Timing for nystagmus evaluation by STANDING or HINTS in patients with vertigo/dizziness in the emergency department

Dizziness or vertigo is a common symptom that covers 1% to 3% of the patients presenting to the emergency department (ED).1 In most cases, the cause is a benign inner ear disease2; however, it may be a more severe one, such as stroke.3,4 According to some studies, the incidence of cerebrovascular disease in these patients is low (2%–6%) but not negligible.5 Moreover, among patients evaluated in the ED, dizziness is the most common symptom as-sociated with a missed stroke diagnosis.6 The lack of or delayed diagnosis can lead to increased mortality