Vertigo is a common yet often misunderstood condition that can significantly impact a person’s a quality of life, causing fear, disorientation, and functional limitations. While symptoms such as dizziness and imbalance are frequently managed symptomatically, the underlying vestibular disorder remains undiagnosed or untreated can result in chronic dysfunction and recurrent episodes of vertigo.
This book provides structured, evidence-based guidance for healthcare providers to identify, diagnose and treat the root causes of vertigo, rather than merely alleviating symptoms. It highlights the critical role of vestibular compensation, a natural recovery process that can be supported through both pharmacological and non-pharmacological approaches such as vestibular rehabilitation therapy (VRT). This guide also emphasizes the importance of betahistine dihydrochloride, which has been shown to improve microcirculation in the inner ear supporting compensation especially when used at the optimal dosage and duration. By addressing conditions such as Benign Paroxysmal Positional Vertigo (BPPV), vestibular neuritis, Meniere’s disease, etc, this guide empowers clinicians to make confident diagnostic decisions, implement effective repositioning maneuvers and rehabilitation strategies, and recognize when to refer. Ultimately, this resource aims to improve outcomes for patients by restoring balance – physically and emotionally – through holistic, patient-centered vestibular care.
The development of this guide was made possible by the active participation and contribution of all members of the Expert Committee.
Dato’ Dr Philip Rajan Devesahayam
Consultant Otorhinolaryngologist
Hospital Raja Permaisuri Bainun, Perak
Dato’ Professor Dr Prepageran Narayanan
Consultant Otorhinolaryngologist
Faculty of Medicine,
Universiti Malaya, Kuala Lumpur
Professor Dr Mazlina Mazlan
Consultant Rehabilitation Physician
Faculty of Medicine,
Universiti Malaya, Kuala Lumpur
Dr Carren Teh
Consultant Otorhinolaryngologist
Hospital Sungai Buloh, Selangor
Professor Dr Tang Ing Ping
Consultant Otorhinolaryngologist
Universiti Malaysia Sarawak,
Sarawak General Hospital, Sarawak
Dr Fadzilah Ismail
Consultant Otorhinolaryngologist
Hospital Sungai Buloh, Selangor
Dr Sakina Mohd Saad
Consultant Otorhinolaryngologist
Hosputal Sultan Abdul Halim, Kedah
Associate Professor Dr Noor Dina Hashim
Consultant Otorhinolaryngologist
Faculty of Medicine,
Universiti Kebangsaan Malaysia,
Kuala Lumpur
Dr Jeyasakthy Saniasiaya
Consultant Paediatric Otorhinolaryngologist
Faculty of Medicine,
Universiti Malaya, Kuala Lumpur
Dr Rosdan Salim
Consultant Otorhinolaryngologist
University Sains Malaysia, Kota Bahru,
Kelantan
Dr David Chang Chee Tao
Research Pharmacist
Clinical Research Centre Perak,
Hospital Raja Permaisuri Bainun, Perak
The “Management of Peripheral Vestibular Disorders in Primary Care – Updated 2025” guide was developed in collaboration with Abbott Laboratories Sdn Bhd (Malaysia).