Bhn Vertigo

Taylor Danette C. Vertigo. Edisi : 29 Januari 2014. Diunduh dari:http://www.edi!inenet.!o/"ertigo#o"er"iew/arti!le.ht$ 1 Juli 201%.&edi!al 'uthor:Charles (atri!) Da"is$ &D$ (hD Doctor's View on Vertigo CausesCoent *y Charles (. Da"is$ &D$ (hDWhat is vertigo?Vertigo is the sensation o+ di,,iness. '*out 40- o+ patients o"er age 40 report "ertigo as a sypto$ soe o+ whi!h report !hroni! "ertigo interittently +or years. &any patients ha"e "ertigo that is ild and resol"es .ui!)ly without edi!al inter"ention. /owe"er$ in soe patients$ "ertigo episodes ay lead to dangerous +alls. 0n+ortunately$ there are any !auses o+ "ertigo. Vertigo is soeties a!!opanied *y nausea and "oiting. The elderly are ore sus!epti*le to !opli!ations li)e +alls when "ertigo o!!urs.Vertigo causes&ost !auses o+ "ertigo originate in the *rain or inner ear. 1oe !auses are relati"ely *enign while others are not. The ost !oon +or o+ "ertigo is *enign paro2ysal positional "ertigo 34((V5. 1oe people re+er to this as otion si!)ness. 6t is triggered *y sudden head o"eents$ild dehydration$ or siply *y standing up .ui!)ly. 1oe people de"elop 4((V a+ter drin)ing al!oholi! *e"erages. Vertigo ay *e !aused *y in+laation o+ the inner ear 3la*yrinthitis or "esti*ular neuritis5 due to a *a!terial or "iral inner ear in+e!tion. &igraine heada!hes !an also trigger "ertigo. &ost !ases o+ 4((V and la*yrinthitis resol"e spontaneously or !an *e treated. &eniere7s disease 3tinnitus$ hearing loss$ "ertigo5 is usually interittent *ut the !ause is not )nown. The syptos ay respond to treatent. &ore serious !auses o+ "ertigo are low *lood pressure$ a!ousti! neuroas 3tuors o+ ear ner"e tissue5$ *leeding into the *rain$ loss o+ *lood to the *rain 3+ro !opli!ations o+ arterios!lerosis or ne!) traua that !oproises *lood "essels that supply *lood to the *rain5$ and ultiple s!lerosis.Diagnosis o+ the underlying pro*les that lead to "ertigo syptos is the *est way to approa!h "ertigo treatentVertigo Overview (cont.)Medical Author:Danette C. Taylor, DO, MS, FAC Medical !ditor:"en#a$in %edro, MD, FAC!&, FAA!M %hat i' vertigo(Vertigo is a sense o+ rotation$ ro!)ing$ or the world spinning$ e2perien!ed e"en when soeone is per+e!tly still.&any !hildren attept to !reate a sense o+ "ertigo *y spinning around +or a tie8 this type o+ indu!ed "ertigo lasts +or a +ew oents and then disappears. 6n !oparison$ when "ertigo o!!urs spontaneously or as a result o+ an in9ury it tends to last +or any hours or e"en days *e+ore resol"ing.1ound wa"es tra"el through the outer ear !anal until they rea!h the ear dru. :ro there$ sound is turned into "i*rations$ whi!h are transitted through the inner ear "ia three sall *ones ;; the in!us$ the alleus$ and the stapes ;; to the !o!hlea and +inally to the "esti*ular ner"e$ whi!h !arries the signal to our *rain. 'nother iportant part o+ the inner ear is the !olle!tion o+ sei!ir!ular !anals. These are positioned at right angles to ea!h other$ and are lined with sensiti"e !ells to a!t li)e a gyros!ope +or the *ody. This distin!ti"e arrangeent$ in !o*ination with the sensiti"ity o+ the hair !ells within the !anals$ pro"ides instantaneous +eed*a!) regarding our position in spa!e.&icture o) the outer and inner 'tructure' o) the ear.%hat cau'e' vertigo(There are a nu*er o+ di++erent !auses o+ "ertigo. Vertigo !an *e de+ined *ased upon whether the!ause is peripheral or !entral. Central !auses o+ "ertigo arise in the *rain or spinal !ord while peripheral "ertigo is due to a pro*le within the inner ear. The inner ear !an *e!oe in+laed *e!ause o+ illness$ or sall !rystals or stones +ound norally within the inner ear !an *e!oe displa!ed and !ause irritation to the sall hair !ells within the sei!ir!ular !anals$ leading to "ertigo. This is )nown as *enign paro2ysal positional "ertigo 34((V5.&eniere7s disease$ "ertigo asso!iated with hearing loss and tinnitus 3ringing in the ear5$ is !aused *y +luid *uildup within the inner ear8 the !ause o+ this +luid a!!uulation is un)nown. /ead in9uries ay lead to daage to the inner ear and *e a !ause o+ "ertigo. 6n+re.uently$ stro)es a++e!ting !ertain areas o+ the *rain$ ultiple s!lerosis$ or tuors ay lead to an onset o+ "ertigo. 1oe patients with a type o+ igraine heada!he !alled *asilar artery igraine ay de"elop "ertigo as a sypto.%hat are the ri'* )actor' )or vertigo(/ead in9uries ay in!rease the ris) o+ de"eloping "ertigo$ as !an di++erent edi!ations$ in!ludingsoe antisei,ure edi!ations$ *lood pressure edi!ations$ antidepressants$ and e"en aspirin. 'nything that ay in!rease your ris) o+ stro)e 3high *lood pressure$ heart disease$ dia*etes$ and so)ing5 ay also in!rease your ris) o+ de"eloping "ertigo. :or soe people$ drin)ing al!ohol !an !ause "ertigo.1tudies o+ the in!iden!e o+ "ertigo +ind that *etween 2- to 9/B), 0/ (>?) had a 'eriou' neurologic diagno'i', including C. cere+rova'cular event'. Di82.> year' with i'olated vertigo la'ting longer than 01 hour' )ound that J (9>?) o) the ,atient' had a caudal cere+ellar in)arction. @:>B Dn)arct' o) the $edial +ranch o) the ,o'terior in)erior cere+ellar artery territory a,,ear to +e the $o't co$$on cere+ellar cau'e o) i'olated vertigo and i$+alance. Cere+rova'cular di'ea'e: A recent hi'tory o) dro, attac*', cranial nerve deFcit', or tran'ient vertigo 'hould rai'e 'u',icion )or cere+rova'cular di'ea'e o) the ,o'terior circulation. o "a'ilar artery occlu'ion: Dn one 'tudy o) +a'ilar artery occlu'ion, 0 o) >C (1?) ,atient' had ,rodro$al 'y$,to$' con'i'ting only o) vertigo and nau'ea.@:JB o Verte+ral artery occlu'ion: Thirty2'even o) 1> (00?) ,atient' who ,re'ented with either +a'ilar or +ilateral di'tal verte+ral artery occlu'ion had ,rodro$al 'y$,to$' that cleared in the 9 $onth' ,rior to ad$i''ion.@:JB Cardiova'cular ri'* )actor' o The ri'* o) 'tro*e in ,atient' with atrial F+rillation i' highe't in the Fr't year a)ter on'et in ,atient' not receiving anticoagulation. o Dia+ete' $ellitu', hy,erli,ide$ia, and cigarette '$o*ing are al'o i$,ortant ri'* )actor'. MKniLre di'ea'e and acou'tic neuro$a o Chronic high2 and low2)re;uency hearing lo'' with a''ociated tinnitu', which Muctuate' over ti$e, 'ugge't' MKniLre di'ea'e. o A''ociated auditory 'y$,to$' 'ugge't that vertigo ha' a ,eri,heral origin, though e=ce,tion' e=i't.o 4earing lo'', o)ten with a''ociated tinnitu', i' the $o't co$$on early 'y$,to$ o) acou'tic neuro$a.@>B Multi,le 'clero'i': Dn younger ,atient', recent hi'tory o) neurologic deFcit', ,articularly wea*ne'' and-or nu$+ne'' in one or $ore li$+' (le'ion' in ti$e and ',ace) or unilateral vi'ual lo'', 'hould rai'e 'u',icion )or $ulti,le 'clero'i'. !$ergency De,art$ent Care:irst$ distinguish true "ertigo +ro dise.uili*riu and other +ors o+ di,,iness. 's!ertaining this history +ro patients soeties re.uires patien!e and persisten!e. @n!e the presen!e o+ "ertigo or dise.uili*riu has *een !on+ired$ !onsider a !entral !ause. E"aluate on the *asis o+ a !are+ulhistory and physi!al e2aination and li*eral use o+ iaging studies o+ the posterior +ossa. Thera,y u'ually target' the etiology o) the 'y$,to$'. 4owever, a variety o) $edication' $ay +e u'ed to reduce 'y$,to$' o) central vertigo, including antihi'ta$ine' and +en