الفهرس | Only 14 pages are availabe for public view |
Abstract Vertigo is defined as false illusions of circular motion. Inspite of vertigo is the second commonest complaint in medical practice, diagnosis is difficult due to vague description by the patient, many different systems included e.g. CNS, ENT, Ophthalmology, Cardiovascular, Hematology, psychiatry, etc. For patients whose history indicates vertigo due to vestibular system disturbance, the task is then directed at distinguishing a peripheral from a central lesion. Proper diagnosis depends on careful history taking. A careful and thorough history is crucial in evaluating the possible cause of vertigo. Several areas must be addressed in detail in taking the history, complete analysis of the complaint, family history, past history, etc. Once a good history has been obtained, the next step is to perform a complete. general, otolaryngologic, neurotologic and ophthalmologic examination. Investigations include vestibular, audiological assessment, imaging and laboratory tests. Treatment of various vertiginous diseases is challenging. The objective for the treatment of a vertiginous disease is to eliminate the underlying pathology either with surgical or non surgical maneuvers. In vertiginous diseases, surgery is performed either to eliminate the underlying pathologic event or to create stability in the incoming vestibular signals. It is not always possible to treat the underlying disease. Therefore, surgery is usually performed for the relief of vertigo The choice of treatment of vertigo should be guided by the symptoms, the supposed etiological factors and the age of the subject. Surgical solutions should be proposed for cases of chronic incapacitating vertigo that are refractory to non surgical treatment (pharmacotherapy and vestibular rehabilitation). Labyrinthectomy, Vestibular Neurectomies and other types of surgery are used in treatment of peripheral vertigo as ventilation tube (VT) insertion but exact explanation for its effect is vague and its therapeutic effect was limited. Intratympanic therapy with gentamycin and steroids has evolved as new methods for the treatment of acute meniere’s disease but comparing with vestibular neurectomy both are effective for relieving vertigo. Also middle ear muscles tenotomy is a successful and enduring therapeutic approach for treating the auditory and vestibular symptoms of Meniere’s disease. Destruction of labyrinthine receptors by using laser as a treatment for benign paroxysmal postural vertigo and otolith symptoms. |