65 y/o F w/ history of HTN presents to your ED with dizziness that began yesterday when she got out of bed. Her symptoms worsen with head motion, she is nauseated, and has vomited several times. ROS is otherwise negative. Her exam is significant only for horizontal nystagmus in right lateral gaze.


Her symptoms moderately improved with oral medications, and she would like to go home.


Yet you are not convinced this is peripheral vertigo. “What you really want is a cheap, quick bediside test to differentiate central from peripheral vertigo.”

This Wednesday Dr. Iris Chandler will guide the discussion, looking at the HINTS exam paper (view here).


View background on the topic here.

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