[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-209134-en":3,"doc-seo-209134-105":30,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":27,"seo_description":14,"update_tm":28,"read_time":29},209134,1374391974585,"Genevieve","https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c",7,"Healthcare","Approach to dizziness in the emergency department","Acute dizziness and vertigo are among the most common reasons for emergency department visits, yet differential diagnosis remains difficult because dizziness may reflect conditions ranging from life-threatening disease to normal physiology, and confirmatory diagnostic tools are unavailable for many causes. The article compares a traditional symptom-quality classification with a newer scheme that organizes dizziness into acute prolonged spontaneous, recurrent spontaneous, recurrent positional, or chronic persistent dizziness and imbalance, emphasizing bedside examination for stroke and focused evaluation for key disorders and benign positional vertigo.","Clin Exp Emerg Med 2015;2(2):75-88 [http://dx.doi.org/10.15441/ceem.15.026](http://dx.doi.org/10.15441/ceem.15.026)  \nApproach to dizziness in the emergency department  \nIleok Jung, Ji-Soo Kim  \nDepartment of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea  \nAcute dizziness/vertigo is among the most common causes for visiting the emergency department. The traditional approach to dizziness starts with categorizing dizziness into four types: vertigo, presyncope, disequilibrium, and nonspecific dizziness. However, a recently proposed approach begins with classifying dizziness/vertigo as acute prolonged spontaneous dizziness/vertigo, recurrent spontaneous dizziness/vertigo, recurrent positional vertigo, or chronic persistent dizziness and imbalance. Vestibular neuritis and stroke are key disorders causing acute prolonged spontaneous dizziness/vertigo, but the diagnosis of isolated vascular vertigo has increased by virtue of developments in clinical neurotology and neuroimaging. However, a well-organized bedside examination appears more sensitive than brain imaging in diagnosing strokes presenting with acute dizziness/vertigo. A detailed history is vital to diagnose recurrent spontaneous dizziness/vertigo since confirmatory diagnostic tests are usually unavailable. Isolated positional vertigo is usually caused by benign paroxysmal positional vertigo, which can be treated at the bedside. In recent years, marked progress has occurred in the evaluation/management of acute dizziness/vertigo. However, even with developments in imaging technology, the diagnosis of acute dizziness/vertigo largely relies on bedside examination.  \nKeywords Dizziness; Vertigo; Stroke; Benign paroxysmal positional vertigo; Emergency service, hospital  \neISSN: 2383-4625  \nRev iew Article  \nReceived: 19 March 2015  \nRevised: 21 April 2015  \nAccepted: 21 April 2015  \nCorrespondence to: Ji-Soo Kim Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro, 173beon-gil, Bundang-gu, Seongnam 463-707, Korea  \n[E-mail: jisookim@snu.ac.kr](E-mail: jisookim@snu.ac.kr)  \nWhat is already known  \nAcute dizziness/vertigo is among the most common causes for visiting the emergency department.  \nWhat is new in the current study  \nA recently proposed approach to dizziness/vertigo begins with classifying those as acute prolonged spontaneous dizziness/vertigo, recurrent spontaneous dizziness/vertigo, recurrent positional vertigo, or chronic persistent dizziness and imbalance. Even with developments in imaging technology, the diagnosis of acute dizziness/vertigo largely relies on bedside examination.  \nHow to cite this article:  \nJung I, Kim JS. Approach to dizziness in the emergency department. Clin Exp Emerg Med 2015;2(2):75-88.  \nThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([http://](http://)[ ](http://)[creativecommons.org/licenses/by-nc/3.0/](creativecommons.org/licenses/by-nc/3.0/)).  \nCopyright © 2015 The Korean Society of Emergency Medicine 75  \nINTRODUCTION  \nAcute dizziness is among the most common causes for visiting the emergency department (ED).1 However, the differential diagnosis of dizziness is challenging for several reasons. First of all, dizziness can be a manifestation of conditions varying from lifethreatening disorders to normal physiologic responses. Second, no diagnostic confirmatory tool is available for most disorders causing dizziness. Thus, the diagnosis is largely based on a constellation of clinical features obtained with careful history taking and bedside examinations.2 Neither blood tests nor brain imaging are cost-effective when applied to dizzy patients without discrimination.3 Third, the term “dizziness” may represent various feelings including vertigo, lightheadedness, pre-syncope, unsteadiness, and just not feeling well.4 The tradition","cbCairqDYXq23lhF","https://ap.wps.com/l/cbCairqDYXq23lhF","pdf",2740009,1,14,"English","en",105,"# Introduction\n## Traditional vs newly proposed classification of dizziness\n## Review scope and focus\n# Acute spontaneous dizziness/vertigo\n## Clinical presentation and diagnostic approach","[{\"question\":\"Why is diagnosing dizziness in the emergency department challenging?\",\"answer\":\"Dizziness can indicate a wide range of conditions, from life-threatening disorders to normal physiologic responses, and most causes lack a confirmatory diagnostic tool. Therefore, diagnosis relies heavily on history and bedside examination.\"},{\"question\":\"What are the main categories in the newer approach to dizziness/vertigo?\",\"answer\":\"The newer approach classifies dizziness/vertigo into acute prolonged spontaneous, recurrent spontaneous, recurrent positional vertigo, or chronic persistent dizziness and imbalance. This structure aims to make differential diagnosis more practical in each category.\"},{\"question\":\"How does bedside examination compare with brain imaging for acute dizziness/vertigo?\",\"answer\":\"Even with advances in imaging technology, diagnosis of acute dizziness/vertigo largely depends on bedside examination. The article highlights that a well-organized bedside examination can be more sensitive than brain imaging for strokes presenting with acute dizziness/vertigo.\"}]","Approach to dizziness in the emergency department | PDF",1788609876,35,{"code":4,"msg":31,"data":32},"ok",{"site_id":24,"language":23,"slug":33,"title":13,"keywords":34,"description":14,"schema_data":35,"social_meta":87,"head_meta":89,"extra_data":91,"updated_unix":28},"approach-to-dizziness-in-the-emergency-department","",{"@graph":36,"@context":86},[37,54,69],{"@type":38,"itemListElement":39},"BreadcrumbList",[40,44,48,51],{"item":41,"name":42,"@type":43,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":45,"name":46,"@type":43,"position":47},"https://docshare.wps.com/document/","Document",2,{"item":49,"name":12,"@type":43,"position":50},"https://docshare.wps.com/document/healthcare/",3,{"item":52,"name":13,"@type":43,"position":53},"https://docshare.wps.com/document/approach-to-dizziness-in-the-emergency-department/209134/",4,{"url":52,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":23,"description":14,"dateModified":62,"datePublished":63,"encodingFormat":61,"isAccessibleForFree":64,"interactionStatistic":65},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":41,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-09-06","2026-09-05",true,{"@type":66,"interactionType":67,"userInteractionCount":20},"InteractionCounter",{"@type":68},"ViewAction",{"@type":70,"mainEntity":71},"FAQPage",[72,78,82],{"name":73,"@type":74,"acceptedAnswer":75},"Why is diagnosing dizziness in the emergency department challenging?","Question",{"text":76,"@type":77},"Dizziness can indicate a wide range of conditions, from life-threatening disorders to normal physiologic responses, and most causes lack a confirmatory diagnostic tool. Therefore, diagnosis relies heavily on history and bedside examination.","Answer",{"name":79,"@type":74,"acceptedAnswer":80},"What are the main categories in the newer approach to dizziness/vertigo?",{"text":81,"@type":77},"The newer approach classifies dizziness/vertigo into acute prolonged spontaneous, recurrent spontaneous, recurrent positional vertigo, or chronic persistent dizziness and imbalance. This structure aims to make differential diagnosis more practical in each category.",{"name":83,"@type":74,"acceptedAnswer":84},"How does bedside examination compare with brain imaging for acute dizziness/vertigo?",{"text":85,"@type":77},"Even with advances in imaging technology, diagnosis of acute dizziness/vertigo largely depends on bedside examination. 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