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KMID : 1201420090020000088
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Journal of Neurocritical Care
2009 Volume.2 No. 0 p.88 ~ p.93
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Diagnosis of Acute Dizziness: Approach by Presenting Pattern and Bedside Examination
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Park Ji-Yun
Lee Tae-Kyeong
Sung Ki-Bum
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Abstract
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Since the report of symptoms from patients can be vague, and sometimes unreliable, classification of the dizziness by presenting patterns can be an effective way for approaching acute dizziness. Dizziness attacks can be classified into three main presentations: 1) acute spontaneous attacks, 2) recurrent attacks, and 3) brief attacks induced by position change. Each pattern of these categories caused by both benign peripheral and sinister central disorders. Because some of the central disorders can present quite similar to benign peripheral disorders, physicians should be able to recognize red flags which connotes ominous symptoms or signs suggesting life-threatening central disorder. Furthermore, common benign peripheral disorders in each of these categories have unique clinical features allowing for bedside diagnosis. Therefore, if the presentation is not typical for a peripheral vestibular disorder, the possibility of the central disorder should be sought. Careful history taking and specific neurolotologic examinations including pattern of nystagmus, head thrust test, head shaking test, and severity of imbalance provide the key information for distinguishing benign peripheral causes from life-threatening central causes.
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KEYWORD
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Acute dizziness, Central causes of vertigo, Head thrust test, Pseudovestibular neuritis
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