Davis L E
Neurology Service (127), VA Medical Center, Albuquerque, NM 87108.
J Am Geriatr Soc. 1994 Nov;42(11):1184-8. doi: 10.1111/j.1532-5415.1994.tb06986.x.
To evaluate the causes of dizziness in elderly men.
A descriptive study involving the clinical and laboratory features of elderly men with dizziness.
A university-affiliated Veterans Affairs medical center.
One hundred seventeen consecutive men more than 50 years of age attending a general neurology clinic with the chief complaint of dizziness.
The median duration of dizziness at first office visit was 45 weeks. Forty-nine percent of patients had more than one diagnosis that contributed to their dizziness. Dysfunctions of the peripheral vestibular system were found in 71% and were the principal causes in 56%. Benign positional vertigo was present in 34%. Disorders of the visual system were found in 26% but were the major cause in only 1%. Diagnoses involving the proprioceptive system were present in 17% and were the principal cause in 7%. Structural lesions of the brainstem or cerebellum or metabolic disorders that affected normal brainstem function were identified in 59% and were the major diagnoses in 22%. A psychophysiologic diagnosis was made in 6% but was the major diagnosis in only 3%. At the 6-months follow-up, 55% of patients improved, 34% were unchanged, 4% worsened, and 7% were lost to follow-up.
Contrary to reports in the literature, dizziness in the elderly is more persistent, has more causes, is less often due to a psychophysiologic cause, and seems to be more incapacitating than dizziness in younger patients.
评估老年男性头晕的原因。
一项描述性研究，涉及头晕老年男性的临床和实验室特征。
一家大学附属退伍军人事务医疗中心。
连续117名年龄超过50岁、因头晕为主诉就诊于普通神经科门诊的男性。
首次就诊时头晕的中位持续时间为45周。49%的患者有不止一种导致头晕的诊断。71%的患者存在外周前庭系统功能障碍，其中56%为主要原因。34%的患者存在良性阵发性位置性眩晕。26%的患者存在视觉系统疾病，但仅1%为主要原因。17%的患者存在涉及本体感觉系统的诊断，其中7%为主要原因。59%的患者发现脑干或小脑的结构性病变或影响正常脑干功能的代谢紊乱，其中22%为主要诊断。6%的患者做出了心理生理诊断，但仅3%为主要诊断。在6个月的随访中，55%的患者病情改善，34%无变化，4%病情恶化，7%失访。
与文献报道相反，老年人头晕更持久，原因更多，较少由心理生理原因引起，且似乎比年轻患者的头晕更使人丧失能力。
