Fife Terry D
Continuum (Minneap Minn). 2017 Apr;23(2, Selected Topics in Outpatient Neurology):359-395. doi: 10.1212/CON.0000000000000450.
This article summarizes an approach to evaluating dizziness for the general neurologist and reviews common and important causes of dizziness and vertigo.
Improved methods of diagnosing patients with vertigo and dizziness have been evolving, including additional diagnostic criteria and characterization of some common conditions that cause dizziness (eg, vestibular migraine, benign paroxysmal positional vertigo, chronic subjective dizziness). Other uncommon causes of dizziness (eg, superior canal dehiscence syndrome, episodic ataxia type 2) have also been better clarified. Distinguishing between central and peripheral causes of vertigo can be accomplished reliably through history and examination, but imaging techniques have further added to accuracy. What has not changed is the necessity of obtaining a basic history of the patient's symptoms to narrow the list of possible causes.
Dizziness and vertigo are extremely common symptoms that also affect function at home and at work. Improvements in the diagnosis and management of the syndromes that cause dizziness and vertigo will enhance patient care and cost efficiencies in a health care system with limited resources. Clinicians who evaluate patients with dizziness will serve their patient population well by continuing to manage patients with well-focused workup and attentive care.
本文为普通神经科医生总结了一种评估头晕的方法，并回顾了头晕和眩晕的常见及重要病因。
诊断眩晕和头晕患者的方法不断改进，包括一些额外的诊断标准以及对某些常见头晕病因（如前庭性偏头痛、良性阵发性位置性眩晕、慢性主观性头晕）的特征描述。其他不常见的头晕病因（如半规管裂综合征、发作性共济失调2型）也得到了更好的阐明。通过病史和体格检查能够可靠地区分眩晕的中枢性和外周性病因，而影像学技术进一步提高了诊断准确性。不变的是，获取患者症状的基本病史对于缩小可能病因范围的必要性。
头晕和眩晕是极其常见的症状，也会影响患者的家庭和工作功能。在资源有限的医疗保健系统中，改善头晕和眩晕综合征的诊断和管理将提高患者护理质量并提升成本效益。评估头晕患者的临床医生通过持续采用针对性强的检查方法和悉心护理来管理患者，将为患者群体提供良好的服务。
