Table 1.

Timing-and-Trigger–Based “Vestibular^* Syndromes” in Acute Dizziness^†

Syndrome	Description	Common Benign Causes	Common Serious Causes
AVS	Acute, continuous dizziness lasting days, accompanied by nausea, vomiting, nystagmus, head motion intolerance, and gait unsteadiness	Vestibular neuritis Labyrinthitis	Posterior circulation ischemic stroke
s-EVS	Episodic dizziness that occurs spontaneously, is not triggered,‡ and usually last minutes to hours	Vestibular migraine Menière’s disease	TIA
t-EVS	Episodic dizziness brought on by a specific, obligate trigger (typically a change in head position or standing up), and usually lasting <1 min	BPPV	CPPV Orthostatic hypotension due to serious medical illness

AVS = acute vestibular syndrome; BPPV = benign paroxysmal positional vertigo; CPPV = central paroxysmal positional vertigo; s-EVS = spontaneous, episodic vestibular syndrome; TIA = transient ischemic attack; t-EVS = triggered, episodic vestibular syndrome.

^*Note that the use of the word vestibular here connotes vestibular symptoms (e.g., dizziness or vertigo or imbalance or lightheadedness), rather than underlying vestibular diseases (e.g., benign paroxysmal positional vertigo, vestibular neuritis).

^†This table lists the more common diseases causing these presenting syndromes and is not intended to be exhaustive.

^‡Dizziness is “triggered” (not dizzy at baseline, dizziness develops with movement), as in positional vertigo due to BPPV. This must be distinguished from dizziness that is “exacerbated” (dizzy at baseline, worse with movement); such exacerbations are common in AVS, whether peripheral (neuritis) or central (stroke).