The Curbsiders Internal Medicine Podcast REBOOT #49 Vertigo and Dizziness: How to Treat, Who to Send Home, and Who Might Have a Stroke
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Sep 5, 2022 
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Vestibular System Is The Sixth Sense
- The vestibular system is the "sixth sense" that normally operates unconsciously in the background.
- People lack rich language to describe dizziness because this sense is usually unnoticed unless dysfunctional.
Prioritize Timing and Triggers
- Focus on timing and triggers rather than type of dizziness when obtaining history.
- Use timing and triggers to classify patients into episodic, acute, or chronic vestibular syndromes for better diagnosis.
Use HINTS Exam For Acute Dizziness
- In acute vestibular syndrome, use the HINTS exam: head impulse test, nystagmus evaluation, and test of skew.
- These simple eye movement tests can distinguish vestibular neuritis from stroke with high accuracy.