When to Use the HINTS Examination in Patients With Dizziness

To optimize the diagnostic utility of the HINTS examination and reduce stroke misdiagnosis, clinicians should first screen for central features before applying HINTS and ensure it is only performed for patients with nystagmus at rest. Future guidelines should provide clearer recommendations to prevent inappropriate HINTS use and thus avoid inaccurate results. Emphasizing the correct application of HINTS in the right patient population will enhance its reliability as a critical tool for emergency physicians in distinguishing central from peripheral causes of dizziness, ultimately improving patient outcomes and reducing unnecessary investigations.

Corresponding Author: Carl Sars, MD, Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77 Stockholm, Sweden (carl.sars@ki.se).

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