• Kiersten L Gurley and Jonathan A Edlow.
• Harvard Medical School, Boston, MA, USA; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Anna Jaques Hospital, Newburyport, MA, USA. Electronic address: kgurley@bidmc.harvard.edu.
• Emerg. Med. Clin. North Am. 2021 Feb 1; 39 (1): 181-201.

AbstractUsing an algorithmic approach to acutely dizzy patients, physicians can often confidently make a specific diagnosis that leads to correct treatment and should reduce the misdiagnosis of cerebrovascular events. Emergency clinicians should try to become familiar with an approach that exploits timing and triggers as well as some basic "rules" of nystagmus. The gait should always be tested in all patients who might be discharged. Computed tomographic scans are unreliable to exclude posterior circulation stroke presenting as dizziness, and early MRI (within the first 72 hours) also misses 10% to 20% of these cases.Copyright © 2020 Elsevier Inc. All rights reserved.

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