The Curbsiders Internal Medicine Podcast

REBOOT #49 Vertigo and Dizziness: How to Treat, Who to Send Home, and Who Might Have a Stroke

Sep 5, 2022

01:16:01

Creator website

Episode guests

David Newman-Toker

Highlights

AI Chapters

Episode notes

Vertigo Symptoms

01:56

Anxiety Trap Type Personality

01:58

What Is Nestagmus?

01:20

Panacea Financial

00:49

Introduction

2min

Is It So Hard for Patients to Describe Dizziness?

2min

Is It a Good Idea to Classify Vertigo?

2min

Is There a Time and Trigger to Physical Exams?

3min

Better Help - A Sponsor of the Curb Siders

3min

The Acute Vestibular Syndrome

2min

Symptoms of Poster Canal and Maner's Disease

4min

What Are the Highest Risk Patients?

4min

Is There a Time Line Based Approach to Chest Pain?

2min

10.

Acute Vestibular Cyndrome in the Emergency Department

2min

11.

Strokes - Is the Nestagmus Changing Direction?

4min

12.

The Vesubulac Reflex Is a Reflex of the Ear Eyes

3min

13.

Left Biding Istagnus

5min

14.

Alternate Cover Testing of the Eyes

2min

15.

How Do You Know if You're Safe to Go?

2min

16.

Cer Cerabele Strke - Is There a Stroke?

3min

17.

Strokes

2min

18.

Dick Hallpike Manoeuvre

6min

19.

The Epley Maneuvre Is Probably the Best Treatment in Modern Medicine

2min

20.

The Dix Hallpike Test Is a Very Specific Test for Poster Cannot Be Pv

4min

21.

Hiring With Indeed at the Curb Siders

5min

22.

Is Meclazine Used in the Treatment of Vestibuleneritus?

4min

23.

What Kind of Exercises Are Best for Patients With a B P P B?

4min

24.

Dizziness - What to Do in the Early Stages

2min

25.

Curb Siders Podcast - The Curbsiders

2min

26.

How to Get a Job in Amazon

2min

A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology, and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab. Original show notes here.

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Show Segments

Intro, Getting to know our guest
Clinical Case
Why can’t patients describe their dizziness?
Classifying dizziness
The 3 vestibular syndrome buckets defined
Episodic vestibular syndrome differential diagnosis
Acute vestibular syndrome differential diagnosis
Chronic vestibular syndrome differential diagnosis
Challenges of medical history taking
Approach to the acute vestibular syndrome/HINTS
How to evaluate nystagmus
How to perform the head impulse test (aka head thrust)
How to perform “test of skew” (alternate cover testing)
Recap of HINTS exam and discussion of MRI
Signs and symptoms of cerebellar stroke
Use of Dix-Hallpike for episodic vertigo
What happens when you choose the wrong test
Continuous versus triggered dizziness, or vertigo
Meclizine use in BPPV
How to cure horizontal canal BPPV
Treatment for vestibular neuritis
Treatment for Meniere’s disease
Who benefits from vestibular rehab/exercises
Dizziness and giddiness
Take home points
Outro

Credits

Produced and Written by: Cyrus Askin MD
Show Notes: Matthew Watto MD
Hosts: Cyrus Askin MD, Stuart Brigham MD, Matthew Watto MD, FACP; Paul Williams MD, FACP
Editor: Matthew Watto MD, FACP
Guest: David Newman-Toker MD, PhD

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