Approaching Acute Vertigo With Diplopia: A Rare Skew Deviation in Vestibular Neuritis

Area of Science:

• Neurology
• Ophthalmology
• Otolaryngology

Background:

• Acute vertigo and diplopia present diagnostic challenges, potentially indicating serious conditions like stroke.
• Distinguishing dangerous from benign causes requires careful symptom and sign interpretation.

Observation:

• Presents a case of acute vertigo and binocular diplopia caused by skew deviation secondary to vestibular neuritis.
• Utilizes text and video commentary to guide clinicians through history, bedside examination, and laboratory evaluation.

Findings:

• Demonstrates interpretation of nystagmus and proper performance of the head impulse test and test of skew deviation.
• Highlights the importance of clinical examination in diagnosing acute vestibular syndrome.

Implications:

• Emphasizes accurate bedside diagnostic skills for acute vestibular syndrome.
• Warns against overreliance on imaging in vertigo evaluation, promoting a systematic clinical approach.
• Provides a valuable learning resource for clinicians managing patients with acute vertigo and diplopia.