ArticleThe Journal of emergency medicine2018
A New Diagnostic Approach to the Adult Patient with Acute Dizziness.
Article in The Journal of emergency medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
51 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Intravenous thrombolysis in patients with acute dizziness or imbalance and suspected ischemic stroke-systematic review.Journal of neurology · 2025Pooled it
- Pooled it
- Emergency Department Vestibular Rehabilitation Therapy for Dizziness and Vertigo: A Nonrandomized Clinical Trial.JAMA network open · 2025Trial
- Is Biofeedback for Vertigo Effective in Ordinary Medical Centers? A Controlled Trial in Northern Italy.Applied psychophysiology and biofeedback · 2023Trial
- Trial
- Trial
- A digital neurotology history: Characteristics and inter-rater reliability.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Acute vestibular syndrome mimicking posterior circulation stroke after intralesional triamcinolone injection for earlobe keloid: a case report.Acta neurologica Belgica · 2026Article
- [The SCD diagnostic strategy, procedure and pathway for episodic vestibular syndrome].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2026Review
- Diagnostic spectrum of unplanned acute hospital admissions within 30 days after emergency department presentation for vertigo in older adults: a province-wide retrospective cohort study.Frontiers in medicine · 2026Article
- Emergency MRI in acute dizziness and headache: current insights and future directions.Frontiers in neurology · 2026Review
- Diagnostic challenges in posterior circulation ischemic stroke presenting with acute dizziness and vertigo.Frontiers in neurology · 2026Review
- Article
- The Role of Biofeedback in Improving Vertigo Management in Older Adults. A Controlled Clinical Study in Italy.Current aging science · 2026Article
- Diagnostic Capabilities of MRI and CT in Evaluating Dizziness: A Systematic Review of Acute Cases in the ED.Cureus · 2025Review
- Sex differences in dizziness diagnoses across acute and chronic neurological settings.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Mind the guideline gap: emergent CT in patients with epilepsy for trauma rule-out-A retrospective cohort study.Neurological research and practice · 2025Article
- Progress in the Study of Diagnostic Methods for Central Acute Vestibular Syndrome of a Vascular Cause.International journal of general medicine · 2025Review
- Leadership Perceptions, Educational Struggles and Barriers, and Effective Modalities for Teaching Vertigo and the HINTS Exam: A National Survey of Emergency Medicine Residency Program Directors.The western journal of emergency medicine · 2025Article
- Diagnosing Emergencies in Undifferentiated Acute Vertigo.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2024Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundDizziness, a common chief complaint, has an extensive differential diagnosis that includes both benign and serious conditions. Emergency physicians must distinguish the majority of patients with self-limiting conditions from those with serious illnesses that require acute treatment. OBJECTIVE OF THE REVIEW: This article presents a new approach to diagnosis of the acutely dizzy patient that emphasizes different aspects of the history to guide a focused physical examination with the goal of differentiating benign peripheral vestibular conditions from dangerous posterior circulation strokes in the emergency department. DISCUSSION: Currently, misdiagnoses are frequent and diagnostic testing costs are high. This relates in part to use of an outdated, prevalent, diagnostic paradigm. The traditional approach, which relies on dizziness symptom quality or type (i.e., vertigo, presyncope, or disequilibrium) to guide inquiry, does not distinguish benign from dangerous causes, and is inconsistent with current best evidence. A new approach divides patients into three key categories using timing and triggers, guiding a differential diagnosis and targeted bedside examination protocol: 1) acute vestibular syndrome, where bedside physical examination differentiates vestibular neuritis from stroke; 2) spontaneous episodic vestibular syndrome, where associated symptoms help differentiate vestibular migraine from transient ischemic attack; and 3) triggered episodic vestibular syndrome, where the Dix-Hallpike and supine roll test help differentiate benign paroxysmal positional vertigo from posterior fossa structural lesions.
conclusionsThe timing and triggers diagnostic approach for the acutely dizzy patient derives from current best evidence and offers the potential to reduce misdiagnosis while simultaneously decreases diagnostic test overuse, unnecessary hospitalization, and incorrect treatments.
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Registered trials
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