Vertigo Clinical Examination

• November 15, 2022
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Vertigo, an illusory sensation of self or environmental rotation is a common presentation to the emergency department, affecting approximately 20–30% of the general population.1 Despite its frequency, most clinicians find acute vertigo challenging. An easy way of approaching it is to have in mind the most common causes and to consider them all during history taking and examination. When acute vertigo presents with other symptoms, the diagnosis is easy, for example with facial numbness in stroke or auditory distortion in Ménière's. This discussion will therefore focus on the clinical approach to patients presenting with acutely isolated vertigo.The vestibular organ detects head motion, so abnormal activity in the vestibular nerves may be interpreted by the brain as self-motion. Lesions in the brainstem may also affect these vestibular signals, thus central lesions such as cerebellar strokes can also cause profound vertigo.

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