Department of Neurology, Charité-Universitätsmedizin Berlin, Campus Virchow Klinikum, Berlin, Germany.
Eur Neurol. 2011;66(5):256-63. doi: 10.1159/000331046. Epub 2011 Oct 6.
Dizziness is among the most frequent neurological chief complaints in emergency room (ER) patients. Although the majority of underlying disorders are benign, serious causes that require immediate in-hospital treatment may occur that are difficult to identify clinically.
Retrospective study of 475 consecutive ER neurological consultations with dizziness as the chief complaint.
Of all ER dizziness patients, 73% were initially assigned to benign and 27% to serious diagnoses. The two most frequent disorders were benign paroxysmal positional vertigo (22%) and stroke (20%). On follow-up (available in 124 patients), 43% of all ER diagnoses were corrected: 6% of benign ER diagnoses were corrected to serious diagnoses, 23% of serious ER diagnoses were revised to benign. The most frequent corrections concerned patients with an ER diagnosis of stroke or vestibular neuronitis.
In the patient sample studied here, serious causes of dizziness were more prevalent than can be expected from population-based surveys or data from specialized outpatient departments. However, inappropriate assignment of dizziness patients to benign diagnoses still occurred in a relevant proportion of patients. ER clinical pathways, planning of imaging resources and follow-up of patients in- and outside the hospital must take these points into consideration.
头晕是急诊（ER）患者最常见的神经科主诉之一。尽管大多数潜在疾病都是良性的，但可能会出现一些难以在临床上识别的严重病因，需要立即住院治疗。
对 475 例以头晕为主要主诉的连续 ER 神经科会诊进行回顾性研究。
所有 ER 头晕患者中，73%最初被分配为良性诊断，27%为严重诊断。两种最常见的疾病是良性阵发性位置性眩晕（22%）和中风（20%）。在随访（124 例患者中可获得）中，所有 ER 诊断中有 43%得到了纠正：6%的良性 ER 诊断被纠正为严重诊断，23%的严重 ER 诊断被修订为良性。最常见的纠正涉及到 ER 诊断为中风或前庭神经元炎的患者。
在本研究的患者样本中，头晕的严重病因比基于人群的调查或专门的门诊部门的数据所预期的更为常见。然而，仍有相当一部分患者被不适当地分配为良性诊断。急诊临床路径、影像学资源的规划以及患者在医院内外的随访必须考虑到这些问题。
