Casani Augusto Pietro, Gufoni Mauro, Ducci Nicola
ENT Section, Medical, Molecular and Critical Area, Department of Surgical Pathology, Pisa University Hospital, 56122 Pisa, Italy.
Audiol Res. 2023 Nov 1;13(6):845-858. doi: 10.3390/audiolres13060074.
(1) Background: Usually, the majority of patients suffering from vertigo and dizziness can be identified in four major categories: acute spontaneous vertigo, episodic (recurrent) vertigo, recurrent positional vertigo, and chronic imbalance. Our purpose is to retrospectively evaluate the main causes of episodic vertigo and to find indications for a reliable clinical suspicion useful for a definitive diagnosis, comparing patients affected by different presenting symptomatology (acute vertigo, recurrent episodic vertigo, and imbalance). (2) Methods: we retrospectively evaluated the clinical records in a population of 249 consecutive patients observed for vertigo in our tertiary referral center in the period 1 January 2019-31 January 2020. On the basis of the reported clinical history, patients were divided into three groups: patients with their first ever attack of vertigo, patients with recurrent vertigo and dizziness, and patients with chronic imbalance. (3) Results: On the basis of the results of the instrumental examination, we arbitrarily divided (for each type of symptoms) the patients in a group with a normal vestibular instrumental examination and a group of patients in which the clinical-instrumental evaluation showed some pathological results; a highly significant difference (: 0.157) was found between recurrent and acute vertigo and between recurrent vertigo and imbalance. (4) Conclusions: Patients with recurrent vertigo more frequently exhibit a negative otoneurological examination since they are often examined in the intercritical phase. A precise and in-depth research of the patient's clinical history is the key to suspect or make a diagnosis together with the search for some instrumental or clinical hallmark, especially in cases where the clinical picture does not fully meet the international diagnostic criteria.
（1）背景：通常，大多数患有眩晕和头晕的患者可分为四大类：急性自发性眩晕、发作性（复发性）眩晕、复发性位置性眩晕和慢性平衡失调。我们的目的是回顾性评估发作性眩晕的主要病因，并找到有助于明确诊断的可靠临床怀疑指征，比较受不同临床表现（急性眩晕、复发性发作性眩晕和平衡失调）影响的患者。（2）方法：我们回顾性评估了2019年1月1日至2020年1月31日期间在我们的三级转诊中心观察的249例连续眩晕患者的临床记录。根据报告的临床病史，患者被分为三组：首次发作眩晕的患者、复发性眩晕和头晕的患者以及慢性平衡失调的患者。（3）结果：根据仪器检查结果，我们（针对每种症状类型）将患者任意分为前庭仪器检查正常的组和临床仪器评估显示有一些病理结果的患者组；在复发性眩晕与急性眩晕之间以及复发性眩晕与平衡失调之间发现了高度显著差异（：0.157）。（4）结论：复发性眩晕患者更常表现出耳神经学检查阴性，因为他们常在发作间期接受检查。对患者临床病史进行精确深入的研究是怀疑或做出诊断的关键，同时要寻找一些仪器或临床特征，特别是在临床表现不完全符合国际诊断标准的情况下。
