meta_pixel
Tapesearch Logo
Log in
The Curbsiders Internal Medicine Podcast

REBOOT #49 Vertigo and Dizziness: How to Treat, Who to Send Home, and Who Might Have a Stroke

The Curbsiders Internal Medicine Podcast

The Curbsiders Internal Medicine Podcast

Health & Fitness, Medicine, Science, Higher Education, Education

4.83.1K Ratings

🗓️ 5 September 2022

⏱️ 76 minutes

🧾️ Download transcript

Summary

A simplified approach to dizziness/vertigo with tips from international expert, Dr. David Newman-Toker, Professor of Neurology, Ophthalmology, and Otolaryngology at Johns Hopkins University. We learn how to differentiate stroke from other causes of dizziness/vertigo; how to approach the differential diagnosis in dizziness/vertigo; how to perform the Dix-Hallpike test, Epley maneuver, and HINTS exam; plus, who benefits from medical therapy and vestibular rehab. Original show notes here.

Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [email protected] | Free CME!

Show Segments

  • Intro, Getting to know our guest
  • Clinical Case
  • Why can’t patients describe their dizziness?
  • Classifying dizziness
  • The 3 vestibular syndrome buckets defined
  • Episodic vestibular syndrome differential diagnosis
  • Acute vestibular syndrome differential diagnosis
  • Chronic vestibular syndrome differential diagnosis
  • Challenges of medical history taking
  • Approach to the acute vestibular syndrome/HINTS
  • How to evaluate nystagmus
  • How to perform the head impulse test (aka head thrust)
  • How to perform “test of skew” (alternate cover testing)
  • Recap of HINTS exam and discussion of MRI
  • Signs and symptoms of cerebellar stroke
  • Use of Dix-Hallpike for episodic vertigo
  • What happens when you choose the wrong test
  • Continuous versus triggered dizziness, or vertigo
  • Meclizine use in BPPV
  • How to cure horizontal canal BPPV
  • Treatment for vestibular neuritis
  • Treatment for Meniere’s disease
  • Who benefits from vestibular rehab/exercises
  • Dizziness and giddiness
  • Take home points
  • Outro

Credits

  • Produced and Written by: Cyrus Askin MD
  • Show Notes: Matthew Watto MD
  • Hosts: Cyrus Askin MD, Stuart Brigham MD, Matthew Watto MD, FACP; Paul Williams MD, FACP
  • Editor: Matthew Watto MD, FACP
  • Guest: David Newman-Toker MD, PhD

Sponsor:
Better Help

Visit BetterHelp.com/curb today to get 10% off your first month.


Sponsor:
Panacea Financial

Visit panaceafinancial.com today to learn how a bank for doctors, by doctors, can help you.


Sponsor:
Indeed

Visit Indeed.com/internalmedicine to start hiring now.


Transcript

Click on a timestamp to play from that location

0:00.0

The Curbsiders podcast is for entertainment, education, and information purposes only, and

0:07.1

the topics discussed should not be used solely at Diagnostreat, cure, or prevent any diseases

0:09.8

or conditions.

0:10.8

For the more the views and statements expressed on this podcast are solely those of those,

0:12.3

and should not be interpreted to reflect official policy or position of any entity

0:14.4

that's either on possibly cash-like moral hospital and affiliate outreach programs.

0:16.7

If indeed there are any, in fact there are none.

0:18.7

Pretty much we aren't responsible if you screw up, you should always do your own homework

0:20.6

and let's know.

0:32.2

Hey listeners, we're going to get right to this Curbsiders classic episode with Dr. David

0:37.8

Newman-Toker, MD-PhD.

0:40.2

He is the director of the Division of Neuro Visual and Vistibular Disorders in the Department

0:45.8

of Neurology and the Professor of Neurology at Johns Hopkins University.

0:51.1

He is an expert in dizziness and vertigo.

0:53.9

This is one of my all-time favorite Curbsiders episodes because it covered a topic that gave

0:58.4

me so much anxiety.

1:00.1

It's an early Curbsiders episodes.

1:02.1

You'll hear my co-hosts, Dr. Stewart Kent, Brigham, Paul Nelson Williams, and Dr. Cyrus

1:08.4

Askin producing his first ever Curbsiders episode.

1:11.6

So without further ado, let's get right into vertigo and dizziness.

1:19.4

I was thinking about starting with a case here, Dr. Newman-Toker, or you said we could call

1:23.8

you David for this.

...

Please login to see the full transcript.

Disclaimer: The podcast and artwork embedded on this page are from The Curbsiders Internal Medicine Podcast, and are the property of its owner and not affiliated with or endorsed by Tapesearch.

Generated transcripts are the property of The Curbsiders Internal Medicine Podcast and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.

Copyright © Tapesearch 2025.