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Related Articles |
Why Acute Dizziness and Vertigo? Articulating the Emergency Neuro-Otology Imperative.
Neurol Clin. 2015 Aug;33(3):xiii-xv
Authors: Newman-Toker DE, Kerber KA, Meurer WJ, Omron R, Edlow JA
PMID: 26231282 [PubMed - indexed for MEDLINE]
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Related Articles |
Acute Diagnosis and Management of Stroke Presenting Dizziness or Vertigo.
Neurol Clin. 2015 Aug;33(3):687-98, xi
Authors: Lee SH, Kim JS
Abstract
Stroke involving the brainstem and cerebellum frequently presents acute vestibular syndrome. Although vascular vertigo is known to usually accompany other neurologic symptoms and signs, isolated vertigo from small infarcts involving the cerebellum or brainstem has been increasingly recognized. Bedside neuro-otologic examination can reliably differentiate acute vestibular syndrome due to stroke from more benign inner ear disease. Sometimes acute isolated audiovestibular loss may herald impending infarction in the territory of the anterior inferior cerebellar artery. Accurate identification of isolated vascular vertigo is very important because misdiagnosis of acute stroke may result in significant morbidity and mortality.
PMID: 26231280 [PubMed - indexed for MEDLINE]
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Related Articles |
TiTrATE: A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo.
Neurol Clin. 2015 Aug;33(3):577-99, viii
Authors: Newman-Toker DE, Edlow JA
Abstract
Diagnosing dizziness can be challenging, and the consequences of missing dangerous causes, such as stroke, can be substantial. Most physicians use a diagnostic paradigm developed more than 40 years ago that focuses on the type of dizziness, but this approach is flawed. This article proposes a new paradigm based on symptom timing, triggers, and targeted bedside eye examinations (TiTrATE). Patients fall into 1 of 4 major syndrome categories, each with its own differential diagnosis and set of targeted examination techniques that help make a specific diagnosis. Following an evidence-based approach could help reduce the frequency of misdiagnosis of serious causes of dizziness. In the spirit of the flipped classroom, the editors of this Neurologic Clinics issue on emergency neuro-otology have assembled a collection of unknown cases to be accessed electronically in multimedia format. By design, cases are not linked with specific articles, to avoid untoward cueing effects for the learner. The cases are real and are meant to demonstrate and reinforce lessons provided in this and subsequent articles. In addition to pertinent elements of medical history, cases include videos of key examination findings.
PMID: 26231273 [PubMed - indexed for MEDLINE]
