THE INTRICACY AND PERSPECTIVES OF DIAGNOSISAND TREATMENT OF ACUTE VERTIGO

Abstract

Aim of the study was to work out and evaluate the clinical value of a VERTIGO algorithm (skew
deviation test, Romberg’s sign, walking test, head impulse test, nystagmus) in order to improve
diagnosis and treatment of vertigo of central or peripheral origin.
Materials and methods. 65 patients aged from 18-75 years (53±6,7 yrs) with acute vertigo
were enrolled in opened observational study. The patients were consulted by neurologist according
to the standard protocol and then in obedience to VERTIGO algorithm. In case the central origin of
vertigo were supposed, neurovisualisation study had been performed. According to the final results
of diagnostic procedure some statistical aspects of VERTIGO algorithm were calculated (sensitivity,
specificity, positive and negative predictive values).
Results. The sensitivity of VERTIGO algorithm for the diagnosis of central vertigo turned up to
be 100% (95% CI: 78,2-100%), specificity 94,0% (95% CI: 83,5-98,8%), positive predictive value -
83,3% (95% CI: 58,6-96,4%), negative predictive value - 100% (95% CI: 92,5-100%). Cohen’s k
calculated after completion of diagnostics procedures was 0,88 which is considered to be “excellent
coherence” of 2 methods (VERTIGO algorithm and neurovisualisation). The therapy of acute
vertigo should be performed according to the actual guidelines and must be aimed at stimulation of
neuroplasticity.
Conclusion. The VERTIGO algorithm enhances the effectiveness of clinical diagnosis of acute
vertigo origin. It is quite simple to perform it in emergency room. The target treatment of acute
vertigo could improve the results of statodynamic function restoration in such patients.