Omron Rodney, Edlow Jonathan
Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Department of Emergency Medicine, Harvard Medical School; Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Emerg Med Clin North Am. 2026 Feb;44(1):85-106. doi: 10.1016/j.emc.2025.08.006. Epub 2025 Oct 15.
A structured, problem-based history and physical examination are essential for accurate diagnosis and treatment of an acutely dizzy patient. The ATTEST or STANDING algorithms are diagnostic approaches for acute vertigo patients presenting to the emergency department. First rule out stroke or look for obvious medical causes. If negative, follow either the ATTEST or STANDING algorithms to differentiate peripheral from central causes of dizziness by separating them into different categories of episodic vestibular syndrome or acute vestibular syndrome. The Dix-Hallpike maneuver is used to diagnose posterior canal benign positional paroxysmal vertigo in patients with triggered episodic vestibular syndrome.
对于急性眩晕患者，结构化的、基于问题的病史采集和体格检查对于准确诊断和治疗至关重要。ATTEST或STANDING算法是用于急诊科急性眩晕患者的诊断方法。首先排除中风或寻找明显的医学病因。如果结果为阴性，则遵循ATTEST或STANDING算法，通过将其分为不同类型的发作性前庭综合征或急性前庭综合征来区分周围性和中枢性眩晕病因。Dix-Hallpike手法用于诊断发作性前庭综合征患者的后半规管良性阵发性位置性眩晕。
