广州医学院：《头颈外科学》课程PPT教学课件（讲稿）Vertigo眩晕

Vertigo眩晕 Dept Otolaryngology Second Affiliated Hospital Guangzhou Medical college Zhang jianguo

Vertigo 眩晕 Dept. Otolaryngology Second Affiliated Hospital Guangzhou Medical College Zhang Jianguo

Define定义 Vertigo is defined as a hallucination幻觉of movement. This may be a sensation of turning, spinning, falling, rocking, etc Dizziness E, although commonly used by the patient as a term to describe the above sensations refers to less severe and distinct sensations of giddiness眼花, faintness衰弱, confusion混 乱, blankness空虚, or unsteadiness摇摆. This differentiation is important, since vertigo arises from disturbance of the vestibular end-organ, vestibular nerve, or vestibular nucleus Dizziness may arise from mild disturbance of the vestibular apparatus but usually indicates disturbance in other regions

Define 定义 Vertigo is defined as a hallucination幻觉of movement. This may be a sensation of turning, spinning, falling, rocking, etc. Dizziness头昏, although commonly used by the patient as a term to describe the above sensations, refers to less severe and distinct sensations of giddiness眼花, faintness衰弱, confusion混 乱, blankness空虚, or unsteadiness摇摆. This differentiation is important, since vertigo arises from disturbance of the vestibular end-organ, vestibular nerve, or vestibular nucleus. Dizziness may arise from mild disturbance of the vestibular apparatus but usually indicates disturbance in other regions

Evaluating vertigo 1. Whether the symptom experienced is true vertigo. If the complaint does consist of a sensation of motion or turning, the origin lies in the vestibular apparatus前庭器; otherwise, other regions must be subjected to examination and evaluation

Evaluating Vertigo 1. Whether the symptom experienced is true vertigo. If the complaint does consist of a sensation of motion or turning, the origin lies in the vestibular apparatus前庭器; otherwise, other regions must be subjected to examination and evaluation

Evaluating vertigo 2. The pattern of the vertigo. It is important to note whether the attacks are spontaneous or precipitated突如其来的 by movement. The presence of paroxysmal突发性的 attacks separated by periods of relative freedom from symptoms indicates a different pathologic condition than more or less continuous dizziness

Evaluating Vertigo 2.The pattern of the vertigo. It is important to note whether the attacks are spontaneous or precipitated突如其来的 by movement. The presence of paroxysmal突发性的 attacks separated by periods of relative freedom from symptoms indicates a different pathologic condition than more or less continuous dizziness

Evaluating vertigo 3. The degree of vertigo. Vertigo arising the labyrinth迷路 is usually accompanied by nausea and often vomiting. Less specific forms may be milder and may arise from any part of the body

Evaluating Vertigo 3. The degree of vertigo. Vertigo arising in the labyrinth 迷 路 is usually accompanied by nausea and often vomiting. Less specific forms may be milder and may arise from any part of the body

Evaluating vertigo 4. The association of hearing loss or tinnitus with dizziness is a definite aid to localization. Complete audiometric听力 测定 evaluation is essential to the examination of the dizzy patient, since these diseases may affect the vestibular apparatus alone, the cochlear apparatus alone, or both together

Evaluating Vertigo 4. The association of hearing loss or tinnitus with dizziness is a definite aid to localization. Complete audiometric听力 测 定 evaluation is essential to the examination of the dizzy patient, since these diseases may affect the vestibular apparatus alone, the cochlear apparatus alone, or both together

Examination Examination of the patient with labyrinthine symptoms(vertigo, hearing loss, and tinnitus) should include caloric examination前庭功能检查之冷热水试验 and hearing evaluation

Examination Examination of the patient with labyrinthine symptoms (vertigo, hearing loss, and tinnitus) should include caloric examination前庭功能检查之冷热水试验 and hearing evaluation

Diagnosis he main causes of vertiginous labyrinthine disturbance are 1. Acute toxic labyrinthitis 2. Meniere's disease 3. Paroxysmal positional vertigo( postural位置性 vertigo) 4. Vestibular neuronitis前庭神经元炎 5. Vertebral-basilar artery insufficiency椎基底动脉供血不足 6. Trauma 7. Tumor( Acoustic neurinoma听神经瘤)

Diagnosis The main causes of vertiginous labyrinthine disturbance are: 1. Acute toxic labyrinthitis 2. Meniere's disease 3. Paroxysmal positional vertigo (postural位置性vertigo) 4. Vestibular neuronitis前庭神经元炎 5. Vertebral-basilar artery insufficiency椎基底动脉供血不足 6. Trauma 7. Tumor (Acoustic neurinoma听神经瘤)

Wang Yifu -Silver Medal In Atlanta Olympic Games in 1996 Vertebral-basilar artery insufficiency Last shooting Vertigo attack Only 0.1 loss Silver medal

Wang Yifu -Silver Medal In Atlanta Olympic Games in 1996 Vertebral-basilar artery insufficiency Last shooting Vertigo attack Only 0.1 loss Silver Medal

Differential Diagnosis 1. Disease of the cerebellum vascular disease and tumors 2. Disease of the proprioceptive本体感受的 system 3 Cerebral anoxemia脑缺氧, arteriosclerosis动脉硬化 postural hypotension位置性低血压, and anemia 4. Endocrine disease, hypothyroidism甲状腺功能低下; and female hormonal disturbance 5. Epilepsy獷痫

Differential Diagnosis 1.Disease of the cerebellum, vascular disease and tumors 2. Disease of the proprioceptive本体感受的system 3.Cerebral anoxemia脑缺氧, arteriosclerosis动脉硬化, postural hypotension位置性低血压, and anemia 4.Endocrine disease, hypothyroidism甲状腺功能低下; and female hormonal disturbance 5. Epilepsy癫痫