Dizziness in the emergency room: Diagnoses and misdiagnoses

Georg Royl*, Christoph J. Ploner, Christoph Leithner

*Corresponding author for this work
34 Citations (Scopus)


Background: Dizziness is among the most frequent neurological chief complaints in emergency room (ER) patients. Although the majority of underlying disorders are benign, serious causes that require immediate in-hospital treatment may occur that are difficult to identify clinically. Methods: Retrospective study of 475 consecutive ER neurological consultations with dizziness as the chief complaint. Results: Of all ER dizziness patients, 73% were initially assigned to benign and 27% to serious diagnoses. The two most frequent disorders were benign paroxysmal positional vertigo (22%) and stroke (20%). On follow-up (available in 124 patients), 43% of all ER diagnoses were corrected: 6% of benign ER diagnoses were corrected to serious diagnoses, 23% of serious ER diagnoses were revised to benign. The most frequent corrections concerned patients with an ER diagnosis of stroke or vestibular neuronitis. Conclusions: In the patient sample studied here, serious causes of dizziness were more prevalent than can be expected from population-based surveys or data from specialized outpatient departments. However, inappropriate assignment of dizziness patients to benign diagnoses still occurred in a relevant proportion of patients. ER clinical pathways, planning of imaging resources and followup of patients in- and outside the hospital must take these points into consideration.

Original languageEnglish
JournalEuropean Neurology
Issue number5
Pages (from-to)256-263
Number of pages8
Publication statusPublished - 01.11.2011

Research Areas and Centers

  • Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)


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