Diagnosing patients presenting to the emergency department with self-limited episodes of isolated dizziness (the episodic vestibular syndrome) requires a broad differential diagnosis that includes posterior circulation transient ischemic attack. Because these patients are, by definition, asymptomatic without new neurologic findings on examination, the diagnosis, largely based on history and epidemiologic context, can be challenging. We review literature that addresses the frequency of posterior circulation transient ischemic attack in this group of patients compared with other potential causes of episodic vestibular syndrome. We present ways of distinguishing posterior circulation transient ischemic attack from vestibular migraine, the most common cause of episodic vestibular syndrome. We also present a diagnostic algorithm that may help clinicians to work their way through the differential diagnosis.

中文翻译：

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识别表现为阵发性孤立性头晕的后循环短暂性缺血发作


诊断到急诊科就诊的自限性孤立性头晕发作（阵发性前庭综合征）的患者需要广泛的鉴别诊断，包括后循环短暂性脑缺血发作。由于根据定义，这些患者没有症状，检查时没有新的神经系统发现，因此主要基于病史和流行病学背景的诊断可能具有挑战性。我们回顾了与阵发性前庭综合征的其他潜在原因相比，探讨该组患者后循环短暂性脑缺血发作频率的文献。我们提出了区分后循环短暂性脑缺血发作和前庭偏头痛的方法，前庭偏头痛是阵发性前庭综合征的最常见原因。我们还提出了一种诊断算法，可以帮助临床医生完成鉴别诊断。