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Background <p>Vertigo and dizziness are common in the emergency room, caused by a broad spectrum of conditions ranging from life-threatening to non-organic causes such as functional dizziness. The latter is often underdiagnosed, leading to chronic symptoms and high costs.</p> Objective <p>To evaluate the diagnostic value of a short dual-task static posturography (sPG) protocol in patients with acute vertigo and dizziness in the neurological emergency department.</p> Methods <p>We prospectively assessed 211 patients using sPG. Established patterns (normal, functional, cerebellar, sensory ataxic) were rated on a 5-point scale by two blinded experts. Interrater agreement and non-parametric analyses were performed, and diagnostic classifications were compared with and without sPG.</p> Results <p>Interrater agreement was high (Kappa = 0.965). sPG identified functional patterns in 29.3% of previously unclear vertigo/dizziness cases, leading to a highly significant increase in the diagnosis of functional dizziness (<i>p</i> &lt; 0.001). Functional patterns were also frequently observed in organic diagnoses, particularly in episodic vestibular disorders. Furthermore, by detecting cerebellar patterns, sPG identified 20% more cases of central vestibular disorders (from 45 to 54 cases).</p> Conclusion <p>sPG offers a rapid, cost-effective tool to identify functional dizziness in the emergency setting, complementing standard clinical assessment. It facilitates early recognition of functional dizziness and may reduce underdiagnosis and prolonged symptom chronification.</p>

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Acute vertigo and dizziness: the diagnostic potential of static posturography in the neurological emergency department

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月21日

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  • Laurin Schappe,
  • HeimigEmily Heimig,
  • Daniel Janitschke,
  • Maximilian Uwe Friedrich,
  • Patrik Theodor Nerdal,
  • Nicolas Rohmann,
  • Frauke Röll,
  • Daniel Martens,
  • Mathias Fousse,
  • Jakob Stögbauer,
  • Gudrun Wagenpfeil,
  • Yaroslav Winter,
  • Sergiu Groppa,
  • Ulrich Dillmann

摘要

Background

Vertigo and dizziness are common in the emergency room, caused by a broad spectrum of conditions ranging from life-threatening to non-organic causes such as functional dizziness. The latter is often underdiagnosed, leading to chronic symptoms and high costs.

Objective

To evaluate the diagnostic value of a short dual-task static posturography (sPG) protocol in patients with acute vertigo and dizziness in the neurological emergency department.

Methods

We prospectively assessed 211 patients using sPG. Established patterns (normal, functional, cerebellar, sensory ataxic) were rated on a 5-point scale by two blinded experts. Interrater agreement and non-parametric analyses were performed, and diagnostic classifications were compared with and without sPG.

Results

Interrater agreement was high (Kappa = 0.965). sPG identified functional patterns in 29.3% of previously unclear vertigo/dizziness cases, leading to a highly significant increase in the diagnosis of functional dizziness (p < 0.001). Functional patterns were also frequently observed in organic diagnoses, particularly in episodic vestibular disorders. Furthermore, by detecting cerebellar patterns, sPG identified 20% more cases of central vestibular disorders (from 45 to 54 cases).

Conclusion

sPG offers a rapid, cost-effective tool to identify functional dizziness in the emergency setting, complementing standard clinical assessment. It facilitates early recognition of functional dizziness and may reduce underdiagnosis and prolonged symptom chronification.