{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T09:40:58Z","timestamp":1772271658873,"version":"3.50.1"},"reference-count":55,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pract Neurol"],"published-print":{"date-parts":[[2008,8]]},"abstract":"<jats:p>Patients complaining of symptoms of acute vertigo present a diagnostic challenge for the clinician; the main differential diagnoses are acute unilateral peripheral vestibulopathy (\u201cvestibular neuritis\u201d), cerebellar stroke or migraine. The head impulse test is useful in the acute situation because, of these three diagnostic alternatives, it will only be positive in patients with vestibular neuritis. A history of acute vertigo and hearing loss suggests M\u00e9ni\u00e8re\u2019s disease but the clinician must be wary of anterior inferior cerebellar artery strokes which may cause audiovestibular loss due to peripheral vestibulocochleal ischaemia, although the accompanying brainstem signs should remove diagnostic ambiguity. We also discuss other less common vertigo diagnoses that may be referred to the neurologist from the acute general hospital take. As ever in neurology, a careful history and focussed examination is necessary in the evaluation and management of acute vertigo.<\/jats:p>","DOI":"10.1136\/jnnp.2008.154799","type":"journal-article","created":{"date-parts":[[2008,7,28]],"date-time":"2008-07-28T18:54:08Z","timestamp":1217271248000},"page":"211-221","source":"Crossref","is-referenced-by-count":42,"title":["A practical approach to acute vertigo"],"prefix":"10.1136","volume":"8","author":[{"given":"B M","family":"Seemungal","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A M","family":"Bronstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2008,7,21]]},"reference":[{"issue":"(Suppl 1)","key":"2024052910314680000_8.4.211.1","doi-asserted-by":"crossref","first-page":"S24","DOI":"10.1007\/s10072-004-0212-9","article-title":"Dizziness and vertigo: an epidemiological survey and patient management in the emergency room.","volume":"25","author":"Crespi","year":"2004","journal-title":"Neurol Sci"},{"key":"2024052910314680000_8.4.211.2","doi-asserted-by":"publisher","DOI":"10.1159\/000073861"},{"key":"2024052910314680000_8.4.211.3","unstructured":"Bronstein AM Lempert T . Dizziness: a practical approach to diagnosis and management. Cambridge Clinical Guides. Cambridge: Cambridge University Press, 2007."},{"key":"2024052910314680000_8.4.211.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.mao.0000178128.66482.7e"},{"key":"2024052910314680000_8.4.211.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911183412107"},{"key":"2024052910314680000_8.4.211.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(96)70251-6"},{"key":"2024052910314680000_8.4.211.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneurobio.2004.11.001"},{"key":"2024052910314680000_8.4.211.8","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh351"},{"key":"2024052910314680000_8.4.211.9","doi-asserted-by":"crossref","first-page":"215","DOI":"10.3233\/VES-2005-15405","article-title":"The minimal ice water caloric test compared with established vestibular caloric test procedures.","volume":"15","author":"Schmal","year":"2005","journal-title":"J Vestib Res"},{"key":"2024052910314680000_8.4.211.10","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.130.2.229"},{"key":"2024052910314680000_8.4.211.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa033280"},{"key":"2024052910314680000_8.4.211.12","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1990.01870060058010"},{"key":"2024052910314680000_8.4.211.13","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/116.1.161"},{"key":"2024052910314680000_8.4.211.14","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.48.3.263"},{"key":"2024052910314680000_8.4.211.15","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.53.9.731"},{"key":"2024052910314680000_8.4.211.16","doi-asserted-by":"publisher","DOI":"10.1016\/0196-0709(91)90122-V"},{"key":"2024052910314680000_8.4.211.17","doi-asserted-by":"crossref","first-page":"1700","DOI":"10.1212\/01.WNL.0000063325.77498.20","article-title":"Nodulus infarction mimicking acute peripheral vestibulopathy.","volume":"60","author":"Lee","year":"2003","journal-title":"Neurology"},{"key":"2024052910314680000_8.4.211.18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2004.03.022"},{"key":"2024052910314680000_8.4.211.19","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1080\/00016480500279977","article-title":"Intracranial vertebral artery dissection mimicking acute peripheral vertigo.","volume":"126","author":"Horii","year":"2006","journal-title":"Acta Otolaryngol"},{"key":"2024052910314680000_8.4.211.20","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.58.4.490"},{"key":"2024052910314680000_8.4.211.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.mric.2006.06.005"},{"key":"2024052910314680000_8.4.211.22","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.56.4.436"},{"key":"2024052910314680000_8.4.211.23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.1992.hed3206300.x"},{"key":"2024052910314680000_8.4.211.24","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000036903.22461.39"},{"key":"2024052910314680000_8.4.211.25","doi-asserted-by":"crossref","first-page":"244","DOI":"10.2466\/pms.101.1.244-256","article-title":"Effect of a novel motion desensitization training regime and controlled breathing on habituation to motion sickness.","volume":"101","author":"Yen Pik Sang","year":"2005","journal-title":"Percept Mot Skills"},{"key":"2024052910314680000_8.4.211.26","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1007\/s00415-006-0144-9","article-title":"Three patients with migraine following caloric-induced vestibular stimulation.","volume":"253","author":"Seemungal","year":"2006","journal-title":"J Neurol"},{"key":"2024052910314680000_8.4.211.27","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050478"},{"key":"2024052910314680000_8.4.211.28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/00005537-199801001-00001","article-title":"Medical management of migraine-related dizziness and vertigo.","volume":"108","author":"Johnson","year":"1998","journal-title":"Laryngoscope"},{"key":"2024052910314680000_8.4.211.29","first-page":"350","article-title":"Efficacy of antimigrainous therapy in the treatment of migraine-associated dizziness.","volume":"18","author":"Bikhazi","year":"1997","journal-title":"Am J Otol"},{"key":"2024052910314680000_8.4.211.30","doi-asserted-by":"publisher","DOI":"10.1080\/00016480600606673"},{"key":"2024052910314680000_8.4.211.31","doi-asserted-by":"crossref","first-page":"247","DOI":"10.3109\/00016489509125239","article-title":"Bilateral loss of vestibular function.","volume":"520","author":"Rinne","year":"1995","journal-title":"Acta Otolaryngol Suppl"},{"key":"2024052910314680000_8.4.211.32","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39388.451019.1F"},{"key":"2024052910314680000_8.4.211.33","doi-asserted-by":"publisher","DOI":"10.1097\/00019052-200402000-00004"},{"key":"2024052910314680000_8.4.211.34","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(95)70100-1"},{"key":"2024052910314680000_8.4.211.35","doi-asserted-by":"publisher","DOI":"10.1097\/00129492-200501000-00013"},{"key":"2024052910314680000_8.4.211.36","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1161\/01.STR.12.4.521","article-title":"Bilateral deafness of vascular origin.","volume":"12","author":"Khurana","year":"1981","journal-title":"Stroke"},{"key":"2024052910314680000_8.4.211.37","doi-asserted-by":"publisher","DOI":"10.1002\/lary.5541011215"},{"key":"2024052910314680000_8.4.211.38","doi-asserted-by":"publisher","DOI":"10.1016\/0196-0709(94)90091-4"},{"key":"2024052910314680000_8.4.211.39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.wco.0000196155.92856.a1","article-title":"Sudden deafness.","volume":"19","author":"Mort","year":"2006","journal-title":"Curr Opin Neurol"},{"key":"2024052910314680000_8.4.211.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2004.10.016"},{"key":"2024052910314680000_8.4.211.41","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/S0194-59989670224-3","article-title":"Audiologic findings in unilateral deafness resulting from contralateral pontine infarct.","volume":"114","author":"Doyle","year":"1996","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2024052910314680000_8.4.211.42","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000038692.17290.24"},{"key":"2024052910314680000_8.4.211.43","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1212\/01.WNL.0000120757.35082.35","article-title":"Sudden unilateral deafness due to a right vertebral artery dissection.","volume":"62","author":"Raupp","year":"2004","journal-title":"Neurology"},{"key":"2024052910314680000_8.4.211.44","doi-asserted-by":"publisher","DOI":"10.1080\/00016480510033676"},{"key":"2024052910314680000_8.4.211.45","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1989.00520390047014"},{"key":"2024052910314680000_8.4.211.46","first-page":"9","article-title":"Relationship between cystic change and rotatory vertigo in patients with acoustic neuroma.","volume":"542","author":"Sugimoto","year":"2000","journal-title":"Acta Otolaryngol Suppl"},{"key":"2024052910314680000_8.4.211.47","first-page":"1101","article-title":"[Case of acoustic neurinoma with intratumoral hemorrhage extending to cerebellar hemisphere].","volume":"12","author":"Ihara","year":"1984","journal-title":"No Shinkei Geka"},{"key":"2024052910314680000_8.4.211.48","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/S0150-9861(05)83139-6","article-title":"Hemorrhagic acoustic schwannoma: radiological and histopathological findings.","volume":"32","author":"Schlieter","year":"2005","journal-title":"J Neuroradiol"},{"key":"2024052910314680000_8.4.211.49","first-page":"321","volume":"82","author":"Voss","year":"1968","journal-title":"Kinderheilk"},{"key":"2024052910314680000_8.4.211.50","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1288\/00005537-196504000-00007","article-title":"Inner ear hemorrhage in leukaemia. A case report.","volume":"75","author":"Schuknecht","year":"1965","journal-title":"Laryngoscope"},{"key":"2024052910314680000_8.4.211.51","first-page":"1437","article-title":"Spontaneous labyrinthine hemorrhage in sickle cell disease.","volume":"19","author":"Whitehead","year":"1998","journal-title":"AJNR Am J Neuroradiol"},{"key":"2024052910314680000_8.4.211.52","doi-asserted-by":"publisher","DOI":"10.1007\/s004050000236"},{"key":"2024052910314680000_8.4.211.53","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-438X(05)82348-5"},{"key":"2024052910314680000_8.4.211.54","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1080\/00016480510033658","article-title":"Intralabyrinthine haemorrhage following cocaine consumption.","volume":"125","author":"Nicoucar","year":"2005","journal-title":"Acta Otolaryngol"},{"key":"2024052910314680000_8.4.211.55","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000215206.75542.BF"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnnp.2008.154799","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T17:32:56Z","timestamp":1717003976000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/jnnp.2008.154799"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,7,21]]},"references-count":55,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2008,7,21]]},"published-print":{"date-parts":[[2008,8]]}},"alternative-id":["10.1136\/jnnp.2008.154799"],"URL":"https:\/\/doi.org\/10.1136\/jnnp.2008.154799","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,7,21]]}}}