Approaching Acute Vertigo With Diplopia: A Rare Skew Deviation in Vestibular Neuritis
Evaluating the patient with acute constant vertigo or diplopia can be a daunting task for clinicians, who recognize that such symptoms can be the manifestation of potentially devastating disorders like stroke but may be uncomfortable eliciting and interpreting the key symptoms and subtle signs that...
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2020-04-01
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2542454819301845 |
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doaj-dab17c3a5cce49b990013eb7d2764d132020-11-25T02:43:23ZengElsevierMayo Clinic Proceedings: Innovations, Quality & Outcomes2542-45482020-04-0142216222Approaching Acute Vertigo With Diplopia: A Rare Skew Deviation in Vestibular NeuritisScott D.Z. Eggers, MD0Jorge C. Kattah, MD1Department of Neurology, Mayo Clinic, Rochester, MN; Correspondence: Address to Scott D. Z. Eggers, MD, Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905Department of Neurology, University of Illinois College of Medicine at PeoriaEvaluating the patient with acute constant vertigo or diplopia can be a daunting task for clinicians, who recognize that such symptoms can be the manifestation of potentially devastating disorders like stroke but may be uncomfortable eliciting and interpreting the key symptoms and subtle signs that distinguish dangerous from benign causes. We present a novel and highly instructive case of a patient with acute vertigo and binocular diplopia from a large skew deviation due to vestibular neuritis. As the case unfolds, text and video commentary guide the clinician through the important elements of the history, bedside examination, and laboratory evaluation necessary for accurate diagnosis in the acute vestibular syndrome. We demonstrate how to interpret nystagmus and properly perform the head impulse test and test of skew deviation and discuss the pitfalls of overreliance on imaging when evaluating patients with acute vertigo.http://www.sciencedirect.com/science/article/pii/S2542454819301845 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Scott D.Z. Eggers, MD Jorge C. Kattah, MD |
spellingShingle |
Scott D.Z. Eggers, MD Jorge C. Kattah, MD Approaching Acute Vertigo With Diplopia: A Rare Skew Deviation in Vestibular Neuritis Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
author_facet |
Scott D.Z. Eggers, MD Jorge C. Kattah, MD |
author_sort |
Scott D.Z. Eggers, MD |
title |
Approaching Acute Vertigo With Diplopia: A Rare Skew Deviation in Vestibular Neuritis |
title_short |
Approaching Acute Vertigo With Diplopia: A Rare Skew Deviation in Vestibular Neuritis |
title_full |
Approaching Acute Vertigo With Diplopia: A Rare Skew Deviation in Vestibular Neuritis |
title_fullStr |
Approaching Acute Vertigo With Diplopia: A Rare Skew Deviation in Vestibular Neuritis |
title_full_unstemmed |
Approaching Acute Vertigo With Diplopia: A Rare Skew Deviation in Vestibular Neuritis |
title_sort |
approaching acute vertigo with diplopia: a rare skew deviation in vestibular neuritis |
publisher |
Elsevier |
series |
Mayo Clinic Proceedings: Innovations, Quality & Outcomes |
issn |
2542-4548 |
publishDate |
2020-04-01 |
description |
Evaluating the patient with acute constant vertigo or diplopia can be a daunting task for clinicians, who recognize that such symptoms can be the manifestation of potentially devastating disorders like stroke but may be uncomfortable eliciting and interpreting the key symptoms and subtle signs that distinguish dangerous from benign causes. We present a novel and highly instructive case of a patient with acute vertigo and binocular diplopia from a large skew deviation due to vestibular neuritis. As the case unfolds, text and video commentary guide the clinician through the important elements of the history, bedside examination, and laboratory evaluation necessary for accurate diagnosis in the acute vestibular syndrome. We demonstrate how to interpret nystagmus and properly perform the head impulse test and test of skew deviation and discuss the pitfalls of overreliance on imaging when evaluating patients with acute vertigo. |
url |
http://www.sciencedirect.com/science/article/pii/S2542454819301845 |
work_keys_str_mv |
AT scottdzeggersmd approachingacutevertigowithdiplopiaarareskewdeviationinvestibularneuritis AT jorgeckattahmd approachingacutevertigowithdiplopiaarareskewdeviationinvestibularneuritis |
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