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Acute vertigo: getting the diagnosis right

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj-2021-069850 (Published 12 August 2022) Cite this as: BMJ 2022;378:e069850

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Stroke risk exaggeration

Dear Editor

The authors must be careful. Having stated a 20% prevalence of dizziness in primary care to then suggest 3% of patients with dizziness have had a stroke is clearly nonsense. The 3% risk quoted turns out to be a secondary care study of patients admitted or seen in A&E.

With pressure already high on A&E, inaccuracy will only serve to undermine GP confidence in handling this common condition safely in the community.

Competing interests: No competing interests

04 September 2022
James Cave
GP
Downland Practice

Re: Acute vertigo: getting the diagnosis right

Dear Editor,

Assessment of vertigo consumes clinical time that is a precious resource. The DIx-Hallpike test takes time to set up and administer. In General Practice, a short, chair based test(1) (2) can identify laterality in BPPV and so leave time for an Epley Manoeuvre.

1.https://bjgp.org/content/bow-and-rise-test-leaves-time-epley-10-minute-c...
2. https://youtu.be/8FpxLPu_JCU

Competing interests: No competing interests

13 August 2022
Andrew j Ashworth
GP and Occupational Physician
Bonhard Medical Ltd
Bonhard House, Bo'ness, EH51 9RR
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