R-cVR, a two-step bedside algorithm for the differential diagnosis of acute dizziness and vertigo.

Area of Science:

• Neurology
• Diagnostic Medicine
• Vestibular System Disorders

Background:

• Differentiating peripheral and central dizziness/vertigo is crucial for timely diagnosis and treatment.
• Existing diagnostic methods may require specialized equipment or extensive training.
• There is a need for a simple, accurate, and accessible tool for early identification of central vertigo.

Purpose of the Study:

• To develop and validate the R-cVR algorithm for the early identification of central-type dizziness or vertigo.
• To assess the diagnostic value of the Romberg test in patients with acute dizziness or vertigo.
• To compare the R-cVR algorithm's accuracy against MRI-DWI results.

Main Methods:

• A retrospective cohort study of 109 patients with isolated dizziness or vertigo.
• Classification of dizziness type based on MRI-DWI findings.
• Development of the R-cVR algorithm integrating the Romberg test and V-shaped stance with closed-eyes protocol.
• Validation of the R-cVR algorithm against MRI-DWI results.

Main Results:

• The R-cVR algorithm demonstrated high diagnostic agreement (kappa=0.80) with MRI-DWI.
• Sensitivity was 88.0% and specificity was 94.0% for the R-cVR algorithm.
• Balance disorders were significantly more prevalent in the central dizziness group (92.0%) compared to the peripheral group (15.5%).

Conclusions:

• The R-cVR algorithm is an effective tool for identifying central-type dizziness or vertigo.
• The algorithm is simple to use for general practitioners, requiring no specialized equipment.
• The R-cVR algorithm holds potential value in diverse clinical settings for early dizziness diagnosis.