The focus of this publication on Neuro-Otology in Neurologic Clinics is on the patient presenting for urgent or emergent care with a chief complaint of new, previously-undiagnosed dizziness or vertigo. Intent is to emphasize throughout the issue five primary components of initial diagnosis and management: (1) Epidemiology, differential diagnosis, and disease definitions; (2) Bedside clinical features that differentiate dangerous from benign causes; (3) Appropriate use of advanced diagnostic tests (including imaging, vestibular tests) and consultations; (4) Application of early treatments (manipulative, pharmacologic, rehabilitative); and (5) Acute disposition strategies, including determining need for admission and urgency of follow-up. Articles have a consistent architecture to highlight key points: 1) Case Scenario (with a representative case example; videos are presented with many of these); 2) Prevalence & Pathomechanisms; 3) Definitions & Diagnostic Criteria; 4) Bedside & Laboratory Diagnostic Tests; 5) Acute Treatment Options (including manipulative, pharmacologic, rehabilitative); and 6) Triage & Disposition (including referrals and follow-up). The articles are presented with four major parts: Overall approach to acute dizziness and vertigo; Episodic vertigo and dizziness; Acute, continuous vertigo and dizziness; and Case unknowns. Among the topics covered are: Bedside evaluation; Transient ischemic attacks; Vestibularl neuritis and labyrinthitis; Stroke; Novel approach to diagnosing the acutely dizzy patient. David Newman-Toker leads this publication with associate editors renown in their fields - Kevin Kerber, William J. Meurer, Rodney Omron, and Jonathan Edlow.
By David E. Newman-Toker, MD, Johns Hopkins