In this episode of the Primary Care Knowledge Boost Podcast Doctors Lisa and Sara talk to Consultant Otolaryngologist Ms Emma Stapleton and Clinical Scientist David Jay about Vertigo.
Together they discuss the definition, differentials, and how to use information around timing and triggers to differentiate between the likely causes of vertigo.
The experts offer their take on the important details in the examination that can help identify the diagnosis, and talk options for managing the most common types of peripheral vertigo.
The resources section of the episode description contains excellent resources to help, including examples of how to perform and interpret the Head Impulse test, as well as vestibular rehabilitation resources for patients.
Listen to the podcast episode at https://pckb.org/e/summer-rewind-vertigo/.
Useful resources
- HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging. Kattah JC, Talkad AV, Wang DZ, Hsieh YH, Newman-Toker DE . Nov 2009, Stroke: https://pubmed.ncbi.nlm.nih.gov/19762709/
- A summary of HINTS by David Jay: Developments in diagnostic approaches for acutely dizzy patients: (Feb 2020 ENT & Audiology News): https://www.entandaudiologynews.com/features/audiology-features/post/developments-in-diagnostic-approaches-for-acutely-dizzy-patients
- TiTrATE: A Novel Approach to Diagnosing Acute Dizziness and Vertigo. Newman-Toker and Edlow J A. Neurology Clinics (Aug 2015) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522574/
- The Five Deadly D’s of Dizziness (red flags to remember): EM Resident, Unravelling the Mystery of Dizziness in the ED: A Guide for the Student Clerkship, Oct 2018 Wilcox K, Shafer K: https://www.emra.org/emresident/article/dizziness/
- BMJ Vertigo: Dix-Hallpike Video: https://www.youtube.com/watch?v=8RYB2QlO1N4
- BMJ Vertigo: Epley Manoeuvre Video: https://www.youtube.com/watch?v=jBzID5nVQjk&t=44s
- Examples of how to perform the Head Impulse Test for Peripheral Vestibular Dysfunction:
- Professor Lucy Yardley: Retraining your Balance: https://www.menieres.org.uk/files/pdfs/balance-retraining-2012.pdf
- VeDA Vestibular Disorders Association USA Resources for Clinicians and Patients:
Main Page: https://vestibular.org/ - VeDA Vestibular Disorders Association USA Resources for Clinicians and Patients:
Type of Vestibular Disorders Page: https://vestibular.org/article/diagnosis-treatment/types-of-vestibular-disorders/ - Meniere’s Society UK: https://www.menieres.org.uk/
- The Migraine Trust: https://migrainetrust.org/
