Dizziness…the good and the ugly…

The differential diagnosis of vertigo can be broken into peripheral and central causes. It is imperative the Emergency Physician consider central causes of vertigo. Signs/ Symptoms Differentiating Peripheral and Central Vertigo   Peripheral Central Onset Sudden or Insidious Sudden Severity of Vertigo Intense Spinning Ill-defined, may be severe or less intense Prodromal Dizziness Occurs in […]

Myths In Emergency Medicine Diagnostic Imaging For Dizziness

“Doctor, I’m feeling dizzy…” What you need to know: CT is worthless and expensive in the evaluation of dizziness. MRI has much better utility but is often unnecessary for the complaint of dizziness. Nystagmus is an unreliable sign and does not differentiate serious neurological disease from other causes of dizziness. Gait instability or imbalance, other […]

Acute Ataxia In The ED Highlights

The word “ataxia”, comes from the Greek word, ” a taxis” meaning “without order or incoordination”. Learn how to evaluate acute ataxia in the ED  

Evaluating the dizzy patient…not everyone needs imaging (and a brain tumour in the long run)

Head CT is poor screening tool for ED

“Our results suggest that most patients presenting with syncope or dizziness to the emergency department may not benefit from head CT unless they are older, have a focal neurologic deficit, or have a history of recent head trauma,”

Epley’s Maneuver

Benign paroxysmal positional vertigo (BPPV) is the likely cause in patients reporting brief recurrent attacks of dizziness triggered by changes in head position. It is important to recognize this cause because it can be readily treated at the bedside and because identification of the key features is the most effective way to exclude a central […]