Dizziness refers to all disorientation in space. An accurate diagnosis is very important for the treatment in this case, which often requires the joint work of neurologists, otolaryngologists and specialists in internal medicine.


The most common cause of dizziness is a disorder of the vestibular apparatus located in the inner ear (otolaryngology) or a disorder of the central pathways of the nervous system in the brain/spinal cord (neurology). Less commonly, dizziness can be caused by a heart rhythm disorder or metabolic disease (internal medicine).


It is very important to drink enough liquid to ensure normal blood circulation both in the inner ear and in the brain tissues. It is recommended to undergo a neurological prophylactic examination of the condition of the blood supplying cerebral arteries (see neurological follow-up examination).


Dizziness may be prolonged or manifest in the form of seizures. There are several types of dizziness. Most common:

  • Vertigo with sensation of rotation
  • Pull in a certain direction
  • Sensation of staggering without a particularly pronounced direction of dizziness


1. The first step in making a diagnosis is an accurate description of the complaints:
– С точки зрения времени протекания головокружения: в виде приступов / длительное головокружение.
– Вид головокружения: головокружение с ощущением вращения, тяга в определенную сторону, ощущение шатания без особо выраженного направления головокружения…
– Дополнительные симптомы: ухудшение слуха, тиннитус, ощущение давления в ухе, двоение изображения, проблемы с координацией, нарушение восприятия или уменьшение силы с одной стороны тела, нарушение речи.

2. Neurological examination of the body / otolaryngological examination:

3. Carrying out duplex sonography of the blood supplying arteries of the brain, including the vertebrobasilar circulation (circulation in the pool of vertebral arteries).

4. Carrying out an electroencephalogram (EEG) to exclude increased cerebral excitability.

5. Depending on the results, magnetic resonance imaging (MRI) of the head. Laboratory studies, examinations by an internist.


Therapy is selected depending on the causative disease that causes dizziness.
Therapy may include:

  • physical and medical methods of treatment (recommendations for the implementation of special therapeutic movement maneuvers, exercises, training of the vestibular apparatus, physiotherapy)
  • medical measures either as infusion therapy or in the form of tablets with a point of application of action on the peripheral vestibular apparatus, vestibular nerve and auditory nerve or centrally in the brain
  • in rare cases, surgery is necessary (tumor of the auditory nerve, neurovascular decompression).
Privatdozent, Doctor of Medical Sciences
Professor, Doctor of Medical Sciences
Head of neurological clinic
Professor, Doctor of Medical Sciences
Head of the neurology clinic
Head of the Rehabilitation Neurological Center