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Clinical progress note: Diagnostic approach to dizziness and vertigo.
Susrutha Kotwal1, Daniel Gold2, Jonathan A Edlow3,4
1Department of Medicine, Division of Hospital Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Journal of Hospital Medicine
|January 26, 2025
Summary
Dizziness diagnosis is challenging due to many causes. This clinical note offers an evidence-based bedside framework for hospitalists to improve the evaluation of acute dizziness in adults.
Area of Science:
- Clinical Medicine
- Neurology
- Otolaryngology
Background:
- Dizziness is a frequent and costly clinical presentation.
- Misdiagnosis is common due to a broad differential diagnosis, including inner ear disease and stroke.
- Current diagnostic frameworks based on symptom quality have limited utility.
Purpose of the Study:
- To review the literature on acute dizziness evaluation in adult patients.
- To present an evidence-based framework for hospitalists to diagnose undifferentiated dizzy patients.
- To guide bedside assessment and improve diagnostic accuracy.
Main Methods:
- Literature review of acute dizziness evaluation strategies.
- Development of an evidence-based diagnostic framework for hospitalists.
- Focus on bedside assessment for undifferentiated dizziness.
Main Results:
- Traditional symptom-based classifications are insufficient for diagnosis.
- An evidence-based framework can aid hospitalists in evaluating dizzy patients.
- The proposed framework aims to improve diagnostic yield at the bedside.
Conclusions:
- A structured, evidence-based approach is needed for acute dizziness evaluation.
- The presented framework can enhance hospitalists' diagnostic capabilities for dizziness.
- Further research should validate this approach's impact on patient care and outcomes.
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