Epidemiology and Pathophysiology

“Dizziness” is the second most common complaint when patients see a general practitioner (GP) in the Western world (second after headache). In Germany, about 25% of the population complains of dizziness at least once a year (Lempert and Neuhauser 2009). The 12-months’ incidence of “dizziness” is 3.1% in Germany, but only 1.4% for original vestibular disorders, both with a female dominance (Neuhauser 2009). Vestibular disorders have a high sociomedical relevance as they are accompanied by longer periods of being unable to work (41% vs. 15% in “dizziness”), social inactivity (40% vs. 10% in “dizziness”) and tend to lead to somatization (19% vs. 10% in “dizziness”). This inevitably leads to the question of a correct, full neurological diagnostic workup of patients which is limited by capacity. Taking the history of the patients is very important to reveal correlations between migraine (14% lifetime prevalence) and vestibular disorders (specifically: benign paroxysmal positional vertigo—BPPV, Meniere’s disease—MD) (von Brevern and Neuhauser 2011), depression and vestibular disorders (Neuhauser et al. 2005), as well as cardiovascular and vestibular disorders (Neuhauser et al. 2005) (Fig. 1.1).