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神经耳科学急症:叙述性综述。

Neurotological emergencies: a narrative review.

机构信息

Department of Neurology, University Hospital Complex of Pontevedra, Mourente, S/N, 36071, Pontevedra, Spain.

Department of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain.

出版信息

Eur Arch Otorhinolaryngol. 2023 Nov;280(11):4759-4774. doi: 10.1007/s00405-023-08125-3. Epub 2023 Aug 7.

Abstract

INTRODUCTION

Vestibular symptoms, including vertigo, dizziness, and gait unsteadiness, are a frequent reason of urgent medical assistance. Their causes are numerous and diverse, including neurological, otorhinolaryngological, and systemic diseases. Therefore, following a systematic approach is essential to differentiate striking but benign conditions from others that can compromise the patient's life. This study is intended to review vestibular disorders from a practical perspective and provide guidance to physicians involved in the emergency care of patients with vestibular symptoms.

MATERIALS AND METHODS

A narrative review was performed, revisiting the main causes of vestibular disorders.

RESULTS

Based on the speed of onset, duration, and history of similar episodes in the past, vestibular disorders can be categorized into three syndromic entities (acute, recurrent, and chronic vestibular syndromes). The most representative conditions pertaining to each group were reviewed (including their diagnosis and treatment) and a practical algorithm was proposed for their correct management in the acute care setting.

CONCLUSIONS

Carrying out a correct categorization of the vestibular disorders is essential to avoid diagnostic pitfalls. This review provides useful tools for clinicians to approach their patients with vestibular symptoms at the emergency room.

摘要

简介

前庭症状(包括眩晕、头晕和步态不稳)是紧急医疗援助的常见原因。其病因众多且多样,包括神经系统、耳鼻喉科和全身性疾病。因此,采用系统的方法对于区分明显但良性的病症和可能危及患者生命的其他病症至关重要。本研究旨在从实用的角度回顾前庭障碍,并为参与前庭症状患者急救的医生提供指导。

材料与方法

进行了叙述性综述,重新审视了前庭障碍的主要病因。

结果

根据发病速度、持续时间和过去类似发作的病史,前庭障碍可分为三种综合征实体(急性、复发性和慢性前庭综合征)。回顾了每个组中最具代表性的病症(包括其诊断和治疗),并提出了在急性护理环境中正确管理它们的实用算法。

结论

正确分类前庭障碍对于避免诊断陷阱至关重要。本综述为临床医生在急诊室处理有前庭症状的患者提供了有用的工具。

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