Acute vertigo: getting the diagnosis right

What you need to knowAll patients presenting with brief episodic acute vertigo or unsteadiness should undergo a Dix-Hallpike manoeuvreConsider stroke in patients with new onset acute unilateral hearing loss and vertigoUrgent brain imaging is always indicated when acute vertigo is accompanied by other central neurological signs (such as dysphagia, dysarthria, diplopia)Severe acute gait ataxia (patient unable to stand without support) is most common with central causes of vertigo (such as cerebellar lesions) rather than inner ear causesDizziness is a common presentation to emergency departments and primary care.12 It is defined as the sensation of disturbed or impaired spatial orientation without a false or distorted sense of motion.3 The estimated prevalence of dizziness in a general practice community sample varies across studies4 but is approximately 20%.56 Its prevalence increases with age.While patients often use the word “dizziness” to describe their symptoms, this encapsulates a variety of distinct symptom clusters, including vertigo…
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