A Practical Diagnostic Approach to Patients Presenting with "Dizziness": Evaluation and Differential Diagnosis Based on the ATTEST/TiTrATE Framework

Scritto il 16/09/2026
da Ichiro Deguchi

Brain Nerve. 2026 Sep;78(9):967-974. doi: 10.11477/mf.188160960780090967.

ABSTRACT

Dizziness is one of the most common complaints encountered in outpatient clinical practice, and is associated with a wide range of underlying conditions, ranging from peripheral vestibular disorders to cerebrovascular disease, cardiovascular abnormalities, and psychological factors. Traditional classifications based on the quality of dizziness symptoms have inherent limitations in diagnostic accuracy. In contrast, the ATTEST approach, which structures clinical reasoning according to temporal profiles and triggering factors, has been shown to be useful. In this article, we outline the practical strategies for evaluating patients with dizziness and emphasize the importance of a thorough basic assessment and the avoidance of premature diagnostic closure to ensure an appropriate differential diagnosis.

PMID:42745710 | DOI:10.11477/mf.188160960780090967