Vertigo and Dizziness
What Is It?
Sensation of spinning or movement when stationary. Benign paroxysmal positional vertigo (BPPV) is most common cause. Other causes: Meniere disease, vestibular neuritis, central causes.
How Is It Diagnosed?
Dix-Hallpike maneuver (BPPV), HINTS exam (head impulse, nystagmus, test of skew - rules out central cause in acute vestibular syndrome). MRI brain if central etiology suspected.
How Is It Treated?
BPPV: Epley maneuver (canalith repositioning). Vestibular neuritis: corticosteroids, vestibular rehabilitation. Meniere disease: low-sodium diet, diuretics, betahistine. Central vertigo: urgent neurology referral.
Tests and Imaging Typically Needed
Clinical exam (Dix-Hallpike, HINTS), audiometry, MRI brain if central etiology suspected, CBC, BMP.
Approximate Self-Pay Costs
Office visit: $95-$150. Epley maneuver: included in visit. Audiometry: $50-$100. MRI brain: $500-$1,200 (if indicated).