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[Management of vertigo and dizziness].
D Bouccara1, F Rubin2, P Bonfils2
1Service d'ORL et de chirurgie cervico-faciale, hôpital européen Georges-Pompidou, hôpitaux universitaires Paris-Ouest, Assistance-publique-Hôpitaux de Paris, 20, rue Leblanc, 75015 Paris, France.
La Revue De Medecine Interne
|March 3, 2018
Summary
Dizziness and vertigo stem from various conditions, with benign paroxysmal positional vertigo being most common. Clinical evaluation, including oculomotor assessment, guides diagnosis and testing for balance disorders, especially in the elderly at risk of falls.
Area of Science:
- Neurology
- Otolaryngology
- Geriatrics
Background:
- Balance disorders, characterized by dizziness and vertigo, arise from diverse underlying pathologies.
- Prompt clinical assessment is crucial for identifying urgent conditions and common etiologies.
Purpose of the Study:
- To outline a clinical approach for diagnosing dizziness and vertigo.
- To emphasize the role of oculomotor assessment in differentiating peripheral and central causes.
- To highlight the specific considerations for elderly patients at risk of falls.
Main Methods:
- Clinical evaluation focusing on patient history and symptoms.
- Oculomotor assessment to distinguish between peripheral and central vestibular lesions.
- Targeted use of imaging and vestibular function tests based on clinical suspicion.
Main Results:
- Benign paroxysmal positional vertigo is identified as the most frequent cause of balance disorders.
- Oculomotor findings provide key orientation for further diagnostic investigations.
- Clinical assessment effectively directs the selection of appropriate diagnostic tools.
Conclusions:
- A systematic clinical approach, integrating oculomotor assessment, is essential for diagnosing dizziness and vertigo.
- Diagnostic strategies should be tailored to differentiate between peripheral and central causes.
- Special attention must be paid to fall risk and its management in elderly individuals with balance issues.
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