title: Differential diagnosis of vertigo and dizziness in the emergency department.
abstract: CONCLUSIONS
  To establish a system of differential diagnosis for vertigo/dizziness at the Emergency Department (ED), careful history-taking of complications and examinations of nystagmus should be helpful and therefore prepared by ED staff.
  
  
  OBJECTIVE
  Vertigo/dizziness could come from various kinds of organs for equilibrium, sometimes resulting in an emergency due to the central origin. In the present study, we checked patients' background data at the ED in advance of a definitive diagnosis at the Department of Otolaryngology and examined the significance of the correlation between the data and the diagnosis.
  
  
  METHODS
  We studied a series of 120 patients with vertigo/dizziness, who visited the Departments of Emergency and Otolaryngology between April 2011 and March 2012. At the ED, we first checked patients' backgrounds and carried out neurologic and neuro-otologic examinations. At the Department of Otolaryngology, we finally diagnosed all the patients according to the criteria and classified the origins of vertigo/dizziness into central and non-central diseases.
  
  
  RESULTS
  The ratio of patients with disease of central origin was 12.5% and that for non-central origin was 87.5%. The risk factors for cerebrovascular disease such as hypertension, heart disease, and diabetes were also the risk factors for central vertigo/dizziness by the chi-squared test. To predict a central origin for vertigo/dizziness, only gaze nystagmus was the significant factor by multivariate regression analysis.
authors.affiliation: Departments of Otolaryngology and Emergency, Osaka Rosai Hospital , Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ozono
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kitahara
authors.forename: Munehisa
authors.initials: M
authors.lastname: Fukushima
authors.forename: Takahiro
authors.initials: T
authors.lastname: Michiba
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Imai
authors.forename: Youichirou
authors.initials: Y
authors.lastname: Tomiyama
authors.forename: Suetaka
authors.initials: S
authors.lastname: Nishiike
authors.forename: Hidenori
authors.initials: H
authors.lastname: Inohara
authors.forename: Hisaki
authors.initials: H
authors.lastname: Morita
mesh_terms: D003389:Cranial Nerve Diseases / Q000453:epidemiology; D003937:Diagnosis, Differential; D004244:Dizziness / Q000175:diagnosis*; D004636:Emergency Service, Hospital; D005260:Female; D006760:Hospitalization; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008487:Medical History Taking; D015999:Multivariate Analysis; D009460:Neurologic Examination; D012307:Risk Factors; D012737:Sex Factors; D014717:Vertigo / Q000175:diagnosis*; D014724:Vestibular Function Tests