Misdiagnosing Dizzy Patients: Common Pitfalls in Clinical Practice
- PMID: 26231272
- PMCID: PMC9023124
- DOI: 10.1016/j.ncl.2015.04.009
Misdiagnosing Dizzy Patients: Common Pitfalls in Clinical Practice
Abstract
This article highlights 5 pitfalls in the diagnosis of common vestibular disorders: (1) overreliance on dizziness symptom type to drive diagnostic inquiry; (2) underuse and misuse of timing and triggers to categorize patients; (3) underuse, misuse, and misconceptions linked to hallmark eye examination findings; (4) overweighting age, vascular risk factors, and neuroexamination to screen for stroke; and (5) overuse and overreliance on head computed tomography to rule out neurologic causes. This article discusses the evidence base describing each pitfall's frequency and likely causes, and potential alternative strategies that might be used to improve diagnostic accuracy or mitigate harms.
Keywords: Dizziness; Management; Vertigo; Vestibular disorder.
Copyright © 2015 Elsevier Inc. All rights reserved.
References
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- Royl G, Ploner CJ, Leithner C. Dizziness in the emergency room: diagnoses and misdiagnoses. European neurology 2011;66:256–263. - PubMed
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- Newman-Toker DE, Camargo CA Jr., Hsieh YH, Pelletier AJ, Edlow JA. Disconnect between charted vestibular diagnoses and emergency department management decisions: a cross-sectional analysis from a nationally representative sample. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2009;16:970–977. - PubMed
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