文档介绍：Vertigo
WARD 3
病例分析
定位诊断
周围前庭系统
临床上表现为典型的眩晕发作,持续时间短数秒至10余秒不等,发作与头的位置有关,不伴其他神经系统受累的证据。
辅助检查:双侧听力骨到导气导均差;脑干诱发电位未见异常;头MRI无相关阳性发现。
定性诊断
位置性眩晕(BENIGN PAROXYSMAL POSITIONAL VERTIGO,BPPV)
患者表现为较典型的源于头位改变引起的眩晕,持续时间短,且与头的某一位置固定方向改变时,症状加重,DIX实验阳性。
鉴别诊断
椎基底动脉系统TIA
混合性颈椎病
脑内多发梗塞
讨论
Definitions:
眩晕(Vertigo )是一种运动幻觉,是指病人感到自身或外界静止的景物运动的幻觉,呈旋转、摇摆或漂浮感,是空间定向感觉的分析失谐,多在周围或申枢前庭系突然发生病变时产生,是临床上常见的症状之一。至于一般头昏、头胀、眼花、眼前发黑等,不应包括在眩晕范踌。
Dizziness:
Vertigo (spinning or other illusion of movement such as tilting, floating, or impulsion). Vertigo is generally caused by an inner ear disturbance, but can also be cause by a central (brain) disturbance. 
Lightheaded sensation, impending faint. Lightheadedness is generally caused by low blood pressure, and may be associated with orthostatic hypotension or syncope.
Confusion. Generally caused by metabolic (blood chemistry) disturbances.
Spatial fort. This category passes all types of dizziness not specifically covered by the above, and is especially applicable to dizziness caused by psychiatric disorders.
Definitions:
Imbalance: Unsteadiness leading to increased risk of fall. monly panies dizziness, but can also be independant. There are a large numberof individual causes of imbalance.
Drop attack: unprovoked fall without loss of consiousness
Hearing disorder: Hearing monly pany dizziness caused by ear disorders. They are mon in individuals over the age of 50, with any type of dizziness.
Definitions:
(一)眩晕的解剖学基础
周围前庭系
包括内耳前庭及前庭神经。内耳前庭感受器系指三个半规管的壶腹嵴和前庭的球囊斑和椭圆囊斑。神经末梢的终器是由毛细胞组成,每一毛细胞的顶端都有两种纤毛,一种称静毛,有60~100条;另一种称为动毛,只有一条,较粗大,位于毛细胞顶端一侧边缘部。静止时,毛细胞纤毛直立,有自发中等频率放电,但平时左右相等,不产生眩晕。