Akiyama Nanako, Suzuki Yusuke, Tanaka Tatsuki, Ito Hiroshi, Ichibayashi Ryo
Division of Emergency Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, JPN.
Cureus. 2025 May 25;17(5):e84779. doi: 10.7759/cureus.84779. eCollection 2025 May.
Dizziness is a common complaint in emergency medicine. Algorithms such as the standing assessment (STANDING) and head impulse, nystagmus, and distortion tests (Head Impulse, Nystagmus, and Test of Skew (HINTS)) are used as "diagnostic aids" and "initial assessment tools". However, obstructive sleep apnea (OSA) is often excluded from these paradigms, despite evidence showing an association between OSA and dizziness. We report two patients with unexplained dizziness in whom conventional evaluations were non-diagnostic. Both exhibited sleep-related symptoms, and simplified polysomnography revealed moderate OSA. Mandibular advancement devices led to symptom resolution. OSA may underlie dizziness when standard assessments are inconclusive. Screening for sleep-related symptoms is essential. We suggest targeted OSA screening in patients with unexplained dizziness and relevant risk factors.
头晕是急诊医学中常见的主诉。诸如站立评估(STANDING)以及摇头眼震试验和偏斜试验(HINTS)等算法被用作“诊断辅助手段”和“初始评估工具”。然而,阻塞性睡眠呼吸暂停(OSA)尽管有证据表明其与头晕有关联,但在这些模式中却常常被排除在外。我们报告了两名不明原因头晕的患者,其常规评估未得出诊断结果。两人均表现出与睡眠相关的症状,简化多导睡眠图显示为中度OSA。下颌前移装置使症状得到缓解。当标准评估无定论时,OSA可能是头晕的潜在原因。筛查与睡眠相关的症状至关重要。我们建议对不明原因头晕且有相关危险因素的患者进行针对性的OSA筛查。