[SCD programmatic diagnostic strategy and diagnostic pathway for vertigo disease]

Area of Science:

• Neurology
• Otolaryngology
• Emergency Medicine

Context:

• Vertigo, a common clinical symptom, suffers from high misdiagnosis rates due to complex multi-system involvement and overlapping presentations.
• Existing diagnostic models like TiTrATE, ATTEST, ABCD 2, TriAGe+, HINTS, HINTS+, and STANDING batteries have improved vertigo assessment.
• Despite advancements, a need persists for a comprehensive and programmatic approach to vertigo diagnosis and management.

Purpose:

• To introduce the SCD (Syndromes, Central, Disease) programmatic diagnostic strategy for vertigo disorders.
• To present the A·E³GAP·AT differentiation battery and A²B²C²D²E³ alarm battery for dangerous central vertigo.
• To provide a structured, step-by-step approach for identifying and managing vertigo, with a focus on high-risk central causes.

Summary:

• The SCD strategy involves classifying vertigo syndromes (S), identifying high-risk central vertigo (C), and differential diagnosis of peripheral vertigo (D).
• It incorporates novel batteries (A·E³GAP·AT, A²B²C²D²E³) for differentiating dangerous central vertigo and rapid peripheral vertigo diagnosis.
• This strategy aims to enhance clinicians' diagnostic capabilities, emphasizing early detection of critical central vertigo cases.

Impact:

• Improves diagnostic accuracy for vertigo disorders, reducing misdiagnosis rates.
• Facilitates identification and timely management of high-risk central vertigo, potentially preventing severe outcomes.
• Equips clinicians with a systematic approach for both common peripheral and critical central vertigo presentations.