Articles: vertigo.
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Dizziness and vertigo are common presenting symptoms in acute care settings. This article describes the most common causes of acute dizziness and vertigo with practical, evidence-based guidance on evaluation of these patients. ⋯ If episodic, determine whether symptoms are triggered or spontaneous. Classify the patient as having post-exposure acute vestibular syndrome (AVS), spontaneous AVS, triggered episodic vestibular syndrome (EVS), or spontaneous EVS.
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Multicenter Study
Development of a Clinical Risk Score to Risk Stratify for a Serious Cause of Vertigo in Patients Presenting to the Emergency Department.
Identify high-risk clinical characteristics for a serious cause of vertigo in patients presenting to the emergency department (ED). ⋯ The Sudbury Vertigo Risk Score identifies the risk of a serious diagnosis as a cause of a patient's vertigo and if validated could assist physicians in guiding further investigation, consultation, and treatment decisions, improving resource utilization and reducing missed diagnoses.
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Vertigo is a priority for training and decision support in emergency departments (ED). Benign paroxysmal positional vertigo (BPPV), though manageable at bedside, remains frequently underdiagnosed and undertreated. This study assessed the effectiveness of a two-tiered educational intervention on posterior and horizontal BPPV management in the ED setting. ⋯ A standardized educational intervention demonstrated enhancing BPPV screening and improved evidence-based diagnosis, showing promise of more efficient treatment in the ED. Further multicenter studies are warranted to evaluate impacts on patient-reported outcomes and resource optimization.
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Three validated diagnostic algorithms for diagnosing patients with acute onset dizziness or vertigo (HINTS, HINTS-plus and STANDING) exist. All are extremely accurate in distinguishing peripheral from central causes of dizziness when done by experienced clinicians. ⋯ Use of these validated algorithms is the best way to accurately diagnose patients with acute dizziness. For clinicians who are unfamiliar with or uncomfortable performing or interpreting HINTS and STANDING, this article will suggest alternative approaches to help with accurate diagnosis of patients with acute dizziness or vertigo.
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Older adults with Benign Paroxysmal Positioning Vertigo (BPPV) may present with unsteadiness that affects gait patterns. ⋯ The findings suggest that gait performance was compromised in older adults with BPPV.