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Master Thesis

Apport de l’examen aux lunettes de Frenzel dans la prise en charge et l’orientation du patient vertigineux aux urgences

Abstract : Background: The management of the vertiginous patient by the emergency department is not based on a Gold Standard. Questioning and physical examination cannot descriminate a peripheral from a central etiology. The aim of this study is to determine if the use of Frenzel goggles by the emergency physicians to detect a nystagmus help in diagnosing a peripheral cause. The performance of this test will be compared to the clinical examination. The type and number of radiological investigations, anamnestic and clinical criteria, will be analyzed. Methods: All patients with complaint of true dizziness presenting to the ED of the University hospital of Grenoble from February 24th to April 3rd 2015 were included. After obtaining their agreement, a physical examination was performed by a first doctor who collected data in a standardized way and a second doctor trained realized blind test whith Frenzel goggles. A specialized consultation and/or brain imaging were performed on the day of inclusion or during the monitoring period. A final diagnosis was established by a board of experts. Results: 18 patients could be included during the period of the study and 14 were analyzed. The test with Frenzel goggles for the detection of a peripheral vertigo had a sensitivity of 44%, specificity of 25%, a positive predictive value (PPV) of 57% and a negative predictive (NPV) of 17%. No brain imaging was realized among peripheral vertigo diagnostic correctly classified by the test with goggles. Conclusion: These data represent the preliminary results of a recently started study whose potential findings could lead to the development of care protocols of dizzy patient in the emergencies.
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Master Thesis
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Submitted on : Thursday, May 7, 2015 - 2:14:25 PM
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  • HAL Id : dumas-01149646, version 1


Émilie Salfranc. Apport de l’examen aux lunettes de Frenzel dans la prise en charge et l’orientation du patient vertigineux aux urgences. Médecine humaine et pathologie. 2015. ⟨dumas-01149646⟩



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