Understand in one article: How should patients with vertigo seek medical treatment?

Which department should I visit for vertigo?

The incidence of vertigo is very high. Many people have experienced the feeling of dizziness, lightheadedness, nausea and vomiting. Most people feel dizzy after the onset of the disease and don’t know what to do. Go to the hospital, but don’t know which department to go to. Among vertigo diseases, peripheral vertigo is more common than central vertigo. Due to the complexity of vertigo, in order to get a satisfactory diagnosis as soon as possible, you should first go to the hospital’s vertigo clinic or vertigo diagnosis and treatment center . At present, hospitals across the country are paying attention to the construction of vertigo clinics, and some hospitals have even opened special vertigo wards.

Because medical history is crucial for the diagnosis of vertigo, patients should express their subjective feelings to the doctor as accurately as possible. First, patients should tell the doctor the specific discomfort of vertigo or dizziness, such as the feeling of external objects rotating or the feeling of self-rotation, unstable walking or balance disorder; secondly, answer general questions about the vertigo attack, such as whether it is sudden or slow, how long each attack lasts, whether it is related to changes in body position, and what are the triggers of the attack; thirdly, tell the doctor whether there are any accompanying symptoms and whether there are any important diseases in the past, such as ear disease, eye condition, hypertension, diabetes, etc. For ear disease, focus on providing a history of deafness, tinnitus, ear pus, ear pain and ear surgery; whether there is double vision or blurred vision. The more detailed the medical history is, the more helpful it will be for the doctor to diagnose.

What diseases can cause vertigo?

According to the anatomical location of the lesion, vertigo can be divided into two categories: peripheral vertigo and central vertigo. Peripheral vertigo refers to vertigo caused by lesions in the vestibular labyrinth located in the inner ear, while central vertigo generally refers to vertigo caused by lesions in the brainstem, cerebellum, and cerebrum.

Characteristics of peripheral vertigo

① Most of them are visual rotation vertigo. ② The duration of vertigo is short (several minutes to several days). ③ Vestibular coordination phenomenon: autonomic dysfunction phenomenon consistent with the degree of vertigo, such as nausea, vomiting, cold sweat, palpitation, diarrhea, etc.; the degree of vertigo and balance disorder is consistent or the vertigo is more severe and the balance disorder is mild. ④ Nystagmus is short, fine and fast, and mostly horizontal rotation. ⑤ Often accompanied by deafness and tinnitus.

Common peripheral vertigo diseases include the following:

1. Otolithiasis: Also known as benign paroxysmal positional vertigo, it is the most common vertigo. It is caused by the dislodgment of stones in the inner ear labyrinth, which causes short-term vertigo. It mostly occurs when sleeping, turning over, getting up, or lying in bed. It is easy to induce and lasts for a short time, generally no more than 1 minute. Severe cases may be accompanied by nausea and vomiting.

2. Meniere's disease: It is an inner ear disease in which water accumulates in the inner ear membranous labyrinth. The main clinical manifestations of this disease are paroxysmal vertigo, tinnitus, deafness or nystagmus. Vertigo has obvious attack and intermittent periods, and a single attack is often difficult to diagnose.

3. Vestibular neuritis: After respiratory or gastrointestinal infection, vertigo may suddenly occur, reaching a peak within a few hours, accompanied by nausea and vomiting, which may last for several days or weeks, and then gradually return to normal. The recovery of the elderly is slow, which may last for several months. One ear may be affected, and occasionally both ears may be affected successively. There is spontaneous nystagmus to the healthy side, no tinnitus during the disease period, and deafness is its characteristic. 4. Labyrinthitis: Labyrinthitis is a common complication of suppurative otitis media mastoiditis. It is mostly caused by cholesteatoma or chronic osteitis destroying the labyrinth bone wall, resulting in local fistula, which makes the middle ear communicate with the labyrinth endosteum or perilymphatic space. . Vertigo, nausea, vomiting, imbalance, and deafness are the main symptoms of this disease. Spontaneous nystagmus can be seen during vertigo attacks. 5. Sudden deafness: It is a sudden hearing loss due to unknown reasons in a short period of time. It is a sensorineural deafness that affects the auditory nerve. However, some patients also experience vertigo. The auditory nerve and the vestibular nerve are very close and are located in the internal auditory canal. Edema of the auditory nerve can affect the vestibular nerve and cause vertigo.

Central vertigo features

① Mainly balance disorder, vertigo is mild. ② Long duration (tens of days to months). ③ Vestibular incoordination phenomenon: the degree of vertigo is inconsistent with the degree of autonomic dysfunction, and the autonomic dysfunction is generally mild. ④ Nystagmus persists, is coarse, vertical, oblique, and separated. ⑤ Often accompanied by cerebral ischemia phenomena such as black eyes and headache.

Common central vertigo diseases include the following :

Trauma, inflammation, poisoning, neurodegeneration, tumors, blood supply disorders, and compression by surrounding tissues. 1. Posterior circulation ischemia (PCI): refers to transient ischemic attacks (TIA) and cerebral infarctions in the carotid artery system of the posterior circulation. Common clinical symptoms include dizziness, vertigo, numbness of limbs or head and face, limb paralysis, paresthesia, gait or limb ataxia, articulation or swallowing disorders, falls, hemianopsia, hoarseness, etc. 2. Cerebellar and brainstem hemorrhage: characterized by persistent vertigo and headaches, and gradually unclear consciousness. The brainstem is the center of life, and the heartbeat and breathing of the human body are controlled by it. Once bleeding or infarction occurs, the mortality rate is very high. 3. Cerebellar tumor: Unsteady walking is the main symptom, often with headaches and dizziness after getting up in the morning, and vomiting without eating, among which there are many cases of children.

4. Vestibular migraine (VM): Patients present with episodic vertigo or unsteadiness, and these patients also have a history of migraine at the onset of or before the onset of the disease. The location and severity of the headache vary. Vertigo often occurs during the migraine attack, but it can also occur during the interval or pre-migraine period. Some patients only show migraine symptoms during the attack. Photophobia, phonophobia, olfactory phobia and visual or other auras are the most common accompanying symptoms of VM.

Therefore, due to the complexity of vertigo, in order to get a satisfactory diagnosis as soon as possible, you should first go to the hospital's vertigo clinic or vertigo diagnosis and treatment center . If the hospital you visit does not have a special vertigo clinic, you can also choose neurology or otolaryngology according to your symptoms.