PDF(Pubmed)
Abstract：
(1) Background: Usually, the majority of patients suffering from vertigo and dizziness can be identified in four major categories: acute spontaneous vertigo, episodic (recurrent) vertigo, recurrent positional vertigo, and chronic imbalance. Our purpose is to retrospectively evaluate the main causes of episodic vertigo and to find indications for a reliable clinical suspicion useful for a definitive diagnosis, comparing patients affected by different presenting symptomatology (acute vertigo, recurrent episodic vertigo, and imbalance). (2) Methods: we retrospectively evaluated the clinical records in a population of 249 consecutive patients observed for vertigo in our tertiary referral center in the period 1 January 2019-31 January 2020. On the basis of the reported clinical history, patients were divided into three groups: patients with their first ever attack of vertigo, patients with recurrent vertigo and dizziness, and patients with chronic imbalance. (3) Results: On the basis of the results of the instrumental examination, we arbitrarily divided (for each type of symptoms) the patients in a group with a normal vestibular instrumental examination and a group of patients in which the clinical-instrumental evaluation showed some pathological results; a highly significant difference (p: 0.157) was found between recurrent and acute vertigo and between recurrent vertigo and imbalance. (4) Conclusions: Patients with recurrent vertigo more frequently exhibit a negative otoneurological examination since they are often examined in the intercritical phase. A precise and in-depth research of the patient\'s clinical history is the key to suspect or make a diagnosis together with the search for some instrumental or clinical hallmark, especially in cases where the clinical picture does not fully meet the international diagnostic criteria.
摘要：
（1）背景：通常，大多数患有眩晕和头晕的患者可以分为四大类:急性自发性眩晕，发作性（复发性）眩晕，复发性位置性眩晕,慢性失衡。我们的目的是回顾性评估发作性眩晕的主要原因，并找到对明确诊断有用的可靠临床怀疑的指征。比较受不同症状影响的患者(急性眩晕，反复发作性眩晕,和不平衡)。（2）方法：我们回顾性评估了2019年1月1日至2020年1月31日期间在我们的三级转诊中心观察到的249名连续眩晕患者的临床记录。根据报告的临床病史，患者分为三组：第一次发作眩晕的患者，复发性眩晕和头晕的患者，和慢性失衡患者。（3）结果：根据仪器检查结果，我们将(每种类型的症状)患者分为一组前庭器械检查正常的患者和一组临床器械评估显示一些病理结果的患者;发现复发性和急性眩晕之间以及复发性眩晕和失衡之间存在非常显著的差异(p:0.157).（4）结论：复发性眩晕患者的耳神经学检查阴性，因为他们经常在临界期进行检查。对患者的临床病史进行精确和深入的研究是怀疑或做出诊断的关键，同时寻找一些仪器或临床标志，尤其是在临床表现不完全符合国际诊断标准的情况下。
