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- Title
Advances in the diagnosis and management of acute vertigo.
- Authors
Herdman, David
- Abstract
Background: Patients presenting to the emergency department with acute vertigo pose a diagnostic challenge. While 'benign' peripheral vestibulopathy is the most common cause, the possibility of a posterior circulation stroke is paradoxically the most feared and missed diagnosis in the emergency department. Objectives: This review will attempt to cover the significant advances in the ability to diagnose acute vertigo that have occurred in the last two decades. The review discusses the role of neurological examinations, imaging and specific oculomotor examinations. The review then discusses the relative attributes of the Head Impulse-Nystagmus-Test of Skew plus hearing ('HINTS+') examination, the timing, triggers and targeted bedside eye examinations ('TiTrATE'), the associated symptoms, timing and triggers, examination signs and testing ('ATTEST') algorithm, and the spontaneous nystagmus, direction, head impulse testing and standing ('STANDING') algorithm. The most recent technological advancements in video-oculography guided care are discussed, as well as other potential advances for clinicians to look out for.
- Subjects
VERTIGO diagnosis; VERTIGO treatment; NEUROLOGIC examination; AUDITORY perception testing; VERTIGO; ACUTE diseases; MEDICAL technology; DIAGNOSTIC imaging; ELECTROOCULOGRAPHY; NYSTAGMUS; EYE examination; ALGORITHMS; VESTIBULAR function tests; DISEASE risk factors; SYMPTOMS
- Publication
Journal of Laryngology & Otology, 2024, Vol 138, pS8
- ISSN
0022-2151
- Publication type
Article
- DOI
10.1017/S0022215123002232