The Cardiovascular
ToolsCalculators

Sudbury Vertigo Risk Score

Risk-stratifies ED patients with vertigo for a serious central cause.

Sudbury Vertigo Risk Score
Male sex
Age > 65 years
Diabetes
Hypertension
Motor or sensory deficit
Cerebellar signs (diplopia, dysarthria, dysphagia, dysmetria, ataxia)
BPPV diagnosed (e.g., positive Dix-Hallpike)
Result0 points

Low risk of a serious cause (stroke, TIA, dissection, tumour): ~0%.

Serious diagnosis risk
~0%

When to use

  • Risk-stratifying adults presenting to the ED with vertigo for a serious central diagnosis.

Formula

Points: male 1, age >65 1, diabetes 1, hypertension 3, motor/sensory deficit 5, cerebellar signs 6, BPPV diagnosis -5. A total <5 corresponds to ~0% risk of a serious cause.

Pearls and pitfalls

  • A score <5 had 100% sensitivity for a serious cause in the validation cohort.
  • A confirmed BPPV diagnosis subtracts 5 points, reflecting its benign nature.

References

  1. Ohle R, et al. Ann Emerg Med. 2024 (derivation).
  2. Validation: Acad Emerg Med. 2025.