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Neurotological emergencies: a narrative review

  • Review Article
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Introduction

Vestibular symptoms, including vertigo, dizziness, and gait unsteadiness, are a frequent reason of urgent medical assistance. Their causes are numerous and diverse, including neurological, otorhinolaryngological, and systemic diseases. Therefore, following a systematic approach is essential to differentiate striking but benign conditions from others that can compromise the patient's life. This study is intended to review vestibular disorders from a practical perspective and provide guidance to physicians involved in the emergency care of patients with vestibular symptoms.

Materials and methods

A narrative review was performed, revisiting the main causes of vestibular disorders.

Results

Based on the speed of onset, duration, and history of similar episodes in the past, vestibular disorders can be categorized into three syndromic entities (acute, recurrent, and chronic vestibular syndromes). The most representative conditions pertaining to each group were reviewed (including their diagnosis and treatment) and a practical algorithm was proposed for their correct management in the acute care setting.

Conclusions

Carrying out a correct categorization of the vestibular disorders is essential to avoid diagnostic pitfalls. This review provides useful tools for clinicians to approach their patients with vestibular symptoms at the emergency room.

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Data availability

All data are available within the article or its supplementary materials.

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Acknowledgements

The authors would like to thank Alejandro Pregue López (for the elaboration of the figures in this article) and Carlos Edreira Tato (for the language review).

Author information

Authors and Affiliations

  1. Department of Neurology, University Hospital Complex of Pontevedra, Mourente, S/N, 36071, Pontevedra, Spain

    Alejandro Rivero-de-Aguilar

  2. Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain

    Alejandro Rivero-de-Aguilar

  3. Department of Otorhinolaryngology, University Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain

    Andrés Soto-Varela

  4. Department of Surgery and Medical-Surgical Specialities, University of Santiago de Compostela, Santiago de Compostela, Spain

    Andrés Soto-Varela

  5. Department of Neurology, Rio Carrion General Hospital, Palencia, Spain

    Marilina Puente-Hernandez

  6. Department of Neurology, San Carlos Clinical Hospital, Madrid, Spain

    Jesús Porta-Etessam

  7. Department of Medicine, Complutense University of Madrid, Madrid, Spain

    Jesús Porta-Etessam

Authors
  1. Alejandro Rivero-de-Aguilar
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  2. Andrés Soto-Varela
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  3. Marilina Puente-Hernandez
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  4. Jesús Porta-Etessam
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Corresponding author

Correspondence to Alejandro Rivero-de-Aguilar.

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Ethical statement

This study does not handle individualized or aggregated patient data, so it did not require informed consent or approval by an Ethics Committee.

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Rivero-de-Aguilar, A., Soto-Varela, A., Puente-Hernandez, M. et al. Neurotological emergencies: a narrative review. Eur Arch Otorhinolaryngol 280, 4759–4774 (2023). https://doi.org/10.1007/s00405-023-08125-3

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  • DOI: https://doi.org/10.1007/s00405-023-08125-3

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