Analysis of Clinical Course and Neuro otological Examination of Vertiginous Patients

概要

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A precise history of the symptoms of vertiginous or dizzy patients suggests the correct diagnosis, which is then confined by neuro-otological examination. Appropriate examinations can be planned from an analysis of the symptoms.We investigated the relationship between the clinical course and the incidence of neure-otological abnormalities, between the clinical course and the differential diagnosis, such as central or peripheral, functional or organic, and between the differential diagnosis and the pattern of neuro-otological abnormalities.1) In patients with vertigo, the incidence of neuro-otological abnormalities differed greately depending on the presence or absence of vertiginous or persisting symptoms on the first examination. In patients with dizziness, there was no distinct difference.2) Patients who complained of vertigo but had no vertiginous or persisting symptoms after the first examination, did not have posterior fossa lesions, such as tumor or degenerative disease.3) Bilateral gaze nystagmus, apogeotropic direction changing positional nystagmus and vertical nystagmus are important findings suggestive of posterior fossa lesions.