Clinical QuickieNeurology
Dizziness / Vertigo
Define what 'dizzy' means before prescribing meclizine.
Separate vertigo from presyncope
Spinning, near-syncope, imbalance, and vague disequilibrium have different differentials.
Timing and triggers matter
Brief triggered positional vertigo supports BPPV; continuous acute vestibular syndrome raises a different differential.
BPPV has a treatment, not just a label
Positional testing and canalith-repositioning maneuvers are central; chronic vestibular suppressants are not the definitive fix.
Central clues matter
New gait inability, focal deficits, severe headache/neck pain, or vascular-risk context with continuous vertigo should raise concern for central disease.
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