When assessing a patient for vertigo, what symptom is most indicative of the condition?

The sensation of spinning or rotating is the hallmark symptom of vertigo and is most indicative of this condition. Patients often describe vertigo as a feeling that either they or their environment is moving, which distinctly separates it from other types of dizziness that do not involve this specific sensation.

In clinical practice, when a patient reports experiencing a spinning sensation, it signals potential inner ear issues or vestibular disorders, which are commonly associated with vertigo. This symptom can help practitioners prioritize differential diagnoses that include conditions such as benign paroxysmal positional vertigo (BPPV), vestibular neuritis, or Ménière's disease.

The other options, such as a sensation of imbalance while walking or lightheadedness associated with position changes, can represent other conditions like general dizziness or balance disorders but do not specifically indicate vertigo. Meanwhile, a sensation of "passing out" often suggests syncope or pre-syncope rather than a vestibular origin. Thus, identifying the specific symptom of a spinning sensation is crucial for effectively diagnosing and managing vertigo.