Journal
NEUROLOGIC CLINICS
Volume 33, Issue 3, Pages 577-+Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.ncl.2015.04.011
Keywords
Dizziness; Vertigo; Stroke; Vestibular diseases; Diagnosis; Medical history taking; Physical examination; Emergency departments
Categories
Funding
- National Institutes of Health, National Institute on Deafness and Other Communication Disorders [1U01DC013778-01A1]
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Diagnosing dizziness can be challenging, and the consequences of missing dangerous causes, such as stroke, can be substantial. Most physicians use a diagnostic paradigm developed more than 40 years ago that focuses on the type of dizziness, but this approach is flawed. This article proposes a new paradigm based on symptom timing, triggers, and targeted bedside eye examinations (TiTrATE). Acute patients fall into 1 of 4 major syndrome categories, each with its own differential diagnosis and set of targeted examination techniques that help make a specific diagnosis. Following an evidence-based approach could help reduce the frequency of misdiagnosis of serious causes of dizziness.
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