Effectiveness of the STANDING Algorithm for the Differential Diagnosis of Vertigo

Summary

Differential diagnosis of vertigo is complex especially in emergency department, nevertheless it is crucial. The aim of this study is to assess the accuracy of STANDING algorithm for discriminate central from peripheral type of vertigo, identifying more easily the presence of ischemic stroke.

Conditions

• Vertigo

Interventions

DIAGNOSTIC_TEST

STANDING algorithm

The STANDING algorithm is composed by four steps. The first phase consists in evaluating the presence of spontaneous nystagmus at rest for at least five minutes with and without Frenzel goggles in order to assess if a acute vestibular syndrome is present. If there is not a spontaneous nystagmus, then positional maneuvers (Pagnini-Mc Cure and Dix-Hallpike) have to be performed. Otherwise if spontaneous nystagmus is observed, its feature are fundamental to diagnose a central vertigo. If nystagmus characteristics suggest a peripheral form, the head impulse test is performed by instructing the patient to keep eyes on a fixed target and then turned the head quickly. An abnormal response is typical of vestibular neuritis. In any cases after the described maneuvers, the patient must be evaluated when standing up and walking: if this turn out to be impossibile, the test is indicative of central nervous system disease.

Sponsors & Collaborators

• Ospedale San Giuseppe di Empoli

  collaborator OTHER

• Ospedale Santo Stefano

  collaborator OTHER

• Azienda USL Toscana Nord Ovest

  collaborator OTHER

• Azienda Ospedaliero-Universitaria Careggi

  collaborator OTHER

• Peiman Nazerian

  lead OTHER

Principal Investigators

• Simone Magazzini, MD · Direttore Dipartimento Emergenza Urgenza e Area Critica AUTC

• Maurizio Bartolucci, MD · Direttore Dipartimento Diagnostica per immagini AUTC

• Paola Bartalucci, MD · Medicina d'Urgenza Empoli AUTC

• Claudia Casula, MD · Medicina d'Urgenza Empoli AUTC

• Simone Vanni, MD · Direttore SOC Medicina d'Urgenza EMPOLI; Direttore Area della Formazione Dipartimento Emergenza Urgenza e Area Critica AUTC

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-06-09

Primary Completion

2023-06-09

Completion

2023-11-01

Countries

• Italy

Study Locations