was graded using nine quality criteria. Results.Dizziness was attributed to a peripheral vestibulopathy in 44% of patients, a central vestibulopathy in 11%, psychiatric causes in 16%, other conditions in 26%, and an unknown cause in 13%. Certain serious causes were relatively uncommon, including cerebrovascular disease (6%), cardiac arrhythmia (1.5%), and brain tumor (<1%). Conclusions.Dizziness is due to vestibular or psychiatric causes in more than 70% of cases. Since serious treatable causes appear uncommon, diagnostic testing can probably be reserved for a small subset of patients.