Diagnosis of Patients with Acute Dizziness
- Resource Type
- Authors
- Jonathan A. Edlow; Kiersten L. Gurley
- Source
- Emergency Medicine Clinics of North America. 39:181-201
- Subject
- medicine.medical_specialty
Nystagmus
Dizziness
Computed tomographic
Diagnosis, Differential
03 medical and health sciences
0302 clinical medicine
Physical medicine and rehabilitation
Vertigo
Humans
Medicine
Diagnostic Errors
Stroke
biology
business.industry
030208 emergency & critical care medicine
biology.organism_classification
medicine.disease
Gait
Acute Disease
Emergency Medicine
Vestibular neuritis
medicine.symptom
Emergency Service, Hospital
business
030217 neurology & neurosurgery
- Language
- ISSN
- 0733-8627
Using an algorithmic approach to acutely dizzy patients, physicians can often confidently make a specific diagnosis that leads to correct treatment and should reduce the misdiagnosis of cerebrovascular events. Emergency clinicians should try to become familiar with an approach that exploits timing and triggers as well as some basic "rules" of nystagmus. The gait should always be tested in all patients who might be discharged. Computed tomographic scans are unreliable to exclude posterior circulation stroke presenting as dizziness, and early MRI (within the first 72 hours) also misses 10% to 20% of these cases.