Lambert P R
University of Virginia Medical Center, Department of Otolaryngology-Head & Neck Surgery, Charlottesville 22906-0008, USA.
Compr Ther. 1997 Nov;23(11):719-23.
This discussion has focused primarily on the history and physical examination of the patient with dizziness which, in fact, are the two most important elements in the evaluation process. To perform the examination expeditiously and completely, a broad differential diagnosis of dizziness must be kept in mind. The clinician should also keep in mind two basic objectives: first, to identify serious pathology (e.g., central nervous system lesion, brainstem ischemia, cardiac arrhythmia); and second, to recognize diseases that can be specifically treated, such as an endocrine abnormality, middle ear infection, Meniere's disease, or a drug reaction. Reassurance and/or vestibular rehabilitation are the mainstays of therapy for the patients not falling into the above two categories.
本次讨论主要聚焦于头晕患者的病史和体格检查，实际上，这两者是评估过程中最重要的两个要素。为了迅速且全面地进行检查，必须牢记头晕的广泛鉴别诊断。临床医生还应牢记两个基本目标：其一，识别严重病变（如中枢神经系统病变、脑干缺血、心律失常）；其二，识别可进行特异性治疗的疾病，如内分泌异常、中耳感染、梅尼埃病或药物反应。对于不属于上述两类的患者，给予安慰和/或前庭康复治疗是主要的治疗方法。
