[The Dutch College of General Practitioners' practice guideline "Dizziness"; reaction from a neurologic perspective]

P J Koehler
Nederlands Tijdschrift Voor Geneeskunde 2003 February 22, 147 (8): 325-7
When a patient complains of dizziness, the term may cover several types of sensations. When the physician carefully takes the history, he or she will most often be able to differentiate between vertigo and other types of dizziness, including a feeling of lightness or fainting. Based on this differentiation, the Dutch College of General Practitioners (NHG) designed a practice guideline for its members. The most important causes of vertigo are paroxysmal benign positional vertigo, vestibular neuritis, Ménière's disease and TIA or stroke in the vertebrobasilar system. Differentiation between vestibular neuritis and stroke may be difficult, in particular at the onset of the complaints and therefore consultation of a neurologist will often be necessary. Fortunately, special drugs for dizziness are not recommended, as their effectiveness has not been proven. Among the causes of non-vertigo dizziness complaints, hyperventilation, often in the context of anxiety disorder, is a major cause. In general, the NHG succeeded in compiling a practical guideline.

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