Reference
Glossary
The working vocabulary of case-based vertigo reasoning. Inline dotted terms throughout the chapter link here.
- Acute vestibular syndrome (AVS) · AVS
- Rapid-onset continuous vertigo lasting > 24 h with nausea, nystagmus and gait unsteadiness — the setting in which HINTS separates vestibular neuritis from stroke.
- Chronic vestibular syndrome
- Persistent dizziness or imbalance over months — PPPD, bilateral vestibulopathy, presbyvestibulopathy or MdDS — where the pattern of provocation or relief is the diagnostic key.
- HINTS
- Head Impulse–Nystagmus–Test of Skew: the three-step bedside battery for AVS. A central ('dangerous') pattern — normal head impulse, direction-changing nystagmus or skew — outperforms early MRI for stroke.
- Multidisciplinary team (MDT) · MDT
- The coordinated group — emergency, neurology, ENT/otology, audiology, vestibular physiotherapy, psychology, geriatrics, paediatrics, radiology and pharmacy — whose combined input manages complex vertigo.
- Red flags
- Features that raise the risk of a dangerous central cause — new severe headache, focal neurological signs, a normal head impulse in AVS, direction-changing nystagmus, skew, or gait failure out of proportion to vertigo.
- Single best answer (SBA)
- A question format with one best option among plausible distractors. Each case here uses an SBA with a rationale for every option to model clinical reasoning.
- Spontaneous episodic vestibular syndrome
- Recurrent spells without a clear trigger — vestibular migraine, Ménière's disease, or vertebrobasilar TIA. Duration and associated features distinguish them.
- TiTrATE
- A diagnostic framework for acute dizziness — Timing and Triggers point to a vestibular syndrome (acute, triggered-episodic, spontaneous-episodic or chronic), And a Targeted Examination confirms it. It anchors the case-based approach.
- Triggered episodic vestibular syndrome
- Brief, recurrent vertigo provoked by a trigger — positional (BPPV) or on standing (orthostatic hypotension). Defined by the trigger, not just the timing.
- Vestibular rehabilitation (VRT) · VRT
- Exercise-based therapy driving central compensation — gaze stabilisation, habituation and balance training. The shared therapeutic thread across almost every case in this chapter.