Sloane P D, Baloh R W
Department of Family Medicine, University of North Carolina, Chapel Hill 27514.
J Am Geriatr Soc. 1989 Nov;37(11):1031-8. doi: 10.1111/j.1532-5415.1989.tb06916.x.
Among the 116 consecutive patients aged 70 and older who were evaluated for dizziness in the UCLA neurotology clinic, the mean duration of symptoms was 36.2 months. One or more specific diagnoses were identified in 100 patients (86.2%), with the most common diagnoses being benign positional vertigo (25.9% of patients) and cerebrovascular disorders (21.6%). Benign positional vertigo was characterized by brief episodes of positional vertigo, a positive Hallpike maneuver, and lack of focal signs on neurologic examination and electronystagmography. Cerebrovascular disease presented as two entities, infarction and transient ischemic attacks, each of which had a distinct clinical picture. Patients who could not be definitively diagnosed frequently described presyncopal lightheadedness provoked by upright posture, and usually had normal physical examinations and electronystagmography. The clinical history, particularly the description and temporal nature of the patient's symptoms, provided the key diagnostic data in 69.0% of cases.
在加州大学洛杉矶分校神经耳科诊所接受头晕评估的116例连续的70岁及以上患者中，症状的平均持续时间为36.2个月。100例患者（86.2%）确定了一种或多种具体诊断，最常见的诊断为良性阵发性位置性眩晕（占患者的25.9%）和脑血管疾病（21.6%）。良性阵发性位置性眩晕的特征为短暂的位置性眩晕发作、Hallpike试验阳性，且神经科检查和眼震电图检查无局灶性体征。脑血管疾病表现为两种类型，即梗死和短暂性脑缺血发作，每种类型都有独特的临床表现。无法明确诊断的患者经常描述由直立姿势诱发的晕厥前头晕，且通常体格检查和眼震电图检查正常。临床病史，尤其是患者症状的描述和时间特点，在69.0%的病例中提供了关键的诊断数据。
