Approach to dizziness in the emergency department

Article information

Clin Exp Emerg Med. 2015;2(2):75-88
Publication date (electronic) : 2015 June 30
doi : https://doi.org/10.15441/ceem.15.026
Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
Correspondence to: Ji-Soo Kim  Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173beon-gil, Bundang-gu, Seongnam 463-707, Korea  E-mail: jisookim@snu.ac.kr
Received 2015 March 19; Revised 2014 April 21; Accepted 2014 April 21.

Abstract

Acute dizziness/vertigo is among the most common causes for visiting the emergency department. The traditional approach to dizziness starts with categorizing dizziness into four types: vertigo, presyncope, disequilibrium, and nonspecific dizziness. However, a recently proposed approach begins with classifying dizziness/vertigo as acute prolonged spontaneous dizziness/vertigo, recurrent spontaneous dizziness/vertigo, recurrent positional vertigo, or chronic persistent dizziness and imbalance. Vestibular neuritis and stroke are key disorders causing acute prolonged spontaneous dizziness/vertigo, but the diagnosis of isolated vascular vertigo has increased by virtue of developments in clinical neurotology and neuroimaging. However, a well-organized bedside examination appears more sensitive than brain imaging in diagnosing