Johkura Ken
Department of Neurology, Yokohama Brain and Spine Center.
Rinsho Shinkeigaku. 2021 May 19;61(5):279-287. doi: 10.5692/clinicalneurol.cn-001570. Epub 2021 Apr 17.
Pathophysiology of vertigo/dizziness can be understood by eye deviation (nystagmus). In benign paroxysmal positional vertigo, eye deviation of causative semicircular canal stimulation is directly observed. In other peripheral vestibular disorders, eye deviation results from the sum of unilateral all semicircular canal disorders. The central vestibular pathway is controlled by the cerebellum. Thus, in vertigo/dizziness of central origin, not only eye deviation due to impairment of the central vestibular pathway but also deviation due to disinhibition of the pathway from the cerebellum is observed. The cerebellar control on the central vestibular pathway also plays an important role in vestibular compensation. When treating vertigo/dizziness, it is necessary to understand the pathophysiology of the vertigo/dizziness, to set the treatment target based on the pathophysiology, and to intervene for the target.
眩晕/头晕的病理生理学可通过眼偏斜（眼球震颤）来理解。在良性阵发性位置性眩晕中，可直接观察到引起半规管刺激的眼偏斜。在其他外周前庭疾病中，眼偏斜是由单侧所有半规管疾病的总和导致的。中枢前庭通路由小脑控制。因此，在中枢性眩晕/头晕中，不仅可观察到由于中枢前庭通路受损引起的眼偏斜，还可观察到由于小脑通路去抑制引起的眼偏斜。小脑对中枢前庭通路的控制在前庭代偿中也起着重要作用。在治疗眩晕/头晕时，有必要了解眩晕/头晕的病理生理学，根据病理生理学设定治疗目标，并针对该目标进行干预。
