眩晕

About 眩晕

定义

眩晕 is a feeling of spinning when a person is standing still. It can be caused by many different health issues.

原因

The inner ear and nerves sense the position of a person's head and body. 眩晕 can happen when there are problems with these nerves and structures. It may also be due to problems in the brain, but this is not as common.

The two main types of 眩晕 are:

Peripheral 眩晕

Peripheral 眩晕 is common and caused by problems with the inner ear. 原因 may be:

• 良性的 paroxysmal positional 眩晕 (BPPV)
• 美尼尔综合症 疾病
• Perilymphatic fistula—an abnormal canal or connection in the inner ear
• Medicines that disrupt the inner ear's ability to 平衡
• 感染
• 声 神经瘤—a benign tumor of the nerve that helps with hearing and 平衡
• Poor blood flow
• 受伤
• 耳硬化症—a bony growth near the middle ear
• A displaced canalith—these are small crystals in the inner ear that help sense 运动. They can sometimes move out of place and cause problems.

Central 眩晕

Central 眩晕 is less common but more serious. It happens due to changes in the brainstem or the cerebellum. These parts of the brain control 平衡. Changes can be caused by:

• Damage to the brain from 疾病s such as 多个 硬化, stroke, or from tumors
• Migraine headaches
• Nervous system problems, such as Parkinson 疾病 or 多个 硬化
• 癫痫
• Too much exposure to alcohol, heavy industrial metals, or poisons
• 受伤

风险因素

The conditions above can raise a person's risk of 眩晕.

症状

A person with 眩晕 may have:

• Sensation of rotation
• Illusion of 运动
• Feeling of being pulled in one direction
• Feeling of being off-平衡

眩晕 is not the same as feeling lightheaded. A person who is lightheaded does not have a feeling of 运动.

诊断

The doctor will ask about symptoms and health history. 一个物理 exam will be done. To look for a cause the doctor may also do:

• 血液测试
• Hearing and vision tests
• Head maneuvers—the doctor will move a person's head to help find out the cause of 眩晕
• Blood pressure test, both lying down and standing up
• Electronystagmogram—to check for 眼球震颤, an abnormal 眼动
• 核磁共振成像扫描
• Rotatory chair test
• Brainstem auditory evoked potential studies—to see how the auditory nerve and brainstem are working

治疗

Some lifestyle changes can help manage 眩晕, such as using a cane to help with 平衡. Treating the cause may also stop the 眩晕.

Some medicines that cause 眩晕 may need to be stopped or changed.

Medicines that may ease or stop symptoms are:

• Antihistamines
• Benzodiazepines
• Anticholinergics
• 止吐药

预防

There are no current guidelines to prevent 眩晕.

参考文献

• Dizziness and 眩晕. The Merck Manual Professional 版. Available at: http://www.merckmanuals.com/professional/ear,鼻子,-and-throat-disorders/approach-to-the-patient-with-ear-problems/dizziness-and-眩晕?query=眩晕.
• Dizziness in adults - approach to the patient. EBSCO DynaMed 网站. Available at: http://www.力学.com/approach-to/dizziness-in-adults-approach-to-the-patient.
• Living with a vestibular disorder. Vestibular Disorders Association 网站. Available at: http://vestibular.org/living-vestibular-disorder/everyday-challenges.
• 曼西,H.L.， Sirmans, S.M.等。. Dizziness: approach to evaluation and management. American Family Physician, 2017; 95 (3): 154-162.