Weinstein B E, Devons C A
Lehman College, City University of New York (CUNY), USA.
Geriatrics. 1995 Jun;50(6):42-6, 49; quiz 50-1.
Dizziness is a common and potentially disabling complaint among older patients. A major consequence of dizziness is falls, which can lead to death or significant functional disability. Dizziness can be separated into four broad categories: vertigo, disequilibrium, near-syncope, and nonspecific. Given its multitude of possible etiologies, dizziness often poses a diagnostic dilemma for the physician. Symptoms can result from a disturbance in any number of balance control systems, including the visual pathways, vestibular apparatus, cardiovascular system, and CNS. In evaluating dizziness, the physician should first obtain a careful medical history and perform a targeted physical examination. Depending upon the organ system involved, an audiologist, otolaryngologist, neurologist, cardiologist, and/or psychiatrist should then be consulted for further assessment and management.
头晕是老年患者中常见且可能导致功能障碍的主诉。头晕的一个主要后果是跌倒，这可能导致死亡或严重的功能残疾。头晕可分为四大类：眩晕、平衡失调、接近晕厥和非特异性头晕。由于其可能的病因众多，头晕常常给医生带来诊断难题。症状可能源于任何数量的平衡控制系统紊乱，包括视觉通路、前庭器官、心血管系统和中枢神经系统。在评估头晕时，医生应首先仔细询问病史并进行针对性的体格检查。然后，根据所涉及的器官系统，应咨询听力学家、耳鼻喉科医生、神经科医生、心脏病专家和/或精神科医生进行进一步评估和处理。
