Pongrácz Endre
Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház, Neurolăgiai Oszt6ly, Szolnok.
Ideggyogy Sz. 2011 Mar 30;64(3-4):101-9.
In the first part of this review the definition of vertigo/dizziness was discussed. The major difference between the two signs is the existence of the direction, which is specific for vertigo. Dizziness is a frequent complaint in the clinical practice. Its frequency is increasing with advance of age, to intimate the play of declining cognitive process in the pathogenesis of its. The popular health significance of vertigo is in the rowing number of the patients. The onset of the most cases with acute vertigo appears between secundums and minutes so the patients will be provided in circumstances of emergency department. First of all three form should be take into account: neuronitis vestibularis, benign paroxysmal positional vertigo and Meniere syndrome. Without typical periferal signs of vertigo, central cause should be searched, principally stroke (lysis possibility). The differential diagnose of the different dizziness/vertigo forms according to the elapsed time of the onset or congenital and acquired nystagmus was created in tables. The recommendations of the therapy of acute and chronic dizziness/vertigo syndromes are, lack of results of evidence based trials doubtful. The more often used drugs based on clinical trials are discussed as vinpocetine, betahistine and piracetam. The in vitro and in vivo data suggest that the last molecule is eligible to use both in periferal and central type of vertigo syndromes.
在本综述的第一部分,讨论了眩晕/头晕的定义。这两种症状的主要区别在于是否存在特定于眩晕的方向。头晕是临床实践中常见的主诉。其发生率随着年龄的增长而增加,提示认知功能下降在其发病机制中起作用。眩晕在患者数量上呈上升趋势,具有重要的健康意义。大多数急性眩晕病例的发作在数秒至数分钟之间,因此患者常出现在急诊科。首先应考虑三种类型:前庭神经炎、良性阵发性位置性眩晕和梅尼埃综合征。如果没有典型的周围性眩晕体征,则应寻找中枢性病因,主要是中风(溶栓可能性)。根据发作时间或先天性和后天性眼球震颤,以表格形式列出了不同头晕/眩晕类型的鉴别诊断。急性和慢性头晕/眩晕综合征的治疗建议,因缺乏循证试验结果而存在疑问。文中讨论了临床试验中更常用的药物,如长春西汀、倍他司汀和吡拉西坦。体外和体内数据表明,最后一种药物适用于周围性和中枢性眩晕综合征。