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

Video

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.

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

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

Sponsor: Better Help

Visit BetterHelp.com/curb today to get 10% off your first month.

Sponsor: Panacea Financial

Visit panaceafinancial.com today to learn how a bank for doctors, by doctors, can help you.

Sponsor: Indeed

Visit Indeed.com/internalmedicine to start hiring now.

Comments

September 8, 2022, 3:36pm Ryan writes:
Great episode. Where are the videos that were talked about in the episode though? Thanks.
- October 3, 2022, 11:16am Ask Curbsiders writes:
  Hi! The videos are linked in the original episode post! Here is the link! Vertigo Video Links
September 12, 2022, 9:07pm Zoraida Arboleda writes:
Hi there! Is this episode not available for CME Credit?
- September 30, 2022, 11:26am Ask Curbsiders writes:
  Hi! There is no CME available for this episode. That is generally the case with our rebooted episodes :)

CME Partner

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit.

Contact Us

Got feedback? Suggest a Curbsiders topic. Recommend a guest. Tell us what you think.

We love hearing from you.