Acute Dizziness, Vertigo, and Unsteadiness

Dizziness, vertigo, and disequilibrium are among the most common chief complaints in patients referred for neurologic evaluation or presenting to the emergency department (ED). These symptoms account for 3.3% to 4% of ED visits annually in the United States.1,2 This corresponds to almost 4.5 million emergent visits, and recent studies indicate that this number is steadily increasing.2 However, the term dizziness encompasses a wide range of symptoms with variable clinical significance. Although most conditions are benign and self-limited, such as semicircular canal dysfunction or orthostatic hypotension, in a subset of patients they may signal the presence of a potentially life-threatening neurologic event, including vertebrobasilar ischemia or brainstem hemorrhage. Serious causes of dizziness may also be medical in origin, such as cardiac arrhythmias and electrolyte derangements, which poses a challenging problem for treating

Automated summary

Dizziness, vertigo, and disequilibrium are common symptoms in patients seeking medical evaluation, with both benign and potentially life-threatening causes. The challenge lies in distinguishing between the different etiologies and providing appropriate treatment.