Vertigo, disequilibrium, and dizziness

Due to the complexity of the balance mechanism in the human body, a variety of systemic diseases can create a sense of dizziness or imbalance. In order to maintain postural control and gaze stability, the body employs sensory input, central integration, and motor output to create appropriate responses to changes in the visual world and support surface. Accordingly, diseases that alter or destroy one or more sensory inputs to the brain, interfere with brainstem and cortical integration and formulation of motor commands, or interrupt motor responses will result in postural or visual instability. The critical feature for localizing the site of lesion in such patients is a thorough history of the nature of the problem and a comprehensive balance examination.