title: Acute vestibulopathy.
abstract: The presentation of acute vertigo may represent both a common benign disorder or a life threatening but rare one. Familiarity with the common peripheral vestibular disorders will allow the clinician to rapidly "rule-in" a benign disorder and recognize when further testing is required. Key features of vertigo required to make an accurate diagnosis are duration, chronicity, associated symptoms, and triggers. Bedside tests that are critical to the diagnosis of acute vertigo include the Dix-Hallpike maneuver and canalith repositioning manuever, occlusive ophthalmoscopy, and the head impulse test. The goal of this review is to provide the clinician with the clinical and pathophysiologic background of the most common disorders that present with vertigo to develop a logical differential diagnosis and management plan.
authors: UCLA Department of Neurology, Los Angeles, CA, USA.
authors: Yoon-Hee
authors: YH
authors: Cha
keywords: BPPV; Dix-Hallpike; Meniere disease; vertigo; vestibular neuritis
references: Laryngoscope. 2005 Oct;115(10):1717-27
references: 16222184
references: Otol Neurotol. 2002 Nov;23(6):926-32
references: 12438857
references: Neurology. 2006 Nov 28;67(10):1870-1
references: 17130428
references: Acta Otolaryngol. 2010 Sep;130(9):1019-23
references: 20331407
references: Acta Otolaryngol. 2005 Mar;125(3):276-9
references: 15966697
references: Stroke. 2009 Dec;40(12):3745-51
references: 19797177
references: N Engl J Med. 2004 Jul 22;351(4):354-61
references: 15269315
references: Arch Neurol. 2004 Oct;61(10):1590-3
references: 15477514
references: Neurology. 2005 Mar 8;64(5):920-1
references: 15753441
references: Ear Nose Throat J. 2004 Dec;83(12):814-5
references: 15724736
references: Laryngoscope. 1996 Apr;106(4):476-8
references: 8614224
references: Acta Otolaryngol. 2000 Mar;120(3):380-5
references: 10894413
references: Cochrane Database Syst Rev. 2006 Jul 19;(3):CD003599
references: 16856015
references: Am J Otolaryngol. 2002 Sep-Oct;23(5):263-6
references: 12239689
references: J Otolaryngol. 2003 Aug;32(4):234-8
references: 14587563
references: Acta Otorhinolaryngol Ital. 1998 Dec;18(6):363-7
references: 10388148
references: Laryngoscope. 2005 Sep;115(9):1667-71
references: 16148714
references: Acta Otolaryngol. 2001 Jan;121(2):234-40
references: 11349786
references: Acta Otolaryngol Suppl. 1984;406:72-7
references: 6591717
references: Semin Neurol. 2009 Nov;29(5):534-40
references: 19834865
references: Brain. 1984 Dec;107 ( Pt 4):1123-42
references: 6334543
references: Curr Opin Otolaryngol Head Neck Surg. 2003 Oct;11(5):340-6
references: 14502064
references: J Neurol Neurosurg Psychiatry. 2007 Jul;78(7):710-5
references: 17135456
references: Neurology. 1997 Sep;49(3):729-33
references: 9305332
references: Arch Otolaryngol Head Neck Surg. 1996 Mar;122(3):281-6
references: 8607956
references: Neurology. 2002 Dec 10;59(11):1700-4
references: 12473755
references: Laryngoscope. 1997 Jan;107(1):90-4
references: 9001271
references: J Otolaryngol Head Neck Surg. 2008 Dec;37(6):832-5
references: 19128712
references: J Psychiatr Res. 2005 Sep;39(5):529-34
references: 15992562
references: Otol Neurotol. 2008 Apr;29(3):368-74
references: 18317392
references: Acta Otolaryngol. 2008 Mar;128(3):272-6
references: 18274913
references: Neurology. 2006 Oct 10;67(7):1178-83
references: 17030749
references: Ann Otol Rhinol Laryngol. 2000 Apr;109(4):377-80
references: 10778892
references: Acta Otolaryngol. 2010 Jun;130(6):644-51
references: 20001444
references: J Vestib Res. 1990-1991;1(2):187-97
references: 1670152
references: Neurology. 2008 May 27;70(22):2067-74
references: 18505980
references: Auris Nasus Larynx. 2009 Dec;36(6):637-43
references: 19410397
references: J Neurol Neurosurg Psychiatry. 1996 Jan;60(1):68-71
references: 8558155
references: Acta Otolaryngol. 2006 Feb;126(2):160-3
references: 16428193
references: Otolaryngol Head Neck Surg. 2006 Mar;134(3):451-4
references: 16500443
references: Neurology. 2008 Sep 23;71(13):1006-14
references: 18809837
references: Otol Neurotol. 2008 Aug;29(5):706-9
references: 18520622
references: Acta Otolaryngol. 2010 May;130(5):565-7
references: 19883173
references: Brain. 2005 Feb;128(Pt 2):365-74
references: 15601663
references: Acta Otolaryngol Suppl. 1993;503:9-12
references: 8470507
references: Otolaryngol Head Neck Surg. 1996 Apr;114(4):586-92
references: 8643269
references: Otolaryngol Head Neck Surg. 1995 Sep;113(3):181-5
references: 7675476
references: Cephalalgia. 2009 May;29(5):550-5
references: 19170697
references: Otol Neurotol. 2005 Jan;26(1):74-81
references: 15699723
references: Laryngoscope. 1992 Sep;102(9):988-92
references: 1518363