An Approach to Vertigo

Beautifully explained sir. 👏👏

This is gold!

Great informative video.

You are just so amazing. Can't thank you enough.

I keep coming back to your videos, they are amazing

OK, so at a former job, I used to spend hours with my head positioned diagonally, being that I'm tall and have a long neck. The chair was not adjusted to my height. Often I would get dizzy and have a hard time keeping my balance once I left the office and during the break. Perhaps using earphones and taking collagen worsened it. I tried the Epley and Hallpike technique and it seemed to work somewhat.

Thank you Doctor Strong and Merry Christmas. I will watch again about HINTS exam, strange that I never learned this on those years, never heard,.

I have a couple questions as a follow-up to this extremely informative video:
1) will central vertigo ever be episodic, or or if it comes and goes can I be pretty certain it's peripheral?
2) do you have a concise description for an abnormal dix Hall pike? (Does any nystagmus indicate a positive test, or do different directions mean differing things?)
3) With a NORMAL dix Hall pike but episodic vertigo and normal neuro exam, would this suggest non-BPPV peripheral vertigo?

Thanks!!

Few years ago, you asked which format do we like the best. 
At that time, I said you standing in front of the text.
You said there were some technical issues to solve first to do this way. Few months later you started doing this format.
I always wonder if I had any influence in that.
You are the Best Eric Strong

GREAT! Thank you !

Super clear and concise. Thanks!

Thank you so much! That was extremely helpful. Just wanted to ask you about the reference. Where can I find these algorithm diagrams and tables?

Fantastic dr Strong

Another great video! I have great difficulty in distinguishing vertigo from lightheadedness in my patients- I usually ask them what they were doing when the sensation came along and can usually rule out vasovagal syncope, orthostatic syncope and situational syncope. But I'm always worried about a cardiogenic syncope in patients complaining of dizziness coming on spontaneously and find it very hard to not order further cardiac work up. Any tips?

nice work

Good video !

A few comments
- the notion that a clinician reliably can distinguish between lightheadedness (presyncope) , vertigo and unbalance has largely been put into doubt by Kerber et al and Newman-toker, and edlow. One may be more probable than the other , but one should be vary to rely to much on this part , as there is a big overlap . More important is the focus on triggers and timing (TITRATE or ATTEST method )
- The section on (true) vertigo could possibly become even better if it was put into the categories suggested by Edlow and others : tEVS, sEVS and AVS
- I would emphasize to do the nystagmus test of the HINTS first . If you do not se nystagmus , you’re done and cannot move in in the HINTS as it should only be carried out on AVS patients with spontaneous / gaze evoked nystagmus . Otherwise the HIT will be always false-negative (indicating central cause)

perfect as always

Wonderful lecture, thanks

thank you so much for this clear and straight forward explanation!

Very clearly explained. Many thanks.

I had vertigo suddenly 2 weeks ago on turning my head in either direction. The physiotherapist said I have BPPV and did a head manipulation for me yesterday. However, my head spinned even more last night when I lied on my bed. The spins were larger than the spins before the head manipulation. What went wrong?

Great work as always, incredible teaching

UNO DE LOS MEJORES VIDEOS DE VERTIGO MUY COMPLETO , GRACIAS DR STRONG

This is really good. Thanks for this!

Now this is some top tier quality material!!!!

How do you differentiate bidirectional and unilateral nystagmus. The pupils go left and right in both cases. Seems awfully subjective in the real world. I’m not sure if I could use this test confidently to rule out central vertigo.

Best

fantastic synchronization, well done

Very informative

Does the saccade or lack thereof during the head impulse test only apply to those with baseline nystagmus?

Wouldn't it be more appropriate to place vestibular migraines in the vascular territory?

Can you please make a video on approach to nystagmus

Great video,but you could have added MTLE , presenting as recurrent vertigo of short durations .

I have a question. Can vertigo be cardiogenic?

Excellent presentation thx

Thank you doctor

I love how you structured this! Great lecture!

❤❤❤❤❤❤❤❤ great 👍

Another great video! Very helpful diagnostic algorithm. Thank you!

Thank you so much
❤
❤
❤

That was just wonderful!

No record of blood sugar.??????

my experience of doing HINTS exam. i found negative head impulse in many patients with vestibular pathology.

What about a structual deformity in the ear canal? Does that cause vertigo?

I've had vertigo a few times its definitely not a good feeling. I'm feeling it rn too. I don't have nausea sweating or any other symptoms. So idk what else causes them. For me sometimes they happen randomly

I recently had tingling in my hands kinda fast heartbeat and feeling hot. I think it was a panic/anxiety attack is was definitely scary. Idk if vertigo has to do with that

❤ such a gem video

Good❤

Hello sir, I'm rohith from India.I have a small doubt.Unidirectional vs bidirectional horizontal nystagmus concept- does it apply for unilateral nystagmus also?Also what about vertical nystagmus?

Doctor,thanks for the video,i suffer from epilepsy and seizures,fibromyalgia,other health issues,if i get ill with something else i get,i had ear wax,doctor refused to remove it he gave me drops,I'm elergic to some medication,within a week,i was passing out forgot what i did during days,was shaking,couldn't talk much,headaches,walking difficult,next visit doctor said he couldn't see past inside my ear,didn't know what he was talking about,he more drops,i felt as if bugs were crawling inside my head,severely painful,difficult to walk,3rd time at docs got an interview but i could barely talk,lady looked at me as i was crazy,upset saw a nurse who had to hold me so i wouldn't fall,another nurse,removed it,painful felt gushing wind going through my head,passed out at home,felt ok next morning,soon as i got out of bed unable to move,no pain,unable to stand,walk,talk,understand,daughter scared,won't go into details,my daughter is a practitioner who looks after mentally disabled people,i had a memory loss health worse,i remember paramedics struggling to take me into ambulance,hospital doctors gave me tests,vertigo? what's that,can't remember what kind,didn't want to stay,went home,my daughter helped me so much,talk,walk,learn all over again ect,she's to scared to tell me exactly what was going on,so i guess i was taking fits also,I'm upset at doctors, this began to happen again when family on holiday,managed to scribble a note went to doctor who gave me pills,i can't remember anything else.

Welcome to my new subscribers, including those who found me in the past week from my coronavirus video! If you are hoping for more coronavirus news, I'll be posting a follow-up video in a few days.