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Dizziness.

Rodney Omron1, Jonathan Edlow2

  • 1Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.

Emergency Medicine Clinics of North America
|November 19, 2025
PubMed
Summary
This summary is machine-generated.

A structured approach to diagnosing acute dizziness is crucial. Utilizing algorithms like ATTEST or STANDING helps differentiate causes, guiding effective treatment for vertigo patients.

Keywords:
AtaxiaBPPVDix-HallpikeDizzinessEpleyHINTSStrokeVertigo

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Otolaryngology

Background:

  • Accurate diagnosis of acute dizziness is challenging but essential for patient outcomes.
  • Dizziness is a common presenting complaint in emergency departments, necessitating efficient diagnostic tools.

Purpose of the Study:

  • To outline structured diagnostic algorithms for patients presenting with acute dizziness.
  • To differentiate between peripheral and central causes of vertigo.

Main Methods:

  • A problem-based history and physical examination are foundational.
  • Utilizing the ATTEST or STANDING algorithms for diagnostic categorization.
  • Performing the Dix-Hallpike maneuver for specific diagnoses.

Main Results:

  • Algorithms help rule out stroke and other serious medical conditions first.
  • Categorization into episodic vestibular syndrome or acute vestibular syndrome aids differentiation.
  • The Dix-Hallpike maneuver identifies posterior canal benign positional paroxysmal vertigo.

Conclusions:

  • Structured diagnostic algorithms are vital for managing acute dizziness.
  • Differentiating peripheral from central vertigo is key to appropriate treatment.
  • Specific maneuvers like Dix-Hallpike are crucial for diagnosing common vestibular disorders.