头晕眩晕疾病诊治思路

庄建华

doi:10.13406/j.cnki.cyxb.002874

您当前的位置：

首页 >

文章列表页 >

头晕眩晕疾病诊治思路

神经精神疾病诊断思路和临床基本功 | 更新时间：2022-06-24

- 头晕眩晕疾病诊治思路
- Thoughts on diagnosis and treatment of dizzy and vertigo diseases
- 重庆医科大学学报 2021年46卷第7期页码：764-768
- 作者机构：
  
  海军军医大学附属长征医院神经内科、海军军医大学眩晕专病诊治中心，上海　200003
- 作者简介：
  
  [ "庄建华，博士，副主任医师、副教授，硕士生导师，海军军医大学附属长征医院神经内科主任。担任中国医师协会眩晕专委会副主任委员、全军神经内科分会头痛头晕副组长等职；发表各类论文100余篇，主持基金5项，获军队成果奖2项。研究方向：眩晕疾病临床和基础研究。Email：jianhuazh11@126.com。" ]
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.002874
  中图分类号： R441.2
- 纸质出版日期：2021-07-28，
  
  收稿日期：2021-03-08，
扫描看全文
庄建华. 头晕眩晕疾病诊治思路[J]. 重庆医科大学学报, 2021,46(7):764-768.

Jianhua Zhuang. Thoughts on diagnosis and treatment of dizzy and vertigo diseases[J]. Journal of Shanxi Agricultural Sciences, 2021,46(7):764-768.
庄建华. 头晕眩晕疾病诊治思路[J]. 重庆医科大学学报, 2021,46(7):764-768. DOI： 10.13406/j.cnki.cyxb.002874.

Jianhua Zhuang. Thoughts on diagnosis and treatment of dizzy and vertigo diseases[J]. Journal of Shanxi Agricultural Sciences, 2021,46(7):764-768. DOI： 10.13406/j.cnki.cyxb.002874.

摘要

头晕是患者最常见的自述症状，但头晕疾病涉及多个学科，且由于患者的病史描述常常不清楚、不可靠，给临床医生带来极大的挑战。正确的头晕眩晕疾病诊断必须建立于完整而详细的病史和关键的体格检查，将患者分为眩晕、头晕、不稳和晕厥前的1972年标准，比Bárány协会推出的前庭症状分类标准更适用于临床，虽然患者描述病史困难但眩晕持续时间和诱发因素常很明确，关键的体格检查包括自发眼震、体位诱发试验、甩头试验、听力和局灶神经系统体征，临床上依据眩晕疾病的诊断标准，合理选择辅助检查，逐步建立分层诊断思路，全面评估并给予综合治疗才能获得满意疗效。

Abstract

Dizziness is the commonest chief complaints

and it often presents a significant challenge to the physician

not only because dizziness involves multiple disciplines but also the patient's description are unclear and unreliable usually. Diagnosis of dizziness must be based on a thorough and detailed history and key physical examinations

the classification established in 1972 was more useful than Bárány criteria

which was traditionally divided into four categories: vertigo

dizziness

disequilibrium

and presyncope. Patients have difficulty describing their symptoms accurately but can consistently identify the timing and triggers. The key physical examination include spontaneous nystagmus

positional provoked test

head impulse test

hearing and focal neurological deficits. Satisfactory results can be achieved only by choosing auxiliary examinations reasonably according to the diagnostic criteria of dizziness

gradually establishing hierarchical diagnosis ideas

and comprehensively evaluating and giving comprehensive treatment.

关键词

头晕眩晕诊断

Keywords

dizzinessvertigodiagnosis

references

Staab JP, Eckhardt-Henn A, Horii A, et al. Diagnostic criteria for persistent postural-perceptual dizziness(PPPD): consensusdocument of the committee for the classification of vestibular disorders of the Bárány Society[J]. J Vestib Res, 2017, 27(4):191-208.

Caplan L. Posterior circulation ischemia: then, now, and tomorrow. The Thomas Willis Lecture-2000[J]. Stroke, 2000, 31(8):2011-2023.

Newman-Toker DE, Cannon LM, Stofferahn ME, et al. Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting[J]. Mayo Clin Proc, 2007, 82(11):1329-1340.

Drachman DA, Hart CW. An approach to the dizzy patient[J]. Neurology, 1972, 22(4):323-334.

Bisdorff A, Von Brevern M, Lempert T, et al. Classification of vestibular symptoms: towards an international classification of vestibular disorders[J]. J Vestib Res, 2009, 19(1-2):1-13.

Dieterich M, Brandt T. Episodic vertigo related tomigraine(90 cases): vestibular migraine?[J]. J Neurol, 1999, 246(10):883-892.

Von Brevern M, Bertholon P, Brant T, et al. Benign paroxysmal positional vertigo: diagnostic criteria[J]. J Vestib Res, 2015, 25(3-4):105-117.

Lempert T, Olesen J, Furman T, et al. Vestibular migraine: diagnostic criteria[J]. J Vestib Res, 2012, 22(4):167-172.

Strupp M, Lopez-Escamez JA, Kim JS, et al. Vestibular paroxysmia: diagnostic criteria[J]. J Vestib Res, 2016, 26(5-6):409-415.

Lopez-Escamez JA, Carey J, Chung WH, et al. Diagnostic criteria for Meniere's disease[J]. J Vestib Res, 2015, 25(1):1-7.

Strupp M, Kim JS, Murofushi T, et al. Bilateral vestibulopathy: diagnostic criteria consensus document of the classification committee of the Bárány Society[J]. J Vestib Res, 2017, 27(4):177-189.

中国医师协会神经内科分会眩晕专业委员会, 中国卒中学会卒中与眩晕分会. 前庭神经炎诊治多学科专家共识[J]. 中华老年医学杂志, 2020, 39(9):985-994.

Bisdorff AR, Staab JP, Newman-Toker DE. Overview of the international classification of vestibular disorders[J]. Neurol Clin, 2015, 33(3):541-550.

Redon C, Lopez C, Bernard-Demanze L, et al. Betahistine treatment improves the recovery of static symptoms in patients with unilateral vestibular loss[J]. J Clin Pharmacol, 2011, 51(4):538-548.

Sokolova L, Hoerr R, Mishchenko T. Treatment of vertigo: a randomized double-blind trial comparing efficacy and safety of ginkgo biloba extract EGb761 and betahistine[J]. Int J Otolaryngol, 2014, 2014:682439.

查看原文

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

头晕/眩晕的临床诊断基本功：病史采集与体格检查

嗜铬细胞瘤及副神经节瘤不同生化表型的CT征象对比研究

非嗜酸性粒细胞哮喘诊治进展

阴囊脓肿24例临床特征与疗效研究

腹膜后血管源性平滑肌肉瘤诊疗策略