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Published on: August 30, 2019
Acute Vestibular Syndrome and ER Presentations of Dizziness
Richard Baron1, Kristen K Steenerson2, Jennifer Alyono3
1Department of Neurology and Neurological Sciences, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94305, USA.
Abstract:
Acute vestibular syndrome (AVS) describes sudden onset, severe, continuous dizziness that persists for more than 24 hours. Its wide differential presents a diagnostic challenge. Vestibular neuritis is the most common cause, but stroke, trauma, medication effects, infectious, and inflammatory causes all present similarly. The TiTrATE model (Timing, Triggers, And Targeted Exam) is systematic way to evaluate these patients, and the HINTS Plus exam (Head Impulse, Nystagmus, Test of Skew, plus hearing loss) is critical in differentiating central and peripheral causes. The importance of recognizing risk factors for stroke and the role of imaging is also discussed.
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