Acute vestibular syndrome (AVS) is a clinical condition characterized by the sudden onset of vertigo, nausea, vomiting, and gait instability, often accompanied by nystagmus and head motion intolerance. AVS represents a frequent and challenging presentation in emergency and neurological settings, where timely differentiation between peripheral and central causes is critical to prevent life-threatening complications, particularly posterior circulation strokes.

This presentation aims to provide an updated overview of AVS, integrating recent advances in diagnostic strategies, risk stratification, and therapeutic approaches. We will focus on the utility of the HINTS (Head Impulse, Nystagmus, Test of Skew) examination as a bedside tool for distinguishing central from peripheral etiologies, emphasizing its sensitivity and specificity compared with early imaging. In addition, recent developments in vestibular function testing, including video head impulse tests and vestibular-evoked myogenic potentials, will be discussed as adjunctive tools for rapid and accurate assessment.

The congress session will also highlight evidence-based management strategies, covering pharmacological interventions for symptom control, vestibular rehabilitation techniques, and current recommendations for anticoagulation or thrombolytic therapy in cases of ischemic stroke. Case studies illustrating diagnostic challenges and treatment outcomes will be incorporated to bridge theory with clinical practice.

By addressing the spectrum of AVS from pathophysiology to bedside evaluation and therapeutic management, this presentation seeks to enhance clinician awareness, improve early recognition of central causes, and optimize patient outcomes. The session is designed for neurologists, emergency physicians, otolaryngologists, and allied healthcare professionals involved in acute care, fostering interdisciplinary dialogue on the latest evidence and best practices in AVS management.