Document Detail


Vertigo and dizziness: the neurologist's perspective.
MedLine Citation:
PMID:  23288313     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The spectrum of diagnoses of patients with dizziness as the leading symptom who consult a neurologist does not differ greatly from the spectrum of those who consult ear nose and throat (ENT) specialists or general practitioners (GP). The most frequent forms are benign paroxysmal positioning vertigo (BPPV), phobic postural vertigo, central vertigo disorders, Menière's disease, vestibular neuritis and bilateral vestibulopathy. However, the first and most important question that is posed to neurologists is whether it is a central or peripheral syndrome. In more than 90 % of cases this differentiation is possible by taking the patient history (asking about the type of vertigo, the duration, triggers and accompanying symptoms) and conducting a physical examination of the patient. In the case of acute vertigo disorders in particular, a five-step procedure has proved to be helpful: the cover test to look for skew deviation as the central sign and component of the ocular tilt reaction, an examination with and without Frenzel's goggles to differentiate between peripheral vestibular spontaneous nystagmus and central fixation nystagmus, an examination of smooth pursuit and gaze-holding function and finally the head-impulse test to look for a deficit in the vestibulo-ocular reflex (VOR). Considerable advances have been made in the treatment of vertigo disorders in the last 10 years, e.g., cortisone for the treatment of acute vestibular neuritis, betahistine as a high-dosage, long-term treatment for Menière's disease, carbamazepine to treat vestibular paroxysmia and aminopyridine for downbeat nystagmus and episodic ataxia type 2.
Authors:
M Strupp
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-5
Journal Detail:
Title:  Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft     Volume:  -     ISSN:  1433-0423     ISO Abbreviation:  Ophthalmologe     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206148     Medline TA:  Ophthalmologe     Country:  -    
Other Details:
Languages:  GER     Pagination:  -     Citation Subset:  -    
Affiliation:
Neurologische Klinik und Deutsches Schwindelzentrum, Klinikum der Universität München, Campus Großhadern, Marchionistr. 15, 81377, München, Deutschland, Michael.Strupp@med.uni-muenchen.de.
Vernacular Title:
Schwindel aus neurologischer Sicht.
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