HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Google Scholar Articles by Seemungal, B M Articles by Bronstein, A M PubMed PubMed Citation Articles by Seemungal, B M Articles by Bronstein, A M

A practical approach to acute vertigo

Clinician Scientist and Consultant Neurologist Neuro-otology Unit, Department of Clinical Neuroscience, Imperial College London, Charing Cross Hospital, London, UK
Professor of Neuro-otology and Consultant Neurologist Neuro-otology Unit, Department of Clinical Neuroscience, Imperial College London, Charing Cross Hospital, London, UK

Correspondence to:
Dr B M Seemungal, Neuro-otology Unit, Department of Clinical Neuroscience, Imperial College London, Charing Cross Hospital, London W6 8RF, UK; b.seemungal{at}imperial.ac.uk

ABSTRACT

Patients complaining of symptoms of acute vertigo present a diagnostic challenge for the clinician; the main differential diagnoses are acute unilateral peripheral vestibulopathy ("vestibular neuritis"), cerebellar stroke or migraine. The head impulse test is useful in the acute situation because, of these three diagnostic alternatives, it will only be positive in patients with vestibular neuritis. A history of acute vertigo and hearing loss suggests Ménière’s disease but the clinician must be wary of anterior inferior cerebellar artery strokes which may cause audiovestibular loss due to peripheral vestibulocochleal ischaemia, although the accompanying brainstem signs should remove diagnostic ambiguity. We also discuss other less common vertigo diagnoses that may be referred to the neurologist from the acute general hospital take. As ever in neurology, a careful history and focussed examination is necessary in the evaluation and management of acute vertigo. ...[End of Extract]

[PDF of this article]