orthostatic vertigo
Introduction
Introduction Dizziness caused by changes in the position of the vertical axis range is postural vertigo. Some longitudinal vertigo is vertigo at a certain height during waking or lying down, and is also a positional vertigo. The position is changed, induced during flexion and extension of the head and neck, or the existing vertigo is exacerbated. More common in adults aged 40 to 60 years old, women often turn to the right side of the head to appear dizziness symptoms, considered to be the performance of the sac. Schuknecht (1962) pathological examination of 3 cases of elliptical sac, balloon and ampullary dome sensation of normal epithelium, only the latter half of the ampulla of the ampulla of the basophilic granules, may be the cause of the sensitivity of gravity stimulation.
Cause
Cause
The position is changed, induced during flexion and extension of the head and neck, or the existing vertigo is exacerbated. More common in adults aged 40 to 60 years old, women often turn to the right side of the head to appear dizziness symptoms, considered to be the performance of the sac. Schuknecht (1962) pathological examination of 3 cases of elliptical sac, balloon and ampullary dome sensation of normal epithelium, only the latter half of the ampulla of the ampulla of the basophilic granules, may be the cause of the sensitivity of gravity stimulation.
Modern research has shown that neurotransmitters in the vestibular system play an important role in the occurrence and remission of vertigo.
The clinical manifestations of vertigo, the severity of symptoms and the duration of duration are related to the onset of disease, unilateral or bilateral vestibular damage, and whether there is good vestibular compensatory function.
Examine
an examination
Related inspection
Cerebrospinal fluid dynorphin Frenzel's glasses examination cerebrospinal fluid arginine vasopressin naked eye examination posture change test
1. Head position nystagmus examination: Let the patient sit on the bed, first sit down on the head, observe 10 seconds without dizziness and nystagmus, let sit up and observe for another 10 seconds, then let the head side to the side and observe for 10 seconds. Then lie on your back and look at the other side for 10 seconds. Each time you change your position, sit up and lie down, you should complete it within 3 seconds. If you have nystagmus in a certain position, you should continue to observe for 30 seconds, such as continuous nystagmus. If it does not disappear, it is a positive test. If the right ear is down, the eye movement is turned to the right, and the eye is gazing to the left side, and vertical nystagmus occurs. The repeated tests are positive, which is called non-fatigue type. Conversely, repeated tests no longer have nystagmus, called fatigue type. . The direction of the nystagmus appearing in different head positions is not called directional type; if nystagmus occurs in different directions, it is called directional type. Where nystagmus occurs in the unidirectional head position, the duration is short, there is an incubation period, and the directional type has fatigue response, mostly peripheral lesions; otherwise, it is mostly central lesions. Other tests, such as tracking and visual acuity, are generally normal.
2. The vestibular function test such as hot and cold temperature change is normal.
3. Pure tone hearing test is more normal.
Diagnosis
Differential diagnosis
Cervical vertigo: also known as vertebral artery compression syndrome. The cause may include cervical degeneration, cervical and neck soft tissue lesions, neck tumors and skull base deformities, etc., causing vertebral artery compression and ischemia leading to vertigo, vertebral artery itself such as atherosclerotic stenosis and deformity, etc. More susceptible to the disease. The cervical sympathetic plexus is directly or indirectly stimulated, causing vertebral artery spasm or reflex inner ear circulatory disorder. Abnormal reflection can also be caused, such as the cervical occipital receptor in the ring pillow joint and the upper three cervical vertebrae capsules are subjected to various stimuli, and the impulse can be transmitted to the cerebellum or vestibular nucleus to produce dizziness and balance disorders. The main clinical manifestations are various forms of vertigo, which are obviously related to sudden head rotation, often accompanied by nausea, vomiting, ataxia, etc. Sometimes there may be black sputum, diplopia, amblyopia, etc., and the symptoms last for a short time. Treatment can be used for neck traction, physiotherapy, massage, etc. Appropriate application of vasodilator drugs, microcirculation drugs and vitamins.
Paroxysmal vertigo: is a common mechanical condition of the inner ear, accounting for about 20% of all vertigo, and is also the cause of about half of otogenic vertigo. Although the disease is an ear disease, it is often diagnosed in the first diagnosis of neurology, and many misdiagnosed as vertebrobasilar insufficiency, cervical vertigo and delayed treatment. Dizziness is a general term for dizziness and dizziness. It is glare with vertigo, unclear vision and darkness and darkness. It can be rotated by the object, or it can not stand as a halo.
Otogenic vertigo: refers to vertigo caused by abnormal vestibular vagus. When there is lost water (Ménière syndrome), motion sickness (sickness sickness), labyrinthitis, labyrinthine bleeding or poisoning, vestibular neuritis or damage, middle ear infections, etc. can cause postural balance disorders, vertigo. Because the vestibular nucleus is closely related to the nucleus of the oculomotor through the medial bundle, nystagmus often occurs when the current court is stimulated by pathology.
Transient vertigo: Benign paroxysmal orthostatic vertigo is caused by problems with the inner ear, which can cause transient vertigo attacks. Dizziness is the feeling that you are spinning or that things around you are spinning. For some people, benign paroxysmal orthostatic vertigo will resolve on its own within a few weeks, but it will recur again, it is not a serious illness.
Symptoms of orthostatic vertigo: The cervical vertebrae, thoracic vertebrae, and caudal vertebrae are a longitudinal axis of the body. The change in the position of the longitudinal axis. For example, getting up, lying down, turning over can cause dizziness.
