TAILIEUCHUNG - Chapter 022. Dizziness and Vertigo

In this context, the term dizziness is being used to describe disturbed ambulation. There may be mild associated lightheadedness, particularly with impaired sensation from the feet or poor vision; this is known as multiple-sensory-defect dizziness and occurs in elderly individuals who complain of dizziness only when walking. Decreased position sense (secondary to neuropathy or myelopathy) and poor vision (from cataracts or retinal degeneration) create an overreliance on the aging vestibular apparatus. A less precise but sometimes comforting designation to patients isbenign dysequilibrium of aging. . | Chapter 022. Dizziness and Vertigo In this context the term dizziness is being used to describe disturbed ambulation. There may be mild associated lightheadedness particularly with impaired sensation from the feet or poor vision this is known as multiple-sensory-defect dizziness and occurs in elderly individuals who complain of dizziness only when walking. Decreased position sense secondary to neuropathy or myelopathy and poor vision from cataracts or retinal degeneration create an overreliance on the aging vestibular apparatus. A less precise but sometimes comforting designation to patients isbenign dysequilibrium of aging. Thus a careful history is necessary to determine exactly what a patient who states Doctor I m dizzy is experiencing. After eliminating the misleading symptoms or gait disturbance dizziness usually means either faintness presyncope or vertigo an illusory or hallucinatory sense of movement of the body or environment most often a feeling of spinning . Operationally after obtaining the history dizziness may be classified into three categories 1 faintness 2 vertigo and 3 miscellaneous head sensations. Faintness Prior to an actual faint syncope there are often prodromal presyncopal symptoms faintness reflecting ischemia to a degree insufficient to impair consciousness. These include lightheadedness dizziness without true vertigo a feeling of warmth diaphoresis nausea and visual blurring occasionally proceeding to blindness. Presyncopal symptoms vary in duration and may increase in severity until loss of consciousness occurs or may resolve prior to loss of consciousness if the cerebral ischemia is corrected. Faintness and syncope are discussed in detail in Chap. 21. Vertigo Vertigo is usually due to a disturbance in the vestibular system. The end organs of this system situated in the bony labyrinths of the inner ears consist of the three semicircular canals and the otolithic apparatus utricle and saccule on each side. The canals transduce angular .

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