Emergency Neuro-Otology: Diagnosis and Management of Acute Dizziness and Vertigo, An Issue of Neurologic Clinics

David E. Newman-Toker

Description

The focus of this publication on Neuro-Otology in Neurologic Clinics is on the patient presenting for urgent or emergent care with a chief complaint of new, previously-undiagnosed dizziness or vertigo. Intent is to emphasize throughout the issue five primary components of initial diagnosis and management: (1) Epidemiology, differential diagnosis, and disease definitions; (2) Bedside clinical features that differentiate dangerous from benign causes; (3) Appropriate use of advanced diagnostic tests (including imaging, vestibular tests) and consultations; (4) Application of early treatments (manipulative, pharmacologic, rehabilitative); and (5) Acute disposition strategies, including determining need for admission and urgency of follow-up. Articles have a consistent architecture to highlight key points: 1) Case Scenario (with a representative case example; videos are presented with many of these); 2) Prevalence & Pathomechanisms; 3) Definitions & Diagnostic Criteria; 4) Bedside & Laboratory Diagnostic Tests; 5) Acute Treatment Options (including manipulative, pharmacologic, rehabilitative); and 6) Triage & Disposition (including referrals and follow-up). The articles are presented with four major parts: Overall approach to acute dizziness and vertigo; Episodic vertigo and dizziness; Acute, continuous vertigo and dizziness; and Case unknowns. Among the topics covered are: Bedside evaluation; Transient ischemic attacks; Vestibularl neuritis and labyrinthitis; Stroke; Novel approach to diagnosing the acutely dizzy patient. David Newman-Toker leads this publication with associate editors renown in their fields - Kevin Kerber, William J. Meurer, Rodney Omron, and Jonathan Edlow.

Sujets

• Médecine
• Médecine Générale
• Medical
• Neurology

Informations

• Publié par: Elsevier
• Date de parution: 12 novembre 2015
• Nombre de lectures: 0
• EAN13: 9780323393478
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

Clinics Review Articles NEUROLOGIC CLINICS
Emergency Neuro-Otology: Diagnosis and Management of Acute Dizziness and Vertigo

David E. Newman-Toker, MD, PhD
Johns Hopkins Hospital, Baltimore, MD, USA

Kevin A. Kerber, MD, MS
Department of Neurology, University of Michigan Health System, Ann Arbor, MI, USA

William J. Meurer, MD, MS
University of Michigan, Ann Arbor, MI, USA

Rodney Omron, MD, MPH
The Johns Hopkins University School of Medicine, Baltimore, MD, USA

Jonathan A. Edlow, MD
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
ISSN  0733-8619 Volume 33 • Number 3 • August 2015
Elsevier
Table of Contents
Cover image
Title page
Copyright
Contributors
Consulting Editor
Editors
Authors
Forthcoming Issues
Forthcoming Issues
Recent Issues
Preface: Why Acute Dizziness and Vertigo? Articulating the Emergency Neuro-Otology Imperative
Section I – Overall Approach to Acute Dizziness and Vertigo
Overview of the International Classification of Vestibular Disorders
Key points
Introduction
Goals and scope for the International Classification of Vestibular Disorders initiative
Methodology and process for developing the International Classification of Vestibular Disorders
International Classification of Vestibular Disorders structure
International Classification of Vestibular Disorders layer I: symptoms and signs
International Classification of Vestibular Disorders layer II: syndromes
International Classification of Vestibular Disorders layer III: disorders and diseases
International Classification of Vestibular Disorders layer III-B: mechanisms
International Classification of Vestibular Disorders and functional outcomes
Summary
Bedside Assessment of Acute Dizziness and Vertigo
Key points
Introduction
The history
The physical examination
What might be seen in a patient presenting with acute vestibular syndrome
What might be seen in episodic spontaneous vertigo
What might be seen in the patient with recurrent positional vertigo
When the patient is acutely dizzy and there are no physical signs to find
Future directions in acute vertigo
Supplementary data
Misdiagnosing Dizzy Patients
Key points
Introduction
Pitfall 1: overreliance on the type of dizziness to guide diagnostic inquiry
Pitfall 2: underuse and misuse of timing and triggers to categorize patients for diagnosis
Pitfall 3: underuse, misuse, and misconceptions linked to hallmark eye examination findings
Pitfall 4: overweighting age, vascular risk factors, and general neurologic examination to screen for stroke
Pitfall 5: overuse and overreliance on head computed tomography to rule out neurologic causes
Summary
TiTrATE
Key points
Introduction
New diagnostic approach
Four vestibular syndromes
Bedside approach summary
Summary
Appendix
Section II – Acute, Episodic Dizziness and Vertigo
Benign Paroxysmal Positional Vertigo in the Acute Care Setting
Key points
Case scenario
Epidemiology
Pathophysiology
Diagnosis
Prognosis
Benign paroxysmal positional vertigo in the emergency department
Summary
Early Diagnosis and Management of Acute Vertigo from Vestibular Migraine and Ménière's Disease
Key points
Vestibular migraine
Ménière’s disease
Transient Ischemic Attacks Presenting with Dizziness or Vertigo
Key points
Case scenario
Introduction
Prevalence and pathomechanisms
Definitions
Diagnostic approach: bedside and laboratory testing
Acute treatment options
Triage and disposition
Summary
Medical and Psychiatric Causes of Episodic Vestibular Symptoms
Key points
Case scenario
Introduction
Definitions
Epidemiology
Bedside diagnosis
Specific conditions that can cause episodic dizziness
Syncope/presyncope (arrhythmia/neutrally mediated syncope)
Medication effects
Hypoglycemia and toxic/metabolic causes
Visual disorders
Cervical spondylosis
Panic attacks and anxiety disorders
Fibromyalgia
Hyperventilation
Summary
Section III – Acute, Continuous Dizziness and Vertigo
Early Diagnosis and Treatment of Traumatic Vestibulopathy and Postconcussive Dizziness
Key points
Introduction
The definition of mild traumatic brain injury
Epidemiology
Balance disorders after blast injuries
Balance disorders after blunt head injury
Diagnosis
Treatment
Summary
Acute Unilateral Vestibulopathy
Key points
Case scenario
Prevalence and pathomechanisms
Definitions and diagnostic criteria, bedside and laboratory diagnostic tests
Short-term treatment options (including manipulative, pharmacologic, rehabilitative)
Supplementary data
Acute Diagnosis and Management of Stroke Presenting Dizziness or Vertigo
Key points
Case (Wallenberg syndrome)
Prevalence and pathomechanism
Diagnosis and classification of strokes
Bedside and laboratory diagnostic tests
Acute treatment options
Triage and disposition
Supplementary data
Medical and Nonstroke Neurologic Causes of Acute, Continuous Vestibular Symptoms
Key points
Introduction
General medical conditions without obvious structural neurologic disease
Nonstroke neurologic conditions
Physiologic unmasking of occult or recovered neurologic disease
Summary
Index
Copyright
ELSEVIER
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NEUROLOGIC CLINICS Volume 33, Number 3
August 2015 ISSN 0733-8619, ISBN-13: 978-0-323-39346-1
Editor: Lauren Boyle
Developmental editor: Donald Mumford
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