{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:40:34Z","timestamp":1790300434093,"version":"4.1.0"},"reference-count":125,"publisher":"Elsevier BV","issue":"4","license":[{"start":{"date-parts":[[2018,4,1]],"date-time":"2018-04-01T00:00:00Z","timestamp":1522540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2018,4,1]],"date-time":"2018-04-01T00:00:00Z","timestamp":1522540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jem-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Emergency Medicine"],"published-print":{"date-parts":[[2018,4]]},"DOI":"10.1016\/j.jemermed.2017.12.024","type":"journal-article","created":{"date-parts":[[2018,2,1]],"date-time":"2018-02-01T17:46:58Z","timestamp":1517507218000},"page":"469-483","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":116,"title":["A New Diagnostic Approach to the Adult Patient with Acute Dizziness"],"prefix":"10.1016","volume":"54","author":[{"given":"Jonathan A.","family":"Edlow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiersten L.","family":"Gurley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David E.","family":"Newman-Toker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jemermed.2017.12.024_bib1","doi-asserted-by":"crossref","first-page":"765","DOI":"10.4065\/83.7.765","article-title":"Spectrum of dizziness visits to US emergency departments: cross-sectional analysis from a nationally representative sample","volume":"83","author":"Newman-Toker","year":"2008","journal-title":"Mayo Clin Proc"},{"key":"10.1016\/j.jemermed.2017.12.024_bib2","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1136\/emj.2009.078014","article-title":"Predictors of important neurological causes of dizziness among patients presenting to the emergency department","volume":"27","author":"Cheung","year":"2010","journal-title":"Emerg Med J"},{"key":"10.1016\/j.jemermed.2017.12.024_bib3","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1111\/acem.12168","article-title":"Rising annual costs of dizziness presentations to U.S. emergency departments","volume":"20","author":"Saber Tehrani","year":"2013","journal-title":"Acad Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib4","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1002\/ana.24532","article-title":"Missed stroke in acute vertigo a time for action, not debate","volume":"79","author":"Newman-Toker","year":"2016","journal-title":"Ann Neurol"},{"issue":"Suppl 2","key":"10.1016\/j.jemermed.2017.12.024_bib5","doi-asserted-by":"crossref","first-page":"ii11","DOI":"10.1136\/bmjqs-2012-001616","article-title":"How much diagnostic safety can we afford, and how should we decide? A health economics perspective","volume":"22","author":"Newman-Toker","year":"2013","journal-title":"BMJ Qual Saf"},{"key":"10.1016\/j.jemermed.2017.12.024_bib6","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/j.ncl.2015.04.009","article-title":"Misdiagnosing dizzy patients: common pitfalls in clinical practice","volume":"33","author":"Kerber","year":"2015","journal-title":"Neurol Clin"},{"key":"10.1016\/j.jemermed.2017.12.024_bib7","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.ncl.2015.04.011","article-title":"TiTrATE: a novel, evidence-based approach to diagnosing acute dizziness and vertigo","volume":"33","author":"Newman-Toker","year":"2015","journal-title":"Neurol Clin"},{"key":"10.1016\/j.jemermed.2017.12.024_bib8","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1212\/01.CON.0000421618.33654.8a","article-title":"Symptoms and signs of neuro-otologic disorders","volume":"18","author":"Newman-Toker","year":"2012","journal-title":"Continuum (Minneap Minn)"},{"key":"10.1016\/j.jemermed.2017.12.024_bib9","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/S1474-4422(08)70216-3","article-title":"Diagnosis and initial management of cerebellar infarction","volume":"7","author":"Edlow","year":"2008","journal-title":"Lancet Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib10","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.mayocp.2012.05.023","article-title":"Rate and predictors of serious neurologic causes of dizziness in the emergency department","volume":"87","author":"Navi","year":"2012","journal-title":"Mayo Clin Proc"},{"key":"10.1016\/j.jemermed.2017.12.024_bib11","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.ajem.2011.02.002","article-title":"ED patients with vertigo: can we identify clinical factors associated with acute stroke?","volume":"30","author":"Chase","year":"2012","journal-title":"Am J Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib12","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1002\/lary.20597","article-title":"Vertebrobasilar insufficiency presenting as isolated positional vertigo or dizziness: a double-blind retrospective cohort study","volume":"119","author":"Moubayed","year":"2009","journal-title":"Laryngoscope"},{"key":"10.1016\/j.jemermed.2017.12.024_bib13","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1212\/WNL.0000000000002141","article-title":"Stroke risk stratification in acute dizziness presentations: A prospective imaging-based study","volume":"85","author":"Kerber","year":"2015","journal-title":"Neurology"},{"key":"10.1016\/j.jemermed.2017.12.024_bib14","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1161\/STROKEAHA.111.646414","article-title":"Application of the ABCD2 score to identify cerebrovascular causes of dizziness in the emergency department","volume":"43","author":"Navi","year":"2012","journal-title":"Stroke"},{"key":"10.1016\/j.jemermed.2017.12.024_bib15","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1212\/WNL.22.4.323","article-title":"An approach to the dizzy patient","volume":"22","author":"Drachman","year":"1972","journal-title":"Neurology"},{"key":"10.1016\/j.jemermed.2017.12.024_bib16","series-title":"Diagnosing Dizziness in the Emergency Department: Why \u201cwhat do you mean by 'dizzy'?\u201d Should Not be the First Question You Ask [PhD]","author":"Newman-Toker","year":"2007"},{"key":"10.1016\/j.jemermed.2017.12.024_bib17","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1111\/acem.12234","article-title":"Diagnosing dizziness: we are teaching the wrong paradigm!","volume":"20","author":"Edlow","year":"2013","journal-title":"Acad Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib18","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.annemergmed.2007.03.037","article-title":"Charted records of dizzy patients suggest emergency physicians emphasize symptom quality in diagnostic assessment","volume":"50","author":"Newman-Toker","year":"2007","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib19","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.4065\/82.11.1329","article-title":"Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting","volume":"82","author":"Newman-Toker","year":"2007","journal-title":"Mayo Clin Proc"},{"key":"10.1016\/j.jemermed.2017.12.024_bib20","doi-asserted-by":"crossref","first-page":"2484","DOI":"10.1161\/01.STR.0000240329.48263.0d","article-title":"Stroke among patients with dizziness, vertigo, and imbalance in the emergency department: a population-based study","volume":"37","author":"Kerber","year":"2006","journal-title":"Stroke"},{"key":"10.1016\/j.jemermed.2017.12.024_bib21","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1007\/s11606-008-0801-z","article-title":"How often is dizziness from primary cardiovascular disease true vertigo? A systematic review","volume":"23","author":"Newman-Toker","year":"2008","journal-title":"J Gen Intern Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib22","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1093\/qjmed\/hci057","article-title":"Benign paroxysmal positional vertigo: clinical characteristics of dizzy patients referred to a Falls and Syncope Unit","volume":"98","author":"Lawson","year":"2005","journal-title":"QJM"},{"key":"10.1016\/j.jemermed.2017.12.024_bib23","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.4065\/82.11.1319","article-title":"Overreliance on symptom quality in diagnosing dizziness: results of a multicenter survey of emergency physicians","volume":"82","author":"Stanton","year":"2007","journal-title":"Mayo Clin Proc"},{"key":"10.1016\/j.jemermed.2017.12.024_bib24","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1159\/000331046","article-title":"Dizziness in the emergency room: diagnoses and misdiagnoses","volume":"66","author":"Royl","year":"2011","journal-title":"Eur Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib25","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1097\/MAO.0b013e318238ff9a","article-title":"Misdiagnosis of acute peripheral vestibulopathy in central nervous ischemic infarction","volume":"32","author":"Braun","year":"2011","journal-title":"Otol Neurotol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib26","first-page":"1518","article-title":"Cerebellar infarctions mimicking acute peripheral vertigo: how to avoid misdiagnosis?","volume":"32","author":"Casani","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"key":"10.1016\/j.jemermed.2017.12.024_bib27","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1212\/01.wnl.0000238500.02302.b4","article-title":"Cerebellar infarction presenting with isolated vertigo: frequency and vascular topographical patterns","volume":"67","author":"Lee","year":"2006","journal-title":"Neurology"},{"key":"10.1016\/j.jemermed.2017.12.024_bib28","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1016\/S1474-4422(07)70248-X","article-title":"A transient ischaemic attack clinic with round-the-clock access (SOS-TIA): feasibility and effects","volume":"6","author":"Lavall\u00e9e","year":"2007","journal-title":"Lancet Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib29","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1016\/S0140-6736(07)61448-2","article-title":"Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison","volume":"370","author":"Rothwell","year":"2007","journal-title":"Lancet"},{"key":"10.1016\/j.jemermed.2017.12.024_bib30","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1197\/j.aem.2006.06.060","article-title":"Pitfalls in the diagnosis of cerebellar infarction","volume":"14","author":"Savitz","year":"2007","journal-title":"Acad Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib31","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1016\/j.jstrokecerebrovasdis.2010.03.005","article-title":"Factors associated with misdiagnosis of acute stroke in young adults","volume":"20","author":"Kuruvilla","year":"2011","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.1016\/j.jemermed.2017.12.024_bib32","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.annemergmed.2010.06.564","article-title":"Zero on the NIHSS does not equal the absence of stroke","volume":"57","author":"Martin-Schild","year":"2011","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib33","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1161\/01.STR.0000217200.61167.39","article-title":"Perceptual, social, and behavioral factors associated with delays in seeking medical care in patients with symptoms of acute stroke","volume":"37","author":"Mandelzweig","year":"2006","journal-title":"Stroke"},{"key":"10.1016\/j.jemermed.2017.12.024_bib34","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.jstrokecerebrovasdis.2012.10.004","article-title":"Factors associated with the misdiagnosis of cerebellar infarction","volume":"22","author":"Masuda","year":"2013","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.1016\/j.jemermed.2017.12.024_bib35","first-page":"29","article-title":"Misssed diagnosis of stroke in the ED: a cross-sectional analysis of a large population based sample","volume":"2","author":"Newman-Toker","year":"2014","journal-title":"Diagnosis (Berl)"},{"key":"10.1016\/j.jemermed.2017.12.024_bib36","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/j.jstrokecerebrovasdis.2013.07.029","article-title":"Discrimination of acute ischemic stroke from nonischemic vertigo in patients presenting with only imbalance","volume":"23","author":"Honda","year":"2014","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.1016\/j.jemermed.2017.12.024_bib37","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.jstrokecerebrovasdis.2008.05.002","article-title":"Patients with acute stroke admitted on the second visit","volume":"17","author":"Nakajima","year":"2008","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"10.1016\/j.jemermed.2017.12.024_bib38","doi-asserted-by":"crossref","first-page":"e35923","DOI":"10.1371\/journal.pone.0035923","article-title":"Increased risk of vascular events in emergency room patients discharged home with diagnosis of dizziness or vertigo: a 3-year follow-up study","volume":"7","author":"Lee","year":"2012","journal-title":"PLoS One"},{"key":"10.1016\/j.jemermed.2017.12.024_bib39","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/ana.24521","article-title":"Outcomes among patients discharged from the emergency department with a diagnosis of peripheral vertigo","volume":"79","author":"Atzema","year":"2016","journal-title":"Ann Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib40","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1002\/ana.24172","article-title":"Stroke risk after nonstroke emergency department dizziness presentations: a population-based cohort study","volume":"75","author":"Kerber","year":"2014","journal-title":"Ann Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib41","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.annemergmed.2010.06.559","article-title":"Risk of vascular events in emergency department patients discharged home with diagnosis of dizziness or vertigo","volume":"57","author":"Kim","year":"2011","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib42","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1111\/j.1553-2712.2009.00523.x","article-title":"Disconnect between charted vestibular diagnoses and emergency department management decisions: a cross-sectional analysis from a nationally representative sample","volume":"16","author":"Newman-Toker","year":"2009","journal-title":"Acad Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib43","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/j.1553-2712.2011.01093.x","article-title":"Nystagmus assessments documented by emergency physicians in acute dizziness presentations: a target for decision support?","volume":"18","author":"Kerber","year":"2011","journal-title":"Acad Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib44","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1212\/WNL.0000000000003814","article-title":"ED misdiagnosis of cerebrovascular events in the era of modern neuroimaging: a meta-analysis","volume":"88","author":"Tarnutzer","year":"2017","journal-title":"Neurology"},{"key":"10.1016\/j.jemermed.2017.12.024_bib45","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.jemermed.2015.10.040","article-title":"Using the physical examination to diagose patients with acute dizziness and vertigo","volume":"50","author":"Edlow","year":"2016","journal-title":"J Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib46","doi-asserted-by":"crossref","first-page":"E571","DOI":"10.1503\/cmaj.100174","article-title":"Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome","volume":"183","author":"Tarnutzer","year":"2011","journal-title":"CMAJ"},{"key":"10.1016\/j.jemermed.2017.12.024_bib47","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.ncl.2015.04.002","article-title":"Medical and nonstroke neurologic causes of acute, continuous vestibular symptoms","volume":"33","author":"Edlow","year":"2015","journal-title":"Neurol Clin"},{"key":"10.1016\/j.jemermed.2017.12.024_bib48","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1007\/s00415-013-6850-1","article-title":"Multiple sclerosis as a cause of the acute vestibular syndrome","volume":"260","author":"Pula","year":"2013","journal-title":"J Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib49","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1136\/emj.2010.104844","article-title":"Does intracerebral haemorrhage mimic benign dizziness presentations? A population based study","volume":"29","author":"Kerber","year":"2012","journal-title":"Emerg Med J"},{"key":"10.1016\/j.jemermed.2017.12.024_bib50","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1212\/01.CPJ.0000435749.32868.91","article-title":"Vestibular signs of thiamine deficiency during the early phase of suspected Wernicke encephalopathy","volume":"3","author":"Kattah","year":"2013","journal-title":"Neurol Clin Pract"},{"key":"10.1016\/j.jemermed.2017.12.024_bib51","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1136\/emj.2010.105874","article-title":"Diagnosis of acute vertigo in the emergency department","volume":"28","author":"Cutfield","year":"2011","journal-title":"Emerg Med J"},{"key":"10.1016\/j.jemermed.2017.12.024_bib52","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1159\/000046131","article-title":"HSV-1 not only in human vestibular ganglia but also in the vestibular labyrinth","volume":"6","author":"Arbusow","year":"2001","journal-title":"Audiol Neurootol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib53","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1097\/00005537-200302000-00020","article-title":"Vertigo from herpes zoster oticus: superior or inferior vestibular nerve origin?","volume":"113","author":"Lu","year":"2003","journal-title":"Laryngoscope"},{"key":"10.1016\/j.jemermed.2017.12.024_bib54","doi-asserted-by":"crossref","first-page":"427","DOI":"10.3233\/VES-1998-8603","article-title":"High resolution Gd-DTPA MR imaging of the inner ear in 60 patients with idiopathic vestibular neuritis: no evidence for contrast enhancement of the labyrinth or vestibular nerve","volume":"8","author":"Strupp","year":"1998","journal-title":"J Vestib Res"},{"key":"10.1016\/j.jemermed.2017.12.024_bib55","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1056\/NEJMcp021154","article-title":"Clinical practice. Vestibular neuritis","volume":"348","author":"Baloh","year":"2003","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib56","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0140-6736(07)60151-2","article-title":"Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison","volume":"369","author":"Chalela","year":"2007","journal-title":"Lancet"},{"key":"10.1016\/j.jemermed.2017.12.024_bib57","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1212\/CPJ.0000000000000028","article-title":"Isolated vestibular syndrome in posterior circulation stroke: frequency and involved structures","volume":"4","author":"Choi","year":"2014","journal-title":"Neurol Clin Pract"},{"key":"10.1016\/j.jemermed.2017.12.024_bib58","doi-asserted-by":"crossref","first-page":"3504","DOI":"10.1161\/STROKEAHA.109.551234","article-title":"HINTS to diagnose stroke in the acute vestibular syndrome: three-step bedside oculomotor examination more sensitive than early MRI diffusion-weighted imaging","volume":"40","author":"Kattah","year":"2009","journal-title":"Stroke"},{"key":"10.1016\/j.jemermed.2017.12.024_bib59","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1212\/WNL.0000000000000573","article-title":"Small strokes causing severe vertigo: frequency of false-negative MRIs and nonlacunar mechanisms","volume":"83","author":"Saber Tehrani","year":"2014","journal-title":"Neurology"},{"key":"10.1016\/j.jemermed.2017.12.024_bib60","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1111\/acem.12223","article-title":"HINTS outperforms ABCD2 to screen for stroke in acute continuous vertigo and dizziness","volume":"20","author":"Newman-Toker","year":"2013","journal-title":"Acad Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib61","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1007\/s00415-010-5853-4","article-title":"Diagnostic accuracy of acute vestibular syndrome at the bedside in a stroke unit","volume":"258","author":"Chen","year":"2011","journal-title":"J Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib62","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1111\/1742-6723.12372","article-title":"Can emergency physicians accurately and reliably assess acute vertigo in the emergency department?","volume":"27","author":"Vanni","year":"2015","journal-title":"Emerg Med Australas"},{"key":"10.1016\/j.jemermed.2017.12.024_bib63","first-page":"419","article-title":"Standing, a four-step bedside algorithm for differential diagnosis of acute vertigo in the emergency department","volume":"34","author":"Vanni","year":"2014","journal-title":"ACTA Otorhinolaryngol Ital"},{"key":"10.1016\/j.jemermed.2017.12.024_bib64","first-page":"348","article-title":"In reply","volume":"21","author":"Newman-Toker","year":"2014","journal-title":"Acad Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib65","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1212\/WNL.0000000000003223","article-title":"Vestibular neuritis affects both superior and inferior vestibular nerves","volume":"87","author":"Taylor","year":"2016","journal-title":"Neurology"},{"key":"10.1016\/j.jemermed.2017.12.024_bib66","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1136\/jnnp.2009.174128","article-title":"Penlight-cover test: a new bedside method to unmask nystagmus","volume":"80","author":"Newman-Toker","year":"2009","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.1016\/j.jemermed.2017.12.024_bib67","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1055\/s-0035-1564298","article-title":"Diagnosing stroke in acute vertigo: the HINTS family of eye movement tests and the future of the \u201cEye ECG.\u201d","volume":"35","author":"Newman-Toker","year":"2015","journal-title":"Semin Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib68","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1001\/archneur.1988.00520310043015","article-title":"A clinical sign of canal paresis","volume":"45","author":"Halmagyi","year":"1988","journal-title":"Arch Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib69","doi-asserted-by":"crossref","first-page":"2378","DOI":"10.1212\/01.wnl.0000314685.01433.0d","article-title":"Normal head impulse test differentiates acute cerebellar strokes from vestibular neuritis","volume":"70","author":"Newman-Toker","year":"2008","journal-title":"Neurology"},{"key":"10.1016\/j.jemermed.2017.12.024_bib70","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1080\/000164800750000207","article-title":"Auditory dysfunction in stroke","volume":"120","author":"Hausler","year":"2000","journal-title":"Acta Otolaryngol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib71","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3988\/jcn.2009.5.2.65","article-title":"Neuro-otological aspects of cerebellar stroke syndrome","volume":"5","author":"Lee","year":"2009","journal-title":"J Clin Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib72","doi-asserted-by":"crossref","first-page":"3745","DOI":"10.1161\/STROKEAHA.109.564682","article-title":"Infarction in the territory of anterior inferior cerebellar artery: spectrum of audiovestibular loss","volume":"40","author":"Lee","year":"2009","journal-title":"Stroke"},{"key":"10.1016\/j.jemermed.2017.12.024_bib73","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/j.ncl.2015.04.006","article-title":"Acute diagnosis and management of stroke presenting dizziness or vertigo","volume":"33","author":"Lee","year":"2015","journal-title":"Neurol Clin"},{"key":"10.1016\/j.jemermed.2017.12.024_bib74","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1097\/MLG.0b013e318157f77f","article-title":"Wrong-way nystagmus in the AICA syndrome [letter to the editor]","volume":"118","author":"Newman-Toker","year":"2008","journal-title":"Laryngoscope"},{"key":"10.1016\/j.jemermed.2017.12.024_bib75","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.1007\/s00415-016-8214-0","article-title":"Vertigo with sudden hearing loss: audio-vestibular characteristics","volume":"263","author":"Pogson","year":"2016","journal-title":"J Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib76","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1093\/brain\/awg169","article-title":"Pure lateral medullary infarction: clinical-radiological correlation of 130 acute, consecutive patients","volume":"126","author":"Kim","year":"2003","journal-title":"Brain"},{"key":"10.1016\/j.jemermed.2017.12.024_bib77","doi-asserted-by":"crossref","first-page":"125","DOI":"10.3389\/fneur.2016.00125","article-title":"The diagnostic accuracy of truncal ataxia and HINTS as cardinal signs for acute vestibular syndrome","volume":"7","author":"Carmona","year":"2016","journal-title":"Front Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib78","doi-asserted-by":"crossref","first-page":"768","DOI":"10.5811\/westjem.2015.7.26158","article-title":"Emergency physician attitudes, preferences, and risk tolerance for stroke as a potential cause of dizziness symptoms","volume":"16","author":"Kene","year":"2015","journal-title":"West J Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib79","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1161\/STROKEAHA.116.015507","article-title":"Acute transient vestibular syndrome: prevalence of stroke and efficacy of bedside evaluation","volume":"48","author":"Choi","year":"2017","journal-title":"Stroke"},{"key":"10.1016\/j.jemermed.2017.12.024_bib80","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1212\/01.wnl.0000237539.09942.06","article-title":"Migrainous vertigo: prevalence and impact on quality of life","volume":"67","author":"Neuhauser","year":"2006","journal-title":"Neurology"},{"key":"10.1016\/j.jemermed.2017.12.024_bib81","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.ncl.2015.04.008","article-title":"Early diagnosis and management of acute vertigo from vestibular migraine and meniere's disease","volume":"33","author":"Seemungal","year":"2015","journal-title":"Neurol Clin"},{"key":"10.1016\/j.jemermed.2017.12.024_bib82","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/S0072-9752(10)97062-0","article-title":"Vestibular migraine","volume":"97","author":"Strupp","year":"2010","journal-title":"Handb Clin Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib83","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.ncl.2015.04.005","article-title":"Transient ischemic attacks presenting with dizziness or vertigo","volume":"33","author":"Blum","year":"2015","journal-title":"Neurol Clin"},{"key":"10.1016\/j.jemermed.2017.12.024_bib84","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/S1474-4422(12)70299-5","article-title":"Transient isolated brainstem symptoms preceding posterior circulation stroke: a population-based study","volume":"12","author":"Paul","year":"2013","journal-title":"Lancet Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib85","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s10286-008-0465-0","article-title":"Influence of age and gender on the occurrence and presentation of reflex syncope","volume":"18","author":"Romme","year":"2008","journal-title":"Clin Auton Res"},{"key":"10.1016\/j.jemermed.2017.12.024_bib86","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.ncl.2010.11.002","article-title":"Ictal panic and interictal panic attacks: diagnostic and therapeutic principles","volume":"29","author":"Kanner","year":"2011","journal-title":"Neurol Clin"},{"key":"10.1016\/j.jemermed.2017.12.024_bib87","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1016\/j.jad.2008.04.014","article-title":"Non-fearful vs. fearful panic attacks: a general population study from the National Comorbidity Survey","volume":"112","author":"Chen","year":"2009","journal-title":"J Affect Disord"},{"key":"10.1016\/j.jemermed.2017.12.024_bib88","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1007\/s004150050478","article-title":"Episodic vertigo related to migraine (90 cases): vestibular migraine?","volume":"246","author":"Dieterich","year":"1999","journal-title":"J Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib89","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/S0140-6736(00)03642-4","article-title":"Observations on recurrent syncope and presyncope in 641 patients","volume":"357","author":"Mathias","year":"2001","journal-title":"Lancet"},{"key":"10.1016\/j.jemermed.2017.12.024_bib90","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1111\/j.1749-6632.2009.03852.x","article-title":"Vertigo as a symptom of migraine","volume":"1164","author":"Lempert","year":"2009","journal-title":"Ann N Y Acad Sci"},{"issue":"Pt 4","key":"10.1016\/j.jemermed.2017.12.024_bib91","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1093\/brain\/107.4.1123","article-title":"Neuro-otological manifestations of migraine","volume":"107","author":"Kayan","year":"1984","journal-title":"Brain"},{"key":"10.1016\/j.jemermed.2017.12.024_bib92","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/S0140-6736(08)61161-7","article-title":"Meniere's disease","volume":"372","author":"Sajjadi","year":"2008","journal-title":"Lancet"},{"key":"10.1016\/j.jemermed.2017.12.024_bib93","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/S0030-6665(02)00017-8","article-title":"History of Meniere's disease and its clinical presentation","volume":"35","author":"Mancini","year":"2002","journal-title":"Otolaryngol Clin North Am"},{"key":"10.1016\/j.jemermed.2017.12.024_bib94","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/j.1749-4486.2007.01552.x","article-title":"Symptoms experienced by patients with peripheral vestibular disorders: evaluation of the Vertigo Symptom Scale for clinical application","volume":"32","author":"Faag","year":"2007","journal-title":"Clin Otolaryngol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib95","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1038\/nrneurol.2009.99","article-title":"A guide to disorders causing transient loss of consciousness: focus on syncope","volume":"5","author":"van Dijk","year":"2009","journal-title":"Nat Rev Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib96","doi-asserted-by":"crossref","first-page":"2631","DOI":"10.1093\/eurheartj\/ehp298","article-title":"Guidelines for the diagnosis and management of syncope (version 2009)","volume":"30","author":"Moya","year":"2009","journal-title":"Eur Heart J"},{"key":"10.1016\/j.jemermed.2017.12.024_bib97","doi-asserted-by":"crossref","first-page":"2360","DOI":"10.1056\/NEJMcp052466","article-title":"Clinical practice. Panic disorder","volume":"354","author":"Katon","year":"2006","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib98","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.jns.2012.11.012","article-title":"Transient neurological attack before vertebrobasilar stroke","volume":"325","author":"Hoshino","year":"2013","journal-title":"J Neurol Sci"},{"key":"10.1016\/j.jemermed.2017.12.024_bib99","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1001\/archneur.1989.00520390047014","article-title":"Vertigo of vascular origin. Clinical and electronystagmographic features in 84 cases","volume":"46","author":"Grad","year":"1989","journal-title":"Arch Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib100","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1136\/jnnp.74.12.1621","article-title":"Heralding manifestations of basilar artery occlusion with lethal or severe stroke","volume":"74","author":"von Campe","year":"2003","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.1016\/j.jemermed.2017.12.024_bib101","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1001\/archotol.1967.00760040531010","article-title":"Vertigo in cerebrovascular disease","volume":"85","author":"Fisher","year":"1967","journal-title":"Arch Otolaryngol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib102","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1097\/NRL.0b013e31826754e1","article-title":"Clinical characteristics of symptomatic vertebral artery dissection: a systematic review","volume":"18","author":"Gottesman","year":"2012","journal-title":"Neurologist"},{"key":"10.1016\/j.jemermed.2017.12.024_bib103","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.annemergmed.2007.08.016","article-title":"Short-term prognosis of stroke among patients diagnosed in the emergency department with a transient ischemic attack","volume":"51","author":"Shah","year":"2008","journal-title":"Ann Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib104","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1093\/brain\/awg197","article-title":"Prognosis of vertebrobasilar transient ischaemic attack and minor stroke","volume":"126","author":"Flossmann","year":"2003","journal-title":"Brain"},{"key":"10.1016\/j.jemermed.2017.12.024_bib105","doi-asserted-by":"crossref","first-page":"2732","DOI":"10.1161\/STROKEAHA.109.553859","article-title":"Vertebrobasilar stenosis predicts high early recurrent stroke risk in posterior circulation stroke and TIA","volume":"40","author":"Gulli","year":"2009","journal-title":"Stroke"},{"key":"10.1016\/j.jemermed.2017.12.024_bib106","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1038\/ncpneuro0125","article-title":"'Cardiogenic vertigo'\u2014true vertigo as the presenting manifestation of primary cardiac disease","volume":"2","author":"Newman-Toker","year":"2006","journal-title":"Nat Clin Pract Neurol"},{"key":"10.1016\/j.jemermed.2017.12.024_bib107","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1212\/WNL.37.3.371","article-title":"Benign positional vertigo: clinical and oculographic features in 240 cases","volume":"37","author":"Baloh","year":"1987","journal-title":"Neurology"},{"key":"10.1016\/j.jemermed.2017.12.024_bib108","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.ncl.2015.04.003","article-title":"Benign Paroxysmal positional vertigo in the acute care setting","volume":"33","author":"Fife","year":"2015","journal-title":"Neurol Clin"},{"issue":"Suppl","key":"10.1016\/j.jemermed.2017.12.024_bib109","doi-asserted-by":"crossref","first-page":"S47","DOI":"10.1016\/j.otohns.2008.08.022","article-title":"Clinical practice guideline: benign paroxysmal positional vertigo","volume":"139","author":"Bhattacharyya","year":"2008","journal-title":"Otolaryngol Head Neck Surg"},{"key":"10.1016\/j.jemermed.2017.12.024_bib110","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1212\/01.wnl.0000313378.77444.ac","article-title":"Practice parameter: therapies for benign paroxysmal positional vertigo (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology","volume":"70","author":"Fife","year":"2008","journal-title":"Neurology"},{"key":"10.1016\/j.jemermed.2017.12.024_bib111","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.ncl.2015.04.001","article-title":"Bedside assessment of acute dizziness and vertigo","volume":"33","author":"Welgampola","year":"2015","journal-title":"Neurol Clin"},{"key":"10.1016\/j.jemermed.2017.12.024_bib112","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1111\/1742-6723.12362","article-title":"Are emergency physicians and paramedics providing canalith repositioning manoeuvre for benign paroxysmal positional vertigo?","volume":"27","author":"Bashir","year":"2015","journal-title":"Emerg Med Australasia"},{"key":"10.1016\/j.jemermed.2017.12.024_bib113","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1177\/0194599812471633","article-title":"Use of BPPV processes in emergency department dizziness presentations: a population-based study","volume":"148","author":"Kerber","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"key":"10.1016\/j.jemermed.2017.12.024_bib114","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1093\/qjmed\/hct006","article-title":"Revised criteria for suspicion of non-benign positional vertigo","volume":"106","author":"Soto-Varela","year":"2013","journal-title":"QJM"},{"key":"10.1016\/j.jemermed.2017.12.024_bib115","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1053\/ajem.2002.34964","article-title":"Prevalence of orthostatic hypotension among patients presenting with syncope in the ED","volume":"20","author":"Sarasin","year":"2002","journal-title":"Am J Emerg Med"},{"key":"10.1016\/j.jemermed.2017.12.024_bib116","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s10286-011-0119-5","article-title":"Consensus statement on the definition of orthostatic hypotension, neurally mediated syncope and the postural tachycardia syndrome","volume":"21","author":"Freeman","year":"2011","journal-title":"Clin Auton Res"},{"key":"10.1016\/j.jemermed.2017.12.024_bib117","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1097\/HJH.0b013e3283279860","article-title":"Orthostatic hypotension in genetically related hypertensive and normotensive individuals","volume":"27","author":"Fedorowski","year":"2009","journal-title":"J Hypertens"},{"key":"10.1016\/j.jemermed.2017.12.024_bib118","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1097\/00007611-199309000-00011","article-title":"Immediate orthostatic hypotension: diagnostic value in acutely ill patients","volume":"86","author":"Gilbert","year":"1993","journal-title":"South Med J"},{"key":"10.1016\/j.jemermed.2017.12.024_bib119","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1136\/jnnp.2006.100420","article-title":"Epidemiology of benign paroxysmal positional vertigo: a population based study","volume":"78","author":"von Brevern","year":"2007","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.1016\/j.jemermed.2017.12.024_bib120","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1067\/mhn.2000.105415","article-title":"Unrecognized benign paroxysmal positional vertigo in elderly patients","volume":"122","author":"Oghalai","year":"2000","journal-title":"Otolaryngol Head Neck Surg"},{"key":"10.1016\/j.jemermed.2017.12.024_bib121","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/j.1365-2710.2005.00629.x","article-title":"High prevalence of orthostatic hypotension and its correlation with potentially causative medications among elderly veterans","volume":"30","author":"Poon","year":"2005","journal-title":"J Clin Pharm Ther"},{"key":"10.1016\/j.jemermed.2017.12.024_bib122","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s10286-010-0114-2","article-title":"Prevalence and complications of orthostatic dizziness in the general population","volume":"21","author":"Radtke","year":"2011","journal-title":"Clin Auton Res"},{"key":"10.1016\/j.jemermed.2017.12.024_bib123","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1291\/hypres.31.897","article-title":"Population-based study on the prevalence and correlates of orthostatic hypotension\/hypertension and orthostatic dizziness","volume":"31","author":"Wu","year":"2008","journal-title":"Hypertens Res"},{"key":"10.1016\/j.jemermed.2017.12.024_bib124","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1136\/jnnp.46.10.883","article-title":"Primary orthostatic cerebral ischaemia","volume":"46","author":"Stark","year":"1983","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.1016\/j.jemermed.2017.12.024_bib125","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/S0303-8467(97)00015-2","article-title":"Spontaneous intracranial hypotension: clinical and magnetic resonance imaging characteristics","volume":"99","author":"Blank","year":"1997","journal-title":"Clin Neurol Neurosurg"}],"container-title":["The Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0736467917311903?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0736467917311903?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:40:38Z","timestamp":1760028038000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0736467917311903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":125,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,4]]}},"alternative-id":["S0736467917311903"],"URL":"https:\/\/doi.org\/10.1016\/j.jemermed.2017.12.024","relation":{},"ISSN":["0736-4679"],"issn-type":[{"value":"0736-4679","type":"print"}],"subject":[],"published":{"date-parts":[[2018,4]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A New Diagnostic Approach to the Adult Patient with Acute Dizziness","name":"articletitle","label":"Article Title"},{"value":"The Journal of Emergency Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jemermed.2017.12.024","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2017 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}