A review of the diagnostic approaches in patients with acute vertigo, dizziness and imbalance

The most important consideration in diagnosing the cause of acute vertigo is stroke detec-tion, which is often difficult to distinguish from peripheral vestibular disorders. There are three possible strategies: (1) use of an algorithm, such as a flowchart, (2) defining symptoms/find-ings suggestive of a stroke, and (3) scoring and evaluation of the symptoms/findings. The sen-sitivity and specificity are increased by defining multiple symptoms and findings suggestive of stroke. However, if many specialized findings are required, it lacks versatility as a diagnostic procedure. The optimal strategy differs depending on the situation, the target patient, and the doctor. The strategies are expected to continue to be evaluated and improved.