ArticleBMJ open2023
Vestibular syndromes, diagnosis and diagnostic errors in patients with dizziness presenting to the emergency department: a cross-sectional study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- The Epidemiology and Clinical Presentation of the Acute Imbalance Syndrome (AIS)-A Systematic Review and Meta-Analysis.European journal of neurology · 2026Pooled it
- The epidemiology and clinical presentation of acute vestibular syndromes: a systematic review of the literature.Journal of neurology · 2026Pooled it
- Dizziness in the emergency department and risk of stroke: A systematic review and meta-analysis.PloS one · 2026Pooled it
- Effectiveness of training on vertigo/dizziness coding in primary care: a community-based cluster-randomized trial.BMC medical education · 2026Trial
- The reliability and validity of the Swedish translation of the Vertigo Symptom Scale - short form in a cohort with acute vestibular syndrome.Annals of medicine · 2025Trial
- Separating stroke and acute unilateral vestibulopathy using history, examination and vestibular tests: a machine learning approach.Journal of neurology · 2026Article
- Conversational Large Language Models for Vestibular Diagnosis in Outpatient Clinics: Prospective Multicenter Diagnostic Accuracy Study.Journal of medical Internet research · 2026Article
- Long-Term DHI Outcomes in Patients with Chronic Dizziness and Initially Uncertain Diagnosis: A Retrospective Follow-Up Study.Audiology research · 2026Article
- A Guide to Patients with Acute Transient Vestibular Symptoms in the Emergency Department.Brain sciences · 2026Review
- [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 challenges in posterior circulation ischemic stroke presenting with acute dizziness and vertigo.Frontiers in neurology · 2026Review
- Prospective quantitative evaluation of gait and stance in patients with acute vertigo and dizziness.Journal of neurology · 2025Article
- 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
- [The diagnostic strategy, procedure and pathway for acute vestibular syndrome SCD].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2025Article
- Separation of stroke from vestibular neuritis using the video head impulse test: machine learning models versus expert clinicians.Journal of neurology · 2025Article
- Diagnostic Errors in the Acutely Dizzy Patient-Lessons Learned.Brain sciences · 2025Review
- Performing the HINTS-exam using a mixed-reality head-mounted display in patients with acute vestibular syndrome: a feasibility study.Frontiers in neurology · 2025Article
- Current insights on predicting vestibular diseases using machine learning.Turkish journal of medical sciences · 2025Review
- [SCD programmatic diagnostic strategy and diagnostic pathway for vertigo disease].Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2024Article
- Chronic Unilateral Vestibular Hypofunction: Insights into Etiologies, Clinical Subtypes, Diagnostics and Quality of Life.Journal of clinical medicine · 2024Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe aimed to determine the frequency of vestibular syndromes, diagnoses, diagnostic errors and resources used in patients with dizziness in the emergency department (ED).
designRetrospective cross-sectional study.
settingTertiary referral hospital.
participantsAdult patients presenting with dizziness. PRIMARY AND SECONDARY OUTCOME MEASURES: We collected clinical data from the initial ED report from July 2015 to August 2020 and compared them with the follow-up report if available. We calculated the prevalence of vestibular syndromes and stroke prevalence in patients with dizziness. Vestibular syndromes are differentiated in acute (AVS) (eg, stroke, vestibular neuritis), episodic (EVS) (eg, benign paroxysmal positional vertigo, transient ischaemic attack) and chronic (CVS) (eg, persistent postural-perceptual dizziness) vestibular syndrome. We reported the rate of diagnostic errors using the follow-up diagnosis as the reference standard.
resultsWe included 1535 patients with dizziness. 19.7% (303) of the patients presented with AVS, 34.7% (533) with EVS, 4.6% (71) with CVS and 40.9% (628) with no or unclassifiable vestibular syndrome. The three most frequent diagnoses were stroke/minor stroke (10.1%, 155), benign paroxysmal positional vertigo (9.8%, 150) and vestibular neuritis (9.6%, 148). Among patients with AVS, 25.4% (77) had stroke. The cause of the dizziness remained unknown in 45.0% (692) and 18.0% received a false diagnosis. There was a follow-up in 662 cases (43.1%) and 58.2% with an initially unknown diagnoses received a final diagnosis. Overall, 69.9% of all 1535 patients with dizziness received neuroimaging (MRI 58.2%, CT 11.6%) in the ED.
conclusionsOne-fourth of patients with dizziness in the ED presented with AVS with a high prevalence (10%) of vestibular strokes. EVS was more frequent; however, the rate of undiagnosed patients with dizziness and the number of patients receiving neuroimaging were high. Almost half of them still remained without diagnosis and among those diagnosed were often misclassified. Many unclear cases of vertigo could be diagnostically clarified after a follow-up visit.
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