Vertigo presentations in the emergency department

Vertigo is among the most common reasons that patients present to the emergency department. Even though the cause is typically a benign disorder, management decisions can be challenging because some sinister causes-such as stroke-can mimic benign peripheral vestibular disorders. Fortunately, common benign peripheral vestibular disorders all have characteristic features enabling a bedside diagnosis. Thus the most effective way to "rule-out" a central disorder is to "rule-in" a specific peripheral vestibular disorder. In this article, the author emphasizes the key elements of the bedside examination and describes a method for managing vertigo patients in the emergency department.