Approach to Acute Dizziness

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00:00 - Intro
01:04 - Case presentation
02:17 - Anatomy of the vestibular system
08:07 - H.I.N.T.S. examination
16:26 - Pathological differential diagnosis
39:56 - Back to the case...
40:44 - Diagnostic testing
42:58 - Treatments
45:13 - Management algorithm

Narrated by:
Igor Rybinnik, MD

Produced by:
Igor Rybinnik MD
Neurology Clerkship Director
Rutgers Robert Wood Johnson Medical School

Special thanks to Dr. Peter Johns, University of Ottawa for his invaluable input and corrections.

Patient videos courtesy of:
- Newman-Toker DE, et al. H.I.N.T.S. to Diagnose Stroke in the Acute Vestibular Syndrome—Three-Step Bedside Oculomotor Exam More Sensitive than Early MRI DWI. Stroke. 2009 Nov; 40(11): 3504–3510.

Brain imaging cases courtesy of:
- Sand IK. Continuum 2016;22(3):864–896.
- Lee SU, et al. Cerebellum. 2019 Mar 2

Graphics, video clips adapted from:
- Cerebellum. Greg Dunn Design
- Netter FH. The Netter Collection of Medical Illustrations. 2nd ed. Saunders, 2013.
- Kandel ER, et al. Principles of Neural Science 5th Edition. McGraw Hill, 2012.
- Martin JH. Neuroanatomy Text and Atlas, 4th ed. McGraw Hill, 2012.
- Young Frankenstein. Dir Mel Books, Gruskoff/Venture Films, 1974.
- The Walk. Dri Robert Zemeckis, Sony Pictures Entertainment, 2015.

Disclaimer: Please note that this material was simplified for educational purposes. For patient management, please review your clinical society's guidelines and engage expert consultation where appropriate. Also, the opinions expressed in this talk do not necessarily reflect those of Rutgers Robert Wood Johnson Medical school or Rutgers University as a whole.
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Awesome, I have been struggling with the HINTS exam for 1 year, which I finally understood in 10 mins lecture and whole dizziness in one video. thank you so much for excellent quality videos and material

shayaanp
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I cannot say how gratefull I am to you. I am a neurology resident and it was so difficult to me :(, until I found your videos.!!
You are a awesome teacher!!!, explain easy and funny all the topics!,
THANK YOU VERY MUCH, !!!! 😀😀😄😄

SakuraClow
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Your content is legendary. I'm an INR and found it useful as hell.

DonPulpote
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Thank you very much, I struggle with patients with dizziness, I now can see the light, and hopefully turn water into wine some day.

meopai
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Thanks a lot, i 'm a med student in greece aspiring to become a neurologist, this content is highly appreciated

mariosgavriil
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This is such a THOROUGH COMPRESIVE PERTINENT explanation/educational video about "DIZZINESS"! Thank you so much making this video! It is helpful! Please make more of these types of video! Thank you so much again!

kyaw
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It's amazing how you turn such a heavy branch that easy . My appreciation

temanoor
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A very comprehensive, informative and useful lecture indeed.

muhammadashfaq
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videos are really branded. really appreciate it.

LEARNING-MEDICAL-EDUCATION
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This is just fantastic! I just hit gold!

sathyanarasimhan
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Mi inglés no es muy bueno, por eso escribo en español, pero muchas gracias por su video, entendí muy bien todos los conceptos, explica todo de una manera fácil y que permite evaluar al paciente de manera más apropiada. De nuevo, muchas gracias por este aporte y sus otros videos, que ham sido una maravilla pars mí.

PauNihon
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Phenomenal presentation. Delivery and visuals always keeps me focused and entertained! I look forward to utilizing these concepts in my upcoming neuro residency!

jordanm
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This is really superb. I've seen many neurology educational videos and this is among the best. Very professionally done, entertaining and thorough. Great job!! I'm looking forward to watching the rest...

danielllano
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Master class in presentation. Outstanding! Highly recommend.

BTabs
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Your videos are amazing. I will ask my students to watch your videos before class. Thank you so much

lindalee
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You are the best! Thank you for your approach

AntonBerezhn
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Thank you very much Sir for this awesome video…🙏🏻🙏🏻

dharmintrivedi
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Very useful for practice and Post graduates

radhagans
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OMG this is the best video about Dizziness i ever see, thanks <3

giapkhac
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THANK YOU SO MUCH!! What an amazing video and explanation! Thank you!!! ❤

irynaYe