(p. 197) The Epidemiology of Vertigo and Imbalance 

The epidemiology of vertigo and imbalance is still an emerging field despite its usefulness for clinical decision making and patient care. In the last decade, population-based epidemiological studies have complemented previous publications from specialised settings and have provided evidence for the high burden of vertigo in the community. Dizziness (including vertigo) affects about one in three women and one in three men every year. Vestibular vertigo accounts for about a quarter of dizziness complaints and has a 12-month prevalence of 5% and an incidence of 1.4%. Its prevalence rises with age and is about two to three times higher in women than in men. Studies on imbalance, on the other hand, are scarce. Recent studies have underscored the high prevalence of benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM), as well as of comorbid anxiety at the population level. BPPV and VM are largely underdiagnosed while Menière’s disease (MD), which is about ten times less frequent than BPPV, appears to be overdiagnosed. Risk factor research is only at its beginning, but has provided some interesting observations such as the consistent association of vertigo and migraine, which has greatly contributed to the recognition of VM as a distinct vestibular syndrome. For a qualitative leap, epidemiologic research on vertigo and imbalance must focus on avoidance of selection bias and misclassification. This chapter gives an overview on the epidemiology of dizziness, vertigo and imbalance as symptoms and of specific vestibular disorders: BPPV, VM, MD and vestibular neuritis.