眩晕患者床旁检査

Bedside Evaluation of Vertigo Patients

眩晕的临床表现复杂,涉及多学科知识,眩晕的定位是眩晕诊断的首要问题。伴有明显的耳科或神经系统体征的眩晕患者较易诊断,但仅表现为孤立性眩晕的患者的诊断却极具有挑战性。近年来,随着研究的深入,除了最为重要的神经系统、耳科查体外,基于前庭耳石通路及眼动通路的眼位、眼震、眼动、头动及姿势步态等的床旁检查,亦极大地丰富了眩晕患者的定位诊断学。这些床旁检查方法的规范应用,将有助于医师及时地进行定位诊断,识别中枢还是外周性眩晕。基于此,本文对眩晕床旁检查方法及其相关临床意义做一简要综述。

Vertigo, which involves multidisciplinary knowledge, can manifest complicated and varied forms. The key of the diagnosis of vertigo is to distinguish central vertigo from peripheral vertigo. Patients accompanied with obvious otology or neurological signs are easy to diagnose, but the diagnosis of patients with isolated vertigo is challenging. In recent years, in addition to the most important examination of otological and the nervous system, with the developing of the research, bedside evaluation of vertigo patients includes eye position, nystagmus, oculomotor, head movements, posture and gait, which is based on vestibular otolith pathway and oculomotor pathway, greatly enriches the topical diagnostic of vertigo. Standardization of the bedside evaluation of vertigo will further help us identify the central or peripheral vertigo. This article will review the method and clinical significance of the bedside evaluation of vertigo patients.