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Their differential diagnosis, however, often imposes a\u00a0challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This work aims to provide evidence-based and practice-oriented recommendations for diagnosis and treatment of vertigo and dizziness for primary care providers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>The consensus statement of an interdisciplinary working group following a\u00a0national survey among Swiss primary care physicians and neurotology specialists (neurologists, otorhinolaryngologists) is presented. The associated literature search in PubMed was conducted up to October 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and conclusion<\/jats:title>\n                    <jats:p>Structured history taking and clinical neurotological examination form the basis for the differential diagnosis of the various acute (AVS), episodic (EVS), and chronic (CVS) vestibular syndromes (AVS: e.g., stroke or acute unilateral vestibulopathy; EVS: e.g., benign paroxysmal positional vertigo [BPPV], Meni\u00e8re\u2019s disease, vestibular migraine, vestibular paroxysmia; CVS: e.g., bilateral vestibulopathy, persistent postural perceptual dizziness). The present paper covers the following topics: i)\u00a0\u201cred flags\u201d for a\u00a0potentially dangerous cause in patients with acute vertigo\/dizziness\/gait and balance disorders; ii)\u00a0essential clinical neurotological examination steps; iii)\u00a0diagnostic and therapeutic maneuvers for posterior and lateral canal BPPV; iv)\u00a0the most important therapeutic strategies for the vestibular syndromes named above; and v)\u00a0the top\u00a010 recommendations regarding history taking, diagnosis, and treatment of vertigo and dizziness in clinical practice. This review aims to serve as a\u00a0clinical companion for physicians of all specialties dealing with the primary diagnosis and treatment of vertigo and dizziness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00106-025-01599-z","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T10:57:26Z","timestamp":1750157846000},"page":"357-369","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Diagnosis and treatment of vertigo and dizziness","Diagnostik und Therapie bei Schwindel"],"prefix":"10.1007","volume":"73","author":[{"given":"Alexander Andrea","family":"Tarnutzer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassen","family":"Kerkeni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzie","family":"Diener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Kalla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Candreia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Piantanida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rapha\u00ebl","family":"Maire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antje","family":"Welge-L\u00fcssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris","family":"Budweg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Zwergal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Dlugaiczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"1599_CR1","doi-asserted-by":"publisher","first-page":"1254080","DOI":"10.3389\/fneur.2023.1254080","volume":"14","author":"A Zwergal","year":"2023","unstructured":"Zwergal\u00a0A, Mantokoudis\u00a0G, Heg\u00a0D, Kerkeni\u00a0H, Diener\u00a0S, Kalla\u00a0R et\u00a0al (2023) What is the current status of primary care in the diagnosis and treatment of patients with vertigo and dizziness in Switzerland? 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Oxford University Press"}],"updated-by":[{"DOI":"10.1007\/s00106-025-01670-9","type":"erratum","label":"Erratum","source":"publisher","updated":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000}}],"container-title":["HNO"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00106-025-01599-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00106-025-01599-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00106-025-01599-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T15:57:21Z","timestamp":1764691041000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00106-025-01599-z"}},"subtitle":["Interdisciplinary guidance paper for clinical practice","Interdisziplin\u00e4rer Leitfaden f\u00fcr die klinische Praxis. Englische Version"],"short-title":[],"issued":{"date-parts":[[2025,6,17]]},"references-count":36,"journal-issue":{"issue":"S3","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["1599"],"URL":"https:\/\/doi.org\/10.1007\/s00106-025-01599-z","relation":{},"ISSN":["0017-6192","1433-0458"],"issn-type":[{"value":"0017-6192","type":"print"},{"value":"1433-0458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,17]]},"assertion":[{"value":"27 November 2024","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 June 2025","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 August 2025","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The original online version of this article was revised: In Table 3 of this article, entries in the second  column \/ heading \u201cDrug treatment \/ Acute phase\/symptomatic\u201d were incorrect. The text was incorrecty given as \u201cMay be considered: antiemetics (domperidone, metoclopramide, ondansetron) and\/or antivertiginous drugs (cinnarizine\u00b1  dimenhydrinate) for a max. of 2\u20133 days, Ginkgo biloba extract (EGb 716) to support central adaptation [28, 29]\u201d but should have been \u201cMay be considered: antiemetics (domperidone, metoclopramide, ondansetron) and\/or antivertiginous drugs (cinnarizine\u00b1  dimenhydrinate) for a max. of 2\u20133 days, Ginkgo biloba extract (EGb 761) to support central adaptation [28, 29]\u201d","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Supplementary file:  In Table S1, Term \u201cAcute imbalance syndrome (AIS)\u201d the Definition should have read \u201e\u2026without spontaneous or gaze-evoked nystagmus\u201d instead of  \u201c\u2026with spontaneous or gaze-evoked nystagmus\u201d .","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 September 2025","order":8,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Erratum","order":9,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"An Erratum to this paper has been published:","order":10,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1007\/s00106-025-01670-9","URL":"https:\/\/doi.org\/10.1007\/s00106-025-01670-9","order":11,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was financially supported by Schwabe Pharma AG (coverage of costs for drawing figures by H\u202f+\u2009O communications; paid lectures to several authors at an advisory board reporting study results). The selection of the contents of this guidance paper and the article writing were done solely by the authors. The content of this guidance paper reflects the authors\u2019 opinion. Both Schwabe Pharma AG and H\u202f+\u2009O communications had no impact on the content of this paper. There was also no medical writing involved. Furthermore, the authors declare: A.A.\u00a0Tarnutzer: Financial interests: lecturing honoraria from \u201cForum f\u00fcr medizinische Fortbildung\u201d (FomF), Diatec, Schwabe Pharma AG and Hennig Pharmaceuticals and coverage of costs for travel and accommodation by Diatec, Schwabe Pharma AG and Hennig Pharmaceuticals. Non-financial interests: Member of the executive board of the Swiss Neurological Society (SNS). H.\u00a0Kerkeni, C.\u00a0Candreia, R.\u00a0Piantanida and A.\u00a0Welge-L\u00fcssen: Financial interests: lecturing honorarium and coverage of costs for travel and accommodation from Schwabe Pharma AG. S.\u00a0Diener, R.\u00a0Kalla, R.\u00a0Maire and J.\u00a0Budweg. Financial interests: lecturing honorarium from Schwabe Pharma AG. A.\u00a0Zwergal: Financial interests: grant support by the European Union (MSCA project PROVIDE), \u201cCures within reach\u201d and by the innovation fund of the \u201cGemeinsamer Bundesausschuss\u201d (Project \u201cPoiSe\u201d). Lecturing honoraria from Schwabe Pharma AG, Pfizer and Astra Zeneca; participation in an advisory board of the Dr. Willmar Schwabe GmbH; Non-financial interests: speaker of the commission \u201cNeuroophthalmologie\/Neurootologie\u201d in the German Neurological Society (DGN). J.\u00a0Dlugaiczyk: Financial interests: lecturing honoraria from \u201cForum f\u00fcr medizinische Fortbildung\u201d (FomF), Diatec, Schwabe Pharma AG and Hennig Pharmaceuticals and coverage of costs for travel and accommodation by Diatec, Schwabe Pharma AG and Hennig Pharmaceuticals. Non-financial interests: Member of the executive board of the working group of German-speaking Audiologists, Neurotologists and Otologists (ADANO) and of the Prosper Meni\u00e8re Society; Editorial Board Member\n                      HNO\n                      , Review Editor\n                      Frontiers in Neurology\n                      .","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human participants or animals performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The supplement containing this article is not sponsored by industry.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}