![]() The nystagmus corresponds to a so-called ampullofugal excitation of the affected posterior vertical semicircular canal of the affected (lower) ear. ![]() After a change in position of one of these types, rotational vertigo and nystagmus arise after a latency of a few seconds and then take a characteristic crescendo-decrescendo course, lasting a total of 30 to 60 seconds. The attacks are precipitated by reclination of the head, or by lateral positioning of the head or body, with the affected ear downward. It is characterized by brief attacks of rotational vertigo, accompanied by vertical positioning nystagmus that rotates toward the lower of the two ears and beats toward the forehead. This is the most common type of vertigo it mainly affects older patients ( table 1) and has a lifetime prevalence of 2.4% ( 1). The important criteria for distinguishing among them are as follows ( 2):īenign paroxysmal positioning vertigo (BPPV) The relative frequencies of various syndromes presenting with dizziness and vertigo are listed in table 1. Ancillary testing is of secondary importance. In other words, these patients often fall into the cracks between medical specialties.Ī patient’s complaint of "dizziness" necessitates the taking of a thorough history precisely because of the many different meanings this term can have. Experience has shown that the affected persons often make an odyssey of visits to physicians belonging to various specialties, beginning with their family physicians and proceeding through ENT specialists, neurologists, ophthalmologists, internists, and orthopedists, before the correct diagnosis is made and the appropriate treatment is begun. ![]() Their lifetime prevalence is approximately 20% to 30% ( 1). Alongside headache, dizziness and vertigo are among the more common symptoms with which patients present to physicians in general, not just to neurologists. The term "dizziness" refers either to an unpleasant disturbance of spatial orientation or to the erroneous perception of movement, which is more specifically called "vertigo." Vertigo involves a perceived movement either of one’s own body, such as swaying or rotation, or of the environment, or both. ![]()
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