HNO · 2025
Diagnosis and treatment of vertigo and dizziness : Interdisciplinary guidance paper for clinical practice.
СтатьяОбзорConsensus StatementНазвание и аннотация: Перевод в очереди
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Tarnutzer Alexander Andrea, Kerkeni Hassen, Diener Suzie, Kalla Roger, Candreia Claudia, Piantanida Renato, Maire Raphaël, Welge-Lüssen Antje, Budweg Joris, Zwergal Andreas, Dlugaiczyk Julia
Аннотация
BACKGROUND: Vertigo and dizziness belong to the most common leading symptoms in clinical practice. Their differential diagnosis, however, often imposes a challenge.
OBJECTIVE: This work aims to provide evidence-based and practice-oriented recommendations for diagnosis and treatment of vertigo and dizziness for primary care providers.
MATERIALS AND METHODS: The consensus statement of an interdisciplinary working group following a national survey among Swiss primary care physicians and neurotology specialists (neurologists, otorhinolaryngologists) is presented. The associated literature search in PubMed was conducted up to October 2024.
RESULTS AND CONCLUSION: Structured history taking and clinical neurotological examination form the basis for the differential diagnosis of the various acute (AVS), episodic (EVS), and chronic (CVS) vestibular syndromes (AVS: e.g., stroke or acute unilateral vestibulopathy; EVS: e.g., benign paroxysmal positional vertigo [BPPV], Menière's disease, vestibular migraine, vestibular paroxysmia; CVS: e.g., bilateral vestibulopathy, persistent postural perceptual dizziness). The present paper covers the following topics: i) "red flags" for a potentially dangerous cause in patients with acute vertigo/dizziness/gait and balance disorders; ii) essential clinical neurotological examination steps; iii) diagnostic and therapeutic maneuvers for posterior and lateral canal BPPV; iv) the most important therapeutic strategies for the vestibular syndromes named above; and v) the top 10 recommendations regarding history taking, diagnosis, and treatment of vertigo and dizziness in clinical practice. This review aims to serve as a clinical companion for physicians of all specialties dealing with the primary diagnosis and treatment of vertigo and dizziness.
OBJECTIVE: This work aims to provide evidence-based and practice-oriented recommendations for diagnosis and treatment of vertigo and dizziness for primary care providers.
MATERIALS AND METHODS: The consensus statement of an interdisciplinary working group following a national survey among Swiss primary care physicians and neurotology specialists (neurologists, otorhinolaryngologists) is presented. The associated literature search in PubMed was conducted up to October 2024.
RESULTS AND CONCLUSION: Structured history taking and clinical neurotological examination form the basis for the differential diagnosis of the various acute (AVS), episodic (EVS), and chronic (CVS) vestibular syndromes (AVS: e.g., stroke or acute unilateral vestibulopathy; EVS: e.g., benign paroxysmal positional vertigo [BPPV], Menière's disease, vestibular migraine, vestibular paroxysmia; CVS: e.g., bilateral vestibulopathy, persistent postural perceptual dizziness). The present paper covers the following topics: i) "red flags" for a potentially dangerous cause in patients with acute vertigo/dizziness/gait and balance disorders; ii) essential clinical neurotological examination steps; iii) diagnostic and therapeutic maneuvers for posterior and lateral canal BPPV; iv) the most important therapeutic strategies for the vestibular syndromes named above; and v) the top 10 recommendations regarding history taking, diagnosis, and treatment of vertigo and dizziness in clinical practice. This review aims to serve as a clinical companion for physicians of all specialties dealing with the primary diagnosis and treatment of vertigo and dizziness.