CME 16/01/14 Vestibular and Vertigo Assessment

Vestibular assessment from SCGH ED CME

Thanks again to Jim for giving a very helpful talk on the assessment of ED patients presenting with vertigo.

Head Thrust Test:

Vertigo Assessment Algorithm:

Here is a the article that Jim mentions in his talk. This article, published in Stroke 2009, examines the sensitivity of occulomotor bedside testing (Head-Impulse—Nystagmus—Test-of-Skew or HINTS) compared with early MRI in differentiating peripheral vestibular neuronitis from verterbro-basilar strokes as the cause of acute vestibular syndrome (AVS) :

HINTS to Diagnose Stroke in the Acute Vestibular Syndrome: Three-Step Bedside Oculomotor Examination More Sensitive Than Early MRI Diffusion-Weighted Imaging

Here are some other useful resources:

EMCrit podcast on the diagnosis of posterior stroke with associated examination video (below) from Dr David Newman-Toker’s website:

Epley’s Manoeuvre for BPPV Handout:

&

Epley’s video demonstration: