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. Special thanks to Dr. Cyrus Askin who found our expert, wrote the questions for this episode, and acted as our cohost. Full show notes available at http://thecurbsiders.com/podcast Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at thecurbsiders@gmail.com. Case: A 45-year-old man presents to the emergency department because of continuous dizziness, nausea, vomiting and unsteady gait that began 18 hours earlier. Time Stamps 00:00 Intro 04:16 Getting to know our guest 11:56 Clinical Case 13:13 Why can’t patients describe their dizziness? 15:20 Classifying dizziness 18:35 The 3 vestibular syndrome buckets defined 22:14 Episodic vestibular syndrome differential diagnosis 26:49 Acute vestibular syndrome differential diagnosis 28:08 Chronic vestibular syndrome differential diagnosis 30:15 Challenges of medical history taking 32:10 Approach to the acute vestibular syndrome/HINTS 33:38 How to evaluate nystagmus 38:00 How to perform the head impulse test (aka head thrust) 45:56 How to perform “test of skew” (alternate cover testing) 47:45 Recap of HINTS exam and discussion of MRI 50:50 Signs and symptoms of cerebellar stroke 55:17 Use of Dix-Hallpike for episodic vertigo 57:00 How to perform Dix-Hallpike 59:50 How to perform the Epley maneuver 64:17 What happens when you choose the wrong test 66:10 Continuous versus triggered dizziness, or vertigo 67:40 Meclizine use in BPPV 69:25 How to cure horizontal canal BPPV 71:00 Treatment for vestibular neuritis 72:56 Treatment for Meniere’s disease 74:32 Who benefits from vestibular rehab/exercises 77:23 Dizziness and giddiness 78:15 Take home points 81:06 Outro Tags: vertigo, dizziness, presyncope, ataxia, stroke, BPPV, Meniere’s, disease, neuritis, vestibular, syndrome, episodic, meclizine, migraine, gait, assistant, care, education, doctor, family, foam, foamed, health, hospitalist, hospital, internal, internist, nurse, medicine, medical, primary, physician, resident, student