跟讀練習: SVINutes: Decoding Dizziness - 通過影片學習英語口語

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Hi, my name is Paige Banyas and I'm a vascular neurologist and today I'm going to teach you how to decode dizziness.

Dizziness is a frequently encountered patient complaint.

Today we are going to focus on vertigo and how to distinguish central from peripheral causes.

This differentiation is vital in identifying the correct diagnosis and subsequent treatment strategies.

It also allows for better patient education as it gives the patient the ability to understand their condition

and what to expect in terms of recovery.

Central vertigo implies that the vertigo arises from a disruption in the central nervous system, so for example in the brain stem or cerebellum.

Compared to peripheral vertigo, central vertigo often indicates a more serious underlying neurological condition.

In terms of characteristics, the onset can be sudden or gradual.

Duration can vary but episodes are more likely to be long or persistent.

The nature of symptoms may be described as a spinning sensation, imbalance, and or incoordination.

Accompanying symptoms may include visual disturbances such as diplopia, weakness, numbness, abnormal speech, dysphagia,

ataxia, altered level of consciousness, or a headache.

Typically symptoms will not have a positional component like they do with peripheral vertigo.

Central vertigo does not typically respond to traditional vestibular medications or maneuvers that are effective for peripheral vertigo.

Some causes of central vertigo include stroke, vertebral basilar insufficiency, multiple sclerosis, and brain tumors.

Peripheral vertigo is a type of dizziness that originates from the inner ear, or in other words, the vestibular apparatus.

It is commonly associated with structures responsible for balance, like the semicircular canals or vestibular nerve.

In terms of characteristics, the onset tends to be sudden.

Duration can be very short, with episodes lasting seconds to minutes, although sometimes symptoms can persist for days.

Associated symptoms can include gait imbalance, tinnitus, hearing loss, nausea, vomiting, and diaphoresis.

It is common for patients to report a positional component to their symptoms, meaning that symptoms are triggered or exacerbated by head movements.

Depending on the specific etiology, patients may have an excellent response to medication, vestibular exercises, and or maneuvers.

Some causes of peripheral vertigo include BPPV, vestibular neuritis and labyrinthitis, and Meniere's disease.

When seeing a patient with vertigo, you want to ask about onset,

duration, nature of symptoms and associated symptoms, and provocative features.

Upon completing your history, there are various diagnostic tools to consider.

First are physical exam maneuvers such as a Dix-Hallpike test and or a HINTS exam.

You may also want to consider head imaging, such as a brain MRI.

If you are worried about a cerebrovascular event, such as stroke, TIA, or vertebrobasilar insufficiency,

you will want to additionally obtain a CTA or MRA of the head

and neck to look for hemodynamically significant stenosis and occlusions.

I hope this review of central versus peripheral vertigo will help you decode dizziness in the future.

Thanks for listening.

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跟讀練習: SVINutes: Decoding Dizziness - 通過影片學習英語口語

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