Triggered episodic vestibular syndrome
Triggered by movement (change in body position, head mvmt, valsalva)
Lasts sec to hours with asymptomatic periods in between
Benign:BPPV (Dix Hallpike), orthostatic hypotension (fluids)
Dangerous: Posterior Fossa Tumor
Triggered by movement (change in body position, head mvmt, valsalva)
Lasts sec to hours with asymptomatic periods in between
Benign:BPPV (Dix Hallpike), orthostatic hypotension (fluids)
Dangerous: Posterior Fossa Tumor
Spontaneous episodic vestibular syndrome
Distinct onset
Lasts min to hours
Typically asymptomatic on presentation
Benign: Anxiety, vasovagal syncope, Meniere's
Dangerous: TIA, arrhythmia, PE
Distinct onset
Lasts min to hours
Typically asymptomatic on presentation
Benign: Anxiety, vasovagal syncope, Meniere's
Dangerous: TIA, arrhythmia, PE
Acute Vestibular Syndrome (AVS)
Abrupt and persistent
Can be exacerbated by movement but not triggered by it (i.e. symptoms persist at rest & exacerbated with movement)
Benign: Vestibular Neuritis, Labyrinthitis,
Dangerous: Posterior Stroke
Utilize HINTS Exam to differentiate
Remember, the HINTS Exam can only be used on symptomatic AVS patients according to the study
Abrupt and persistent
Can be exacerbated by movement but not triggered by it (i.e. symptoms persist at rest & exacerbated with movement)
Benign: Vestibular Neuritis, Labyrinthitis,
Dangerous: Posterior Stroke
Utilize HINTS Exam to differentiate
Remember, the HINTS Exam can only be used on symptomatic AVS patients according to the study
Remember, the HINTS Exam can only be used on symptomatic AVS patients according to the study
Vertigo
Vestibular/otologic
Tinnitus
Benign paroxysmal positional vertigo 
Sympathetic ophthalmia
Traumatic 
Herpes zoster ophthalmicus
Infection