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Med Klin Intensivmed Notfmed. 2013 Feb;108(1):41-6. doi: 10.1007/s00063-012-0173-3. Epub 2013 Feb 3.

[Vertigo and dizziness. Diagnostic algorithm from the perspective of emergency medicine].

[Article in German]

Author information

1
Notfallzentrum, St├Ądtisches Klinikum M├╝nchen Bogenhausen, Englschalkinger Strasse 77, Munich, Germany. Christoph.Dodt@klinikum-muenchen.de

Abstract

Vertigo and dizziness are common symptoms in the acute care setting and have a wide diagnostic range. The most deleterious diagnosis is vertebrobasilar disease with brain infarction in the posterior fossa. Therefore, every patient with acute vestibular syndrome needs to be evaluated by a structured interview and a systematic physical examination for red flag symptoms which indicate vertebrobasilar infarction. Routinely, the physical examination should cover the head impulse (Halmagyi) test, test for nystagmus as well as the test of skew and in cases of benign paroxysmal positional vertigo, by the Dix-Hallpike maneuver. The suspicion of a central cause of vertigo is ideally confirmed by a magnetic resonance imaging (MRI) scan. Most patients with a peripheral cause of vertigo can be discharged under symptomatic therapy with the advice to consult an ear nose and throat physician while patients with a central cause of vertigo are admitted for further neurological treatment.

PMID:
23377286
DOI:
10.1007/s00063-012-0173-3
[Indexed for MEDLINE]
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