Dizziness: neurological emergencies

A patient's medical history provides the key information for deciding on the type of dizziness and its likely cause. First, one must separate vestibular from non-vestibular causes of dizziness to determine the focus of the diagnostic work-up. Of the common causes of vertigo, benign positional vertigo can be reliably diagnosed and cured at the bedside. One of the few instances where neuroimaging is required on an emergent basis is for a patient presenting with acute vertigo and profound imbalance likely to be a cerebellar hemorrhage or infarct. Antivertiginous and anti-emetic drugs can provide relief of acute vertigo and nausea, but medications should be rapidly tapered to allow compensation to occur.