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Acute vestibular syndrome: a critical review and diagnostic algorithm concerning the clinical differentiation of peripheral versus central aetiologies in the emergency department

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Abstract

Almost 20 % of cerebral ischaemic strokes occur in the posterior circulation. Estimates are that 20 % of these patients present with isolated vertigo. In approximately one-sixth to one-third of these patients, this symptom is wrongly diagnosed to be peripheral vestibular in origin. As a result, these missed stroke patients are withheld from therapeutic and secondary prophylactic treatment, which may result in unnecessary morbidity and mortality. We therefore propose a diagnostic algorithm concerning the clinical differentiation of acute vestibular syndrome (AVS) patients based on a critical review of the available literature.

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Authors and Affiliations

  1. Department of Neurology and Clinical Neurophysiology, Albert Schweitzer Hospital, PO Box 444, 3300, Dordrecht, The Netherlands

    J. Venhovens

  2. Department of Neurology and Clinical Neurophysiology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands

    J. Meulstee & W. I. M. Verhagen

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  1. J. Venhovens
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  2. J. Meulstee
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  3. W. I. M. Verhagen
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Correspondence to J. Venhovens.

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Venhovens, J., Meulstee, J. & Verhagen, W.I.M. Acute vestibular syndrome: a critical review and diagnostic algorithm concerning the clinical differentiation of peripheral versus central aetiologies in the emergency department. J Neurol 263, 2151–2157 (2016). https://doi.org/10.1007/s00415-016-8081-8

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  • DOI: https://doi.org/10.1007/s00415-016-8081-8

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