掌握正确的头晕眩晕诊断思路与方法：《眩晕诊治多学科专家共识》解读与启示.pdfVIP

中国现代神经疾病杂志2018年2月第18卷第2期 ChinJContempNeurolNeurosurg,February2018,Vol.18,No.2 · ·79 ·标准与指南· 掌握正确的头晕眩晕诊断思路与方法：《眩晕诊治多学科 专家共识》解读与启示 李焰生 【摘要】 头晕眩晕是常见临床症状，临床表现复杂，病因多样，因此应掌握正确诊断思路和方法。 首先应进行详细的病史询问，了解头晕眩晕发作性质和类型、持续时间、伴随症状及相关病史；其次应进 行仔细的神经耳科检查和针对性辅助检查，不加选择的辅助检查并不能有助于诊断。基于上述过程，方 可以实现不同前庭综合征（急性、阵发性或慢性）的诊断，再结合诊断标准完成疾病诊断。本文拟结合 《眩晕诊治多学科专家共识》，就如何通过病史询问、体格检查和辅助检查建立综合征的诊断并最终完成 头晕眩晕病因诊断进行阐述。 【关键词】 头晕； 眩晕； 综合征； 诊断； 综述 Grasp the correct diagnostic approaches and methods of dizziness and vertigo: interpretation and enlightenment from Multidisciplinary expert consensus of diagnosisandtreatmentofvertigo LIYan⁃sheng DepartmentofNeurology,SouthCampus,RenjiHospital,ShanghaiJiaotongUniversitySchoolofMedicine, Shanghai201112,China(Email:lliyans@) 【Abstract】 Dizziness and vertigo are common clinical conditions with complex and overlapped clinical features that caused by various disorders and diseases. Therefore, it is important to grasp the correctdiagnosticapproachesandmethods. First,itisnecessarytocarryoutacarefulhistoryinquiryto understandthenatureandtype,duration,accompanyingsymptomsandrelatedmedicalhistory. Thesecond is to carry out careful neuro⁃otological examinations and targeted tests. The indiscriminate auxiliary examinationdoesnothelpthediagnosis. Basedontheaboveprocess,thediagnosisofdifferentvestibular syndromes(acute,episodicorchronic)canberealized,andthediagnosisofdisordersordiseasescanbe madeaccordingtodiagnosticcriteria. Thepaperdiscussedhowtomakethefinaldiagnosisbyinquiryand physical examination, auxiliary examination and syndrome diagnosis on the basis of Multidisciplinary expertconsensusofdiagnosisandtreatmentofvertigo. 【Keywords】 Dizziness; Vertigo; Syndrome; Diagnosis; Review 头晕（dizziness）和眩晕（vertigo）是常见临床症 病因诊断主要依靠临床表现而非辅助检查，因此， 状，患病率随年龄的增长而增加，是老年人群就诊 很大部分患者未能得到及时和准确诊断，从而接受 的前3位主要原因。然而，头晕和眩晕却不像脑卒