Distinguishing between serious (e.g., stroke) and benign (e.g., benign paroxysmal positional vertigo, BPPV) disorders remains challenging in emergency consultations for vertigo and dizziness (VD). A number of clues from patient history and clinical examination, including several diagnostic index tests have been reported recently. The objective of the present study was to analyze frequency and distribution patterns of specific vestibular and non-vestibular diagnoses in an interdisciplinary university emergency room (ER), including data on daytime and season of presentation. A retrospective chart analysis of all patients seen in a one-year period was performed. In the ER 4.23% of all patients presented with VD (818 out of 19,345). The most frequent-specific diagnoses were BPPV (19.9%), stroke/transient ischemic attack (12.5%), acute unilateral vestibulopathy/vestibular neuritis (UVH; 8.3%), and functional VD (8.3%). Irrespective of the diagnosis, the majority of patients presented to the ER between 8 a.m. and 4 p.m. There are, however, seasonal differences. BPPV was most prevalent in December/January and rare in September. UVH was most often seen in October/November; absolute and relative numbers were lowest in August. Finally, functional/psychogenic VD was common in summer and autumn with highest numbers in September/October and lowest numbers in March. In summary, daytime of presentation did not distinguish between diagnoses as most patients presented during normal working hours. Seasonal presentation revealed interesting fluctuations. The UVH peak in autumn supports the viral origin of the condition (vestibular neuritis). The BPPV peak in winter might be related to reduced physical activity and low vitamin D. However, it is likely that multiple factors contribute to the fluctuations that have to be disentangled in further studies.

严重（例如中风）和良性（例如阵发性位置性眩晕，BPPV）疾病之间的区别在针对眩晕和头晕（VD）的紧急咨询中仍然具有挑战性。最近已经报道了来自患者病史和临床检查的许多线索，包括几种诊断指标测试。本研究的目的是分析跨学科大学急诊室（ER）中特定前庭和非前庭诊断的频率和分布模式，包括白天和就诊季节的数据。回顾性分析了一年内所有患者的病历。在急诊室中，所有患者中有4.23％患有VD（19,345名患者中有818名）。最常见的诊断是BPPV（19.9％），中风/短暂性脑缺血发作（12.5％），急性单侧前庭病变/前庭神经炎（UVH； 8.3％）和功能性VD（8.3％）。不论诊断如何，大多数患者在上午8点至下午4点之间接受急诊就诊，但存在季节性差异。BPPV在12月/ 1月最为盛行，在9月很少见。UVH最常见于10月/ 11月。绝对数和相对数在8月份最低。最后，功能性/心因性VD在夏季和秋季很常见，9月/ 10月最高，3月最低。总而言之，由于大多数患者在正常工作时间就诊，因此就诊的白天没有区别诊断。季节性显示显示出有趣的波动。秋季的UVH峰值支持该病的病毒起源（前庭神经炎）。