[Detection, investigation, and management of delirium in hospitalized elderly].

Delirium is common in hospitalized older adults. The condition is frequently not recognized, or managed appropriately, and has a poor prognosis. This review finds that a proactive multicomponent interdisciplinary non-farmacological approach can reduce incidence. Delirium is managed by identification of the condition, accurate diagnosis and treatment of the causes, and all other correctable contributing factors, using nonpharmacologic approaches. In some cases, and if required for patient safety, low doses of high-potency antipsychotic agents can be used, in lowest possible dose and for the shortest possible time.

[The chronically dizzy patient].

Many medical, neurologic and psychiatric conditions as well as drugs can give chronic dizziness, and a systematic diagnostic workup is essential. Chronic vestibular syndrome is a clinical syndrome of chronic vertigo, dizziness or unsteadiness lasting months to years. There is generally a persistent unilateral or bilateral vestibular loss. Treatment depends on the aetiology, but in general, treatment with vestibular rehabilitation is effective, which is summarised in this review. Betahistin or other anti-vertigo-drugs are not indicated in the treatment of chronic vertigo.

[Episodic vestibular syndrome].

Dizziness and vertigo are frequent symptoms in the primary care facility and emergency departments. Episodic vestibular syndrome (EVS) is defined as episodic dizziness, vertigo or postural imbalance with remission between episodes. EVS can be divided into spontaneous (s-EVS) and triggered EVS (t-EVS). Causes of s-EVS are vestibular migraine, Menière's disease, transient ischaemic attack and vestibular paroxysmia. Causes of t-EVS are benign paroxysmal positionel vertigo, orthostatic hypotension and panick attacks. In this review, we recommend using vestibular syndromes in order to reduce the number of differential diagnoses.