救急総合診療部受診例と耳鼻咽喉科受診例のめまい患者の比較検討

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We recently studied the characteristics of vertigo and dizziness in 197 patients who first visited the emergency room (ER group) and in 288 patients who first visited the otorhinolaryngological clinic of Minoh City Hospital (ENT group) between January 1 and December 31 of 2009. The ER group can be regarded as representing the hyperacute phase and the ENT group as representing the acute to chronic phase. These two groups were completely distinct. We also subdivided these groups into the high risk subgroup (H subgroup) for cases with the underlying diseases of diabetes mellitus, hypertension, cerebrovascular disease and hyperlipidemia, and the normal subgroup (N subgroup). Comparison of the two groups showed that, in the ER group, a significantly larger numbers of patients had symptoms of peripheral vestibular origin except for BPPV and Menieres disease, and a significantly larger number of patients had symptoms of unknown origin in the ENT group. Half of this group may be accounted for by patients with symptoms of peripheral vestibular origin except for BPPV and Menieres disease in the ER group. In 8 out of 158 patients of the ER group and 1 out of 122 patients of the ENT group, cerebral lesions were not found on CT images but were found with MRI. Careful investigation is necessary in the patients with normal CT findings. Central vestibular lesions were found in 7 out of 197 patients (3.5%) of the ER group and 5 out of 288 patients (1.7%) of the ENT group. The incidence of central lesions tended to be higher in the ER group than in the ENT group. There was no significant difference in the incidence of central lesion among the H and N subgroups of both groups. Careful investigation of the central vestibular lesion is also necessary in the N subgroup.

救急総合診療部受診例と耳鼻咽喉科受診例のめまい患者の比較検討

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