Diagnosis and treatment of dizziness: a general practice perspective

ZHU Ying; REN Jingjing

doi:10.16766/j.cnki.issn.1674-4152.004235

Volume 23 Issue 11

Nov. 2025

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ZHU Ying, REN Jingjing. Diagnosis and treatment of dizziness: a general practice perspective[J]. Chinese Journal of General Practice, 2025, 23(11): 1813-1817. doi: 10.16766/j.cnki.issn.1674-4152.004235

Citation:

ZHU Ying, REN Jingjing. Diagnosis and treatment of dizziness: a general practice perspective[J]. Chinese Journal of General Practice, 2025, 23(11): 1813-1817. doi: 10.16766/j.cnki.issn.1674-4152.004235

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Diagnosis and treatment of dizziness: a general practice perspective

doi: 10.16766/j.cnki.issn.1674-4152.004235

ZHU Ying
, REN Jingjing^,

Department of General Practice, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, China

Funds:

72274169

Received Date: 2025-04-29
Available Online: 2026-01-07

Abstract

Abstract

Dizziness is a common medically unspecified disease in general practice, with high incidence and prevalence, which affects patients ' physical, psychological, and social health at all times. A study found that dizziness may cause related functional damage, increase the risk of falls by 12 times, seriously affect their quality of life, and even lead to death. Dizziness involves a wide range of diseases with relatively complex causes, making it prone to missed diagnosis and misdiagnosis by general practitioners during initial consultations. Therefore, it is imperative to train general practitioners to adopt a holistic approach, standardize the diagnosis and treatment of dizziness, and improve the skills of differential diagnosis. For patients with complaints of dizziness, the general practitioner collects medical history through the RICE interview, conducts a detailed physical examination, targeted examination, and carries out a comprehensive evaluation. In particular, it is very important to quickly assess the degree of dizziness, identify the "red flag signs", and refer patients in time. The management strategies of general practitioners encompass non-pharmacological therapies, pharmacological interventions, rehabilitation programs, psychotherapy, and follow-up appointments, and play a coordinating role by combining primary diagnosis and treatment with referral to general hospitals, in order to alleviate symptoms, reduce functional damage, improve quality of life, and reduce medical burden. In addition, there is a lack of a complete system for evaluating dizziness in China, as well as an assessment scale and standardized diagnosis and treatment model that meet the national conditions of China. For general practitioners, how to diagnose dizziness with unknown causes, help some patients live with symptoms, and provide long-term management remains to be further researched. This article reviews the relevant domestic and foreign literature on dizziness, summarizes the common diseases, clinical characteristics, and diagnosis and treatment of dizziness, aiming to provide help for general practitioners to standardize the diagnosis and continued management of patients with dizziness.
- Dizziness,
- General practitioners,
- Diagnosis and treatment

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References(29)

References

[1]	TAENUTER A A, KERKENI H, DIENER S, et al. Diagnosis and treatment of vertigo and dizziness: interdisciplinary guidance paper for clinical practice. german version[J]. HNO, 2025, 73(7): 461-473. DOI: 10.1007/s00106-025-01598-0.
[2]	RUTHBERG J S, RASENDRAN C, KOCHARYAN A, et al. The economic burden of vertigo and dizziness in the United States[J]. J Vestib Res, 2021, 31(2): 81-90. doi: 10.3233/VES-201531
[3]	任菁菁, 江孙芳, 史玲, 等. 全科常见未分化疾病诊疗手册[M]. 北京: 人民卫生出版社, 2023: 652. REN J J, JIANG S F, SHI L, et al. Clinical Handbook of the iagnosis and treatment of common medically unspecified diseases in general practice[M]. Beijing: People's Medical Publishing House, 2023: 652.
[4]	DRACHMAN D A, HART C W. An approach to the dizzy patient[J]. Neurology, 1972, 22(4): 323-334. doi: 10.1212/WNL.22.4.323
[5]	BISDORFF A, VON BREVERN M, LEMPERT T, et al. Classification of vestibular symptoms: towards an international classification of vestibular disorders[J]. J Vestib Res, 2009, 19(1-2): 1-13. doi: 10.3233/VES-2009-0343
[6]	中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 头晕/眩晕基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2020, 19(3): 201-216. Chinese Medical Association, Chinese Medical Journals Publishing House, Chinese Society of General Practice, et al. Guideline for primary care of dizziness/vertigo(2019)[J]. Chinese Journal of General Practitioners, 2020, 19(3): 201-216.
[7]	蒋睿娟, 胡梦杰, 朱佳宏, 等. 以头晕为表现的未分化疾病诊治进展[J]. 中华全科医学, 2025, 23(4): 647-650, 664. JIANG R J, HU M J, ZHU J H, et al. Research progress in the diagnosis and treatment of medically unspecified disease manifested by dizziness[J]. Chinese Journal of General Practice, 2025, 23(4): 647-650, 664.
[8]	KIM H J, PARK J, KIM J S. Update on benign paroxysmal positional vertigo[J]. J Neurol, 2021, 268(5): 1995-2000. doi: 10.1007/s00415-020-10314-7
[9]	牛庆东, 马雅静, 戴崇亮, 等. 神经内科眩晕门诊1894例眩晕患者病因分析[J]. 中国社区医师, 2021, 37(29): 48-49. NIU Q D, MA Y J, DAI C L, et al. Analysis of the etiology of 1894 patients with vertigo in the vertigo clinic of the department of neurology[J]. Chinese Community Doctors, 2021, 37(29): 48-49.
[10]	李长青, 郭东升, 刘思维, 等. 神经内科门诊中老年人群头晕/眩晕患者病因分层特点[J]. 武警医学, 2022, 33(6): 476-479. LI C Q, GUO D S, LIU S W, et al. Etiological distribution of middle-aged and elderly patients with dizziness/vertigo in neurology outpatient department[J]. Medical Journal of the Chinese People's Armed Police Force, 2022, 33(6): 476-479.
[11]	中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 良性阵发性位置性眩晕诊断和治疗指南(2017)[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52(3): 173-177. Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association. Guideline of diagnosis and treatment of benign paroxysmal positional vertigo(2017)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2017, 52(3): 173-177.
[12]	王玉琳, 张钰, 刘佳, 等. 眩晕相关评价量表研究进展及应用[J]. 神经损伤与功能重建, 2024, 19(3): 170-174. WANG Y L, ZHANG Y, LIU J, et al. Research Progress and Application of Vertigo Related Evaluation Scales[J]. Neural Injury and Functional Reconstruction, 2024, 19(3): 170-174.
[13]	中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会. 梅尼埃病诊断和治疗指南(2017)[J]. 中华耳鼻咽喉头颈外科杂志, 2017, 52(3): 167-172. Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Society of Otorhinolaryngology Head and Neck Sugery, Chinese Medical Association. Guideline of diagnosis and treatment of Meniere disease(2017)[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2017, 52(3): 167-172.
[14]	蒋子栋. 多学科合作规范眩晕/头晕诊治[J]. 中华神经科杂志, 2019, 52(2): 153-156. JIANG Z D. Multidisciplinary cooperation in the diagnosis and treatment of vertigo/dizziness[J]. Chinese Journal of Neurology, 2019, 52(2): 153-156.
[15]	胡全福, 杜一, 徐正燕, 等. 前庭阵发症的临床评估与进展[J]. 中华耳科学杂志, 2024, 22(1): 9-13. HU Q F, DU Y, XU Z Y, et al. Advances in Clinical Evaluation of Vestibular Paroxysmia[J]. Chinese Journal of Otology, 2024, 22(1): 9-13.
[16]	STRUPP M, LOPEZ-ESCAMEZ J A, KIM J S, et al. Vestibular paroxysmia: diagnostic criteria[J]. J Vestib Res, 2016, 26(5-6): 409-415.
[17]	中华医学会神经病学分会, 中华神经科杂志编辑委员会. 眩晕诊治多学科专家共识[J]. 中华神经科杂志, 2017, 50(11): 805-812. Society of Neurology, Chinese Medical Association, Editorial Board of Chinese Journal of Neurology. Multidisciplinary expert consensus on diagnosis and treatment of vertigo[J]. Chinese Journal of Neurology, 2017, 50(11): 805-812.
[18]	王武庆, 付蓉, 毕国荣, 等. 血管源性头晕/眩晕诊疗中国专家共识[J]. 中国神经免疫学和神经病学杂志, 2020, 27(4): 253-260. WANG W Q, FU R, BI G R, et al. Chinese expert consensus on assessment and management of vascular dizziness and vertigo[J]. Chinese Journal of Neuroimmunology and Neurology, 2020, 27(4): 253-260.
[19]	中国卒中学会卒中与眩晕分会, 中国医师协会神经内科医师分会眩晕专业委员会. 前庭性偏头痛诊疗多学科专家共识[J]. 中华内科杂志, 2019, 58(2): 102-107. Stroke and Vertigo Association of Chinese Stroke Association, Vertigo Professional Committee of Neurology Branch of Chinese Physicians Association, et al. Chinese multidisciplinary expert consensus on assessment and management of vestibular migraine[J]. Chinese Journal of Internal Medicine, 2019, 58(2): 102-107.
[20]	于生元, 万琪, 王武庆, 等. 前庭性偏头痛诊治专家共识(2018)[J]. 中国疼痛医学杂志, 2018, 24(7): 481-488. YU S Y, WAN Q, WANG W Q, et al. Chinese multidisciplinary expert consensus on assessment and management of vestibular migraine[J]. Chinese Journal of Pain Medicine, 2018, 24(7): 481-488.
[21]	中华医学会心身医学分会整体健康协作学组. 精神性头晕诊疗中国专家共识[J]. 中国全科医学, 2024, 27(2): 125-131. Holistic Health Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association. Chinese expert consensus on diagnosis and treatment of psychiatric dizziness[J]. Chinese General Practice, 2024, 27(2): 125-131.
[22]	阿依达娜·哈力木, 李芳蕾, 张丽华, 等. 颈性眩晕的研究进展[J]. 中国老年保健医学, 2022, 20(4): 118-122, 126. HALIMU AYIDANA, LI F L, ZHANG L h, et al. The research progress of Cervical Vertigo[J]. Chinese Journal of Geriatric Care, 2022, 20(4): 118-122, 126.
[23]	张佳, 徐京育. 半夏白术天麻汤联合中医疗法治疗眩晕临床研究进展[J]. 光明中医, 2021, 36(23): 4099-4102. ZHANG J, XU J Y. Clinical Research Progress on Banxia Baizhu Tianma Decoction Combined with Therapy of Traditional Chinese Medicine in the Treatment of Vertigo[J]. Guangming Journal of Chinese Medicine, 2021, 36(23): 4099-4102.
[24]	王思南, 刘寅, 王阿慧, 等. 小柴胡汤在现代眩晕疾病中的临床应用及作用机制研究进展[J]. 中国民间疗法, 2024, 32(17): 97-100. WANG S N, LIU Y, WANG A H, et al. Research progress on clinical application and Mechanism of Xiaochaihu Decoction in modern vertigo disease[J]. China's Naturopathy, 2024, 32(17): 97-100.
[25]	张自珍, 杜扬, 陈俐志, 等. 加味半夏白术天麻汤治疗高血压合并高脂血症疗效的系统评价[J]. 山东医药, 2022, 62(5): 52-56. ZHANG Z Z, DU Y, CHEN L Z, et al. Systematic review of the effect of modified Banxia Baizhu Tianma decoction in the treatment of hypertension complicated with hyperlipidemia[J]. Shandong Medical Journal, 2022, 62(5): 52-56.
[26]	刘寅, 李秀玲, 孙莉. 认知行为疗法治疗眩晕疾病的研究进展[J]. 神经损伤与功能重建, 2023, 18(2): 100-102. LIU Y, LI X L, SUN L. Research progress of cognitive behavioral therapy in treating vertigo[J]. Neural Injury And Functional Reconstruction, 2023, 18(2): 100-102.
[27]	于晓松, 路孝琴, 江孙芳, 等. 全科医学概论[M]. 北京: 人民卫生出版社, 2024: 304. YU X S, LU X Q, JIANG S F, et al. Introduction to general practice[M]. Beijing: People's Medical Publishing House, 2024: 304.
[28]	国家卫生健康委员会, 国家中医药管理局. 关于进一步做好分级诊疗制度建设有关重点工作的通知[EB/OL]. (2018-08-20)[2025-02-19]. http://www.gov.cn/xinwen/2018-08/20/content_5315056.htm. National Health Commission, National Administration of Traditional Chinese Medicine. Notice on further improving key work related to the construction of the tiered diagnosis and treatment system[EB/OL]. [2018-08-20]. http://www.gov.cn/xinwen/2018-08/20/content_5315056.htm.
[29]	许培裕, 卢梓健, 汤健鹏, 等. 腰背痛全科诊疗思路[J]. 中华全科医学, 2024, 22(10): 1631-1635. XU P Y, LU Z J, TANG J P, et al. General practice ideas for low back pain[J]. Chinese Journal of General Practice, 2024, 22(10): 1631-1635.