Epidemiology and health services research in vertigo

Principle Investigator:

Prof. Dr. Eva Grill, MPH



1. To examine prevalence and specific determinants of vertigo and dizziness in the community.

2. To examine current diagnostic and referral behaviour of the healthcare providers.

3. To develop an intervention for the implementation of pragmatic diagnostic and therapeutic management strategies for vertigo and dizziness in primary care and to examine its cost-effectiveness.


Project descriptions:

I.        Population-based cohort study

Within the KORA representative cohort study, the vertigo module of the FF4 follow-up consists of an initial screening about vertigo symptoms for all participants; those with occurrence within the last 12 months receive a more detailed questionnaire on quality, frequency and duration of symptoms and undergo a video-documented head impulse test using the EyeSeeCam. In a nested case-control approach, an additional, randomly drawn sample of asymptomatic controls also underwent testing.


 II.        Secondary data analysis

To examine prevalence and determinants of vertigo and dizziness in the general population, we analyse data from the SHARE cohort studies (www.share-project.org) and the Munich Vertigo Study. Both studies included questions on vertigo, dizziness and balance problems, but without detailed vestibular testing. Moreover, routine data from the DSGZ will be analyzed regarding impact of distinct disease entities as diagnosed by the experts of the DSGZ on quality of life and functioning.

Munich Vertigo Study

III.        Community cohort study:

This study is a practice-based cohort study in the primary care setting. The main research question is how patients with vertigo and dizziness are diagnosed in primary care and which resulting treatment and referral patterns as well as associated patient-reported outcomes can be observed. Participating urban and rural primary care practices are asked to include patients who are currently treated for primary symptoms of vertigo or dizziness, or newly present with those symptoms.

Diag measures


IV.        Development and evaluation of an intervention program:

We are currently developing an intervention that aims to optimize the management of patients with vertigo and dizziness in primary care.



  • Community-based cohort study
  • Cross sectional survey
  • Systematic Review
  • Qualitative research


Relevant publications:

Grill E, Strupp M, Mueller M and Jahn K (2014). Health services utilization of patients with vertigo in primary care: a retrospective cohort study. J Neurol 261(8): 1492-1498.

Grill, E, Bronstein, A, Furman, J, Zee, DS and Mueller, M (2012). International Classification of Functioning, Disability and Health (ICF) Core Set for patients with vertigo, dizziness and balance disorders. J Vestib Res 22(5-6): 261-271.

Grill, E, Furman, AC, Alghwiri, A, Mueller, M and Whitney, SL (2013). Using Core Sets of the International Classification of Functioning, Disability and Health (ICF) to measure disability in vestibular disorders: study protocol. J Vestib Res in press.

Grill, E, Mueller, M, Brandt, T and Jahn, K (2013). Vertigo and dizziness: challenges for epidemiological research. OA Epidemiology 1(2): 12.

Mueller, M, Strobl, R, Jahn, K, Linkohr, B, Peters, A, Grill E. (2013) Burden of disability attributable to vertigo and dizziness in the aged: results from the KORA-Age study. Eur J Public Health. Nov 19.

Schaeffler, F, Mueller, M, Huppert, D, Brandt, T and Grill, E (2014). Consequences of visual height intolerance for quality of life: a qualitative study. Qual Life Res 23(2): 697-705.



grill müller strobl kovacs phillips
Prof. Dr. Eva Grill,
Dr. Martin Müller,
Dr. Ralf Strobl,
Dr. Eva Kovacs,
Amanda Phillips,


Prof. Dr. Eva Grill, MPH

Address: Marchinonistr. 17 81377 Munich, Germany

Tel: + 49 (0) 89 2180 78223

Fax: + 49 (0) 89 2180 78230