Differential diagnosis of vertigo in the emergency department

Abstract

Vertigo is a common complaint among admissions in emergency department (ED); however, it is difficult to make the differential diagnose. In vertigo, a subtype of dizziness, it is important to find the underlying etiologies as central and peripheral. The aim of this study is to find the etiologic frequency of vertigo as peripheral and central, to make its differential diagnosis and to emphasize the importance of vertigo about the first symptom of some life threatening central lesions. The patients in whom vertigo was diagnosed in Ondokuz Mayis University Emergency Department between May 2006-2007 were evaluated prospectively. The patients were divided into two groups as peripheral and central according to clinical characteristics. Some patients who were thought to have central vertigo clinically had computerized brain tomography. The groups were compared for the duration of vertigo, clinic severity, the presence of headache, age group, vertigo history, cranial imaging, and the respons of treatment.The study included 56 patients with vertigo. The ratio of female to male was 1.54. The mean age of the patients during the admission was 48.3±14.9 years. The frequency of vertigo among emergency admissions was 0.33%. There was no significant difference in age and sex between the peripheral and central vertigo groups. Benign paroxismal positional vertigo was the most frequent established cause of peripheral vertigo. In the central vertigo patients, the most frequent etiology was vertebrobasillar insufficiency. Of all the patients, in 85.7%, the symptoms were recovered with the treatment in ED. Central causes were not rare in the patientswith vertigo. So the differantial diagnosis of vertigo should be made in Emergency Department and the threatment should be planned according to this. On the other hand our finding which show the vertigo's frequency among the all emergency admissions may be a reference to other studies. © 2012 OMU.