PubMed · 13683136
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
H C ANDERSEN. 1960. [Dizziness].. https://pubmed.ncbi.nlm.nih.gov/13683136/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Explore the source record for details and available documents.
Dizziness and imbalance are common presenting complaints to the neurologist. The lack of a systematic approach to the examination and laboratory evaluation of the vestibular system often leads to incorrect diagnoses and suboptimal care. With a basic understanding of vestibular physiology and proper examination techniques, a correct diagnosis can generally be made at the bedside. We review the principles of the neuro-otological examination, including assessment for static vestibular imbalance, dynamic vestibular function, provocative maneuvers, ocular motor examination, and vestibulospinal testing. The use of additional vestibular laboratory testing and neuroimaging is then considered to further localize and quantify abnormalities.
Vertigo is caused by disturbance of the input or central processing of sensory signals from the vestibular apparatus that provide information regarding the position of the body in space. It is caused either by asymmetric disruption of sensory input from the vestibular organs or asymmetric integration of vestibular input into the central nervous system. Vertigo is readily differentiated from other causes of dizziness by a sensation of motion. A crucial aspect of the management of the emergency department patient with vertigo is the differentiation of vertigo associated with acute stroke syndromes from vertigo due to peripheral causes. Routine computerized axial tomography imaging is insensitive for posterior circulation strokes, so for emergency physicians, the history and neurological examination remain the most useful diagnostic tools. This article emphasizes the history and physical examination in the localization of the lesion in patients with vertigo and offers a rational basis for decisions regarding the need for special neurological imaging and consultation. It also emphasizes subtle findings that may prevent the erroneous diagnosis of peripheral vertigo in the presence of an acute stroke syndrome.