[Acute vertigo]

Three questions are raised when a patient experiences sudden vertigo. Is it due to a disease of the vestibule? This would be suggested in case of a revolving nature of the vertigo, the presence of nystagmus and of vestibular ataxia. Are there associated otological (infection of the labyrinth, zoster neuritis) or neurological (ischemic vascular accidents of the cerebral trunk and of the cerebellum, cerebellar haemorrhage) signs? What is the evolution of the sudden vertigo? A single, isolated episode of vertigo will generally be related to vestibular neuritis. However, it may rather be a first episode of repeated vertigo, Ménière's disease, recurrent vertigo, migraine, or very rarely transitory ischemic accident.