About this episode
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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
