Acute vestibular syndrome: from diagnosis to rehabilitation

The management of patients with acute vestibular vertigo remains a challenging and pressing issue in modern medicine due to the variety of etiological factors, the subjective nature of patient complaints, and the limited application of existing neurovestibular diagnostic algorithms in real-world clinical practice. Despite numerous publications on the management of patients with acute vestibular vertigo, certain issues regarding examination and treatment pathways remain unresolved. Approximately a quarter of conditions presenting with acute vestibular syndrome (AVS) are caused by stroke or other life-threatening diseases, so urgent diagnostics are always necessary. Due to the insufficient information from neuroimaging methods in patients with isolated vestibular vertigo, clinical diagnosis becomes paramount, requiring specialized training from physicians. Patients with peripheral causes of AVS and vestibular migraine often do not receive fully effective treatment or recommendations for further rehabilitation in a neurological hospital setting. This makes an initially benign cause a trigger for chronic dizziness complaints, subsequently leading to various functional disorders that slow recovery, reduce productivity, and significantly impair patients' quality of life. On November 22, 2025, an expert council was held to discuss important issues related to the diagnosis, management, and rehabilitation of patients with acute vestibular vertigo. Based on the results, a patient management strategy was proposed.