الفهرس 
Introduction and RationaleOnly 14 pages are availabe for public view
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Abstract
Background: Studies of vertigo suggest that despite the high prevalence of vertigo in the primary care settings, diagnosis and treatment remain a challenge, and in many cases no definite diagnosis is reached. Failure of treatment leads to increased work absences, resources misuse, and chronicity.
Objective: the objective of this study is to spot the light on the diagnostic and therapeutic dilemma facing primary care physicians during the management of a patient with vertigo and to explore the updated evidence-based approach of vertigo and how to avoid false or unnecessary therapy.
Methods: PubMed for English-language literature was searched through to 2020 for different studies and articles discussing the process of management of vertigo in primary health care settings.
Results: Primary care physicians play the main role in the management of vertigo. Referral rates are as low as 4% in some developed countries. Implantation of diagnostic maneuvers such as Dix-Hallpike maneuver and Head impulse, nystagmus, and skew test (HINT) examination is very useful. Evidence points to the lack of effectiveness of drugs especially antihistamines in treating Benign paroxysmal positional vertigo (BPPV).
Recommendations: Using of diagnostic tools such as Dix-Hallpike maneuver and HINT examination in the primary care approach to vertigo patient are recommended. Liberating maneuvers and physical therapy as the treatment of choice for BPPV also are recommended. Using antihistamines for treating chronic vertigo patients should not be used.