[Vertigo in the Emergency Department: new bedside tests]

Orv Hetil. 2016 Mar 13;157(11):403-9. doi: 10.1556/650.2016.30388.
[Article in Hungarian]

Abstract

According to international statistics, the first examination of 25% of patients with vertigo is carried out in Emergency Departments. The most important task of the examining physician is to diagnose life threatening pathologic processes. One of the most difficult otoneurological diagnostic challange in Emergency Departments is to differentiate between dangerous posterior scale stroke presenting with isolated vertigo and the benign vestibular neuritis.These two disorders can be safely differentiated using fast, non-invasive, evidence based bedside tests which have been introduced in the past few years. 35% of stroke cases mimicking vestibular neuritis (pseudoneuritis) are misdiagnosed at the Emergency Department, and 40% of these cases develop complications. During the first 48 hours, sensitivity for stroke of the new test that is based on the malfunction of the oculomotor system is better than the diffusion-weighted cranial magnetic resonance imaging. Using special test glasses each component of the new test can be made objective and repeatable.

Keywords: acute vestibular syndrome; akut vestibularis szindróma; bedside test; bizonyítékon alapuló; emergency; evidence based; szédülés; sürgősségi betegellátás; vertigo; ágy melletti diagnosztika.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Central Nervous System Diseases / complications
  • Central Nervous System Diseases / diagnosis*
  • Diagnosis, Differential
  • Diagnostic Errors
  • Diagnostic Techniques, Neurological*
  • Diagnostic Techniques, Otological*
  • Diffusion Magnetic Resonance Imaging
  • Emergency Service, Hospital*
  • Encephalitis / complications
  • Encephalitis / diagnosis
  • Humans
  • Labyrinth Diseases / complications
  • Labyrinth Diseases / diagnosis*
  • Labyrinthitis / complications
  • Labyrinthitis / diagnosis
  • Mastoiditis / complications
  • Mastoiditis / diagnosis
  • Miller Fisher Syndrome / complications
  • Miller Fisher Syndrome / diagnosis
  • Multiple Sclerosis / complications
  • Multiple Sclerosis / diagnosis
  • Point-of-Care Testing*
  • Sensitivity and Specificity
  • Stroke / complications
  • Stroke / diagnosis
  • Vertigo / classification
  • Vertigo / etiology*
  • Vertigo / physiopathology
  • Vestibular Function Tests
  • Vestibular Neuronitis / complications
  • Vestibular Neuronitis / diagnosis*
  • Wernicke Encephalopathy / complications
  • Wernicke Encephalopathy / diagnosis