Introduction
A vertigo clinic is a service, not a room.
The dizzy patient needs more than a piece of equipment. They need a workflow: a clinician who can take the history, a bedside exam done right the first time, instrumented tests on the same visit, and a rehab path that starts the same week. This chapter is the operational blueprint.
Vertigo is common. Roughly one in three adults will be troubled by it during their lifetime, and dizziness accounts for around 5% of all outpatient visits and 3–4% of emergency-department presentations.1,3
Yet most of these patients are still seen in generalist clinics with no vestibular-aware workflow, no Frenzel goggles, no VNG, and no link to a vestibular physiotherapist. The result is long diagnostic delay and avoidable distress. A dedicated vertigo clinic — even a modest one — closes that gap.
National-survey data show that ~35% of US adults aged 40+ have measurable vestibular dysfunction, with the prevalence rising sharply with age.2 Dizziness drives ~3.9 million ED visits a year in the US alone; charted diagnoses correlate poorly with the management actually delivered.3,4
A vertigo clinic exists to close the gap between the symptom and the right intervention. It does that through three things in combination: a standardised history and bedside exam, an instrumented battery (audiometry, VNG, vHIT, VEMP) on the same visit, and a vestibular rehab pathway. The kit alone does not deliver the service — the workflow does.
Published service-redesign studies show that a structured vertigo clinic reduces unnecessary imaging, ED revisits and inpatient stays while increasing same-visit diagnosis rates.5 The economic case sits on top of a stronger clinical case: a single Epley delivered at the bedside on visit 1 is the most cost-effective intervention in the building.
This chapter is organised end-to-end: how to build the clinic (planning → infrastructure → equipment → staffing → launch), how to run it (history, bedside, instrumented, MDT), what treatment pathways to be ready for, and how to measure and improve the service over its first 12 months. Operational vocabulary follows the Bárány Society classification for diagnostic categories.6