[Vestibular dizziness. Differential diagnosis and therapy].
Dizziness includes a wide variety of subjective sensations which are not conclusive as to their localization or pathogenesis. Even in the absence of other symptoms an analysis of dizziness, including consideration not only of its occurrence but also of its quality and course, can suggest several possibilities for differential diagnosis. We differentiate between positional vertigo, permanent vertigo and attacks of dizziness, which may be of long or only short (seconds to few minutes) duration. Based on this classification the differential diagnosis of vestibularly-induced dizziness, which ranges from distinct entities of peripheral disease (acute vestibulopathy, Ménière's disease) to symptomatic forms of peripheral or central pathogenesis, is discussed. The symptomatic medical treatment of vestibular dizziness is based on sedation of the central vestibular system. Translabyrinthine vestibular neurectomy is the treatment of choice for drug resistant Ménière's disease with a high frequency of attacks.