Halmagyi G M
Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia.
Clin Med (Lond). 2005 Mar-Apr;5(2):159-65. doi: 10.7861/clinmedicine.5-2-159.
Vertigo is an illusion of rotation due to a disorder of the vestibular system, almost always peripheral. In the history it must be distinguished from pre-syncope, seizures and panic attacks. A single attack of acute, isolated spontaneous vertigo lasting a day or more is due either to vestibular neuritis or cerebellar infarction; distinguishing between the two requires mastery of the head impulse test. Recurrent vertigo is mostly due to benign paroxysmal positioning vertigo (BPPV), Meniere's disease or migraine. With a good history, a positional test, an audiogram and a caloric test, it is usually possible to distinguish between these. BPPV is the single most common cause of recurrent vertigo and can usually be cured immediately with a particle repositioning manoeuvre. Posterior circulation ischaemia very rarely causes isolated vertigo attacks and when it does the attacks are brief and frequent and the history is short.
眩晕是由于前庭系统紊乱导致的旋转幻觉，几乎总是外周性的。在病史方面，必须将其与晕厥前期、癫痫发作和惊恐发作区分开来。单次急性、孤立性自发性眩晕发作持续一天或更长时间，要么是由于前庭神经炎，要么是小脑梗死；区分两者需要掌握摇头试验。复发性眩晕大多是由于良性阵发性位置性眩晕（BPPV）、梅尼埃病或偏头痛。凭借详细的病史、位置试验、听力图和冷热试验，通常可以区分这些情况。BPPV是复发性眩晕最常见的单一原因，通常通过颗粒复位手法可立即治愈。后循环缺血极少引起孤立性眩晕发作，一旦发作，发作短暂且频繁，病史较短。
