| خلاصه مقاله | Background: Vertigo is a common symptom that frequently encountered in neurology,
otolaryngology, and general medical practice, and generates many visits to emergency
departments and medical clinics. Vertigo designates the false perception of motion in any
direction. This sensation can be confused with dizziness, which is a non-specific
term, so an adequate history is required to differentiate this symptom from the
disequilibrium (feeling of imbalance), light-headedness (sensation of giddiness)
And presyncope (sensation of feeling faint).
The first step in the evaluation is to fit the patient with typical symptoms into one
of these categories.
In this lecture we discuss the pathophysiology, epidemiology, evaluation and
differentials diagnosis of vertigo.
Also, we review a method of obtaining the medical history of patients presenting
with vertigo. The goal is to identify patterns and an effective differential diagnosis
for this group of patients to help lead to an accurate diagnosis.
A practical method guided by: Titrate (Timing, Triggers, associated symptoms and
Targeted Examination) or ATTEST (Associated symptoms, Timing, Triggers,
Examination). Targeted exams including head impulse, nystagmus, and test of
skew (HINTS) exam, dix-Hallpike, cerebellar and balance tests, cranial nerves,
motor and sensory exams help to different ion of peripheral and central causes.
And finally, treatment is tailored to the specific causes of vertigo. Vestibular
suppressants should be used for a few days at most because they delay the brain’s
natural compensatory mechanism for peripheral vertigo. |