Why is this patient circling? Circling is not a diagnosis. It’s a localization clue. Your job in the ER or GP setting is to decide where the lesion likely lives before you chase why. Step 1️⃣ Pattern matters • Tight, persistent circling → think forebrain • Wide arcs, falling, drifting → think vestibular system • Intermittent circling with pain → consider cervical disease or intracranial pressure Direction helps, but it’s not everything. Context is king. Step 2️⃣ Neuro exam pearls that actually l
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