As vertigo cases rise, specialists raise concerns over diagnostic gaps

Vertigo and balance disorders are increasingly emerging as a significant yet under-recognised health concern in India, with specialists pointing to widespread gaps in diagnosis and management, particularly at the first point of care.

At a clinical workshop that brought together neurologists, ENT specialists and general physicians on Saturday, experts noted that a substantial proportion of patients presenting with dizziness are either misdiagnosed or treated symptomatically without identifying the underlying cause.

An estimated 15% to over 20% of adults experience vertigo or dizziness each year, with prevalence peaking in the 55-64 years age group. Vertigo is a sensation that the environment around the person is spinning in circles.

Specialists highlighted that one of the key challenges lies in differentiating between various types of vertigo- peripheral, central and functional- which often present with overlapping symptoms but require distinct treatment pathways.
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Delay in diagnosis

Despite its frequency, vertigo is often dismissed as a minor or transient condition, leading to delay in diagnosis and prolonged discomfort. In some cases, clinicians cautioned, this may result in missing serious underlying neurological or vestibular disorders.

Suryanarayana Sharma P.M., senior consultant neurologist and stroke specialist, said, “In India, more than 70 million people are suffering from vertigo. Though about 74% of cases are benign, recognising red flags and identifying serious neurological or ENT conditions is crucial. This requires a multidisciplinary approach.” He underlined the need for dedicated vertigo clinics.

Key challenge

Specialists highlighted that one of the key challenges lies in differentiating between various types of vertigo- peripheral, central and functional- which often present with overlapping symptoms but require distinct treatment pathways. They stressed the importance of structured clinical evaluation, including detailed patient history and bedside examination of vestibular and ocular motor systems, rather than relying solely on symptomatic treatment.

Sunil Narayan Dutt, senior consultant in ENT, emphasised the need for more practical, experience-based training for clinicians. He noted that hands-on sessions and case-based discussions can help physicians build confidence in assessing patients, particularly in busy clinical settings where time and resources are limited.

Adding an international perspective, Michael Strupp, neurologist and vestibular expert, said that advances in vestibular medicine have made many vertigo conditions highly treatable. “The challenge is no longer the lack of treatment, but ensuring that the right diagnosis is made early through structured clinical evaluation,” he said.

Post-viral conditions

Experts also observed that vertigo is increasingly being seen in association with broader neurological and post-viral conditions, adding to the complexity of diagnosis and care.

They underlined that improving diagnostic accuracy at the primary care level is critical to reducing unnecessary investigations and ensuring better patient outcomes, especially in the context of an ageing population and rising lifestyle-related risks.

The workshop was organised by Apollo Hospitals in Bengaluru.