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Review
. 2021 Oct;54(5):925-938.
doi: 10.1016/j.otc.2021.05.013. Epub 2021 Jul 20.

Acute Vestibular Syndrome and ER Presentations of Dizziness

Richard Baron  1 , Kristen K Steenerson  2 , Jennifer Alyono  3
Affiliations
Review

Acute Vestibular Syndrome and ER Presentations of Dizziness

Richard Baron et al. Otolaryngol Clin North Am. 2021 Oct.

Abstract

Acute vestibular syndrome (AVS) describes sudden onset, severe, continuous dizziness that persists for more than 24 hours. Its wide differential presents a diagnostic challenge. Vestibular neuritis is the most common cause, but stroke, trauma, medication effects, infectious, and inflammatory causes all present similarly. The TiTrATE model (Timing, Triggers, And Targeted Exam) is systematic way to evaluate these patients, and the HINTS Plus exam (Head Impulse, Nystagmus, Test of Skew, plus hearing loss) is critical in differentiating central and peripheral causes. The importance of recognizing risk factors for stroke and the role of imaging is also discussed.

Keywords: Acute vestibular syndrome; Dizzy; Emergency; HINTS Plus; Stroke; TiTrATE; Vestibular neuritis.

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Conflict of interest statement

Disclosure “The authors have nothing to disclose.”