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Vertigo   and   dizziness :   differential diagnostics and individual treatment procedures Trinus K. P.L.Shupyk National Medical Academy for  Postgraduate Education, Ukraine, Kyiv
Vertigo - ,[object Object],[object Object],[object Object]
Dizziness ,[object Object],[object Object]
Vertigo ,[object Object],[object Object]
Dizziness ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Coordination disorders (disequilibria) ,[object Object],[object Object],[object Object]
Material and methods ,[object Object],[object Object],[object Object]
Subjective sensations during caloric test
Nystagmus frequency  ( per  1  min .)  p = 0,04 (F test)
Nystagmus frequency ,[object Object],[object Object]
Hair cells ,[object Object],[object Object]
Vestibular nerve ,[object Object],[object Object],[object Object]
Vestibular nuclei ,[object Object],[object Object]
Vestibular pathways ,[object Object],[object Object]
Vestibulo-cortical pathways ,[object Object],[object Object],[object Object]
In physiological conditions ,[object Object],[object Object],[object Object]
In pathological conditions ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Methods for documentation ,[object Object],[object Object],[object Object]
Vestibular lesion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vestibular dysfunction ,[object Object],[object Object],[object Object],[object Object],[object Object]
Coordination disturbance ,[object Object],[object Object],[object Object],[object Object],[object Object]
Methods for balance evaluation ,[object Object]
Typical cases of the CCG ,[object Object],[object Object]
Differential diagnostics Disturbance Severe disturbance Small disturbance Balance Might be present High frequency Low frequency Nystagmo graphy Might be normal Increased all latencies Increased latencies of  Р1  and   N 1 VestEP Typical Clear description Unclear Complaints Balance disorder Vertigo Dizziness
Effect of Tanakan at the symptomatics of vertigo-dizziness, horizontal axis - % of patients, vertical - symptoms
Dizziness ,[object Object],[object Object]
Effect of Cinnarizine at the   dizziness -vertigo
Vertigo ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
NB! Strict differentiation of the complaints might be the first step for the correct diagnostics and treatment choice .
Complaints distribution
Patient: P.  25 years old,   military officer Complaints:  intensive headaches without clear localization   1-3 times per week with 1-2 days duration and accompanied with severe  vertigo  and  dizziness , hyperhydrosis, loss of consciousness and vomiting episodes. Labor capacities and quality of life are seriously decreased.
Anamnesis morbi: ,[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Positive effect of betahistine appeared at the first days of treatment . ,[object Object],[object Object]
Evoked potentials :  ( latency of   P 1 ) ,[object Object],[object Object]
Vertigo, dizziness and additional symptoms Medicine of choice   betahistine
Differentiated approach to the treatment of vestibular migraine Cinnarizin Dimenhydrinate
Conclusions ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]

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dizziness, vertigo, balance, migraine

  • 1. Vertigo and dizziness : differential diagnostics and individual treatment procedures Trinus K. P.L.Shupyk National Medical Academy for Postgraduate Education, Ukraine, Kyiv
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  • 9. Nystagmus frequency ( per 1 min .) p = 0,04 (F test)
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  • 24. Differential diagnostics Disturbance Severe disturbance Small disturbance Balance Might be present High frequency Low frequency Nystagmo graphy Might be normal Increased all latencies Increased latencies of Р1 and N 1 VestEP Typical Clear description Unclear Complaints Balance disorder Vertigo Dizziness
  • 25. Effect of Tanakan at the symptomatics of vertigo-dizziness, horizontal axis - % of patients, vertical - symptoms
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  • 27. Effect of Cinnarizine at the dizziness -vertigo
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  • 30. NB! Strict differentiation of the complaints might be the first step for the correct diagnostics and treatment choice .
  • 32. Patient: P. 25 years old, military officer Complaints: intensive headaches without clear localization 1-3 times per week with 1-2 days duration and accompanied with severe vertigo and dizziness , hyperhydrosis, loss of consciousness and vomiting episodes. Labor capacities and quality of life are seriously decreased.
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  • 38. Vertigo, dizziness and additional symptoms Medicine of choice betahistine
  • 39. Differentiated approach to the treatment of vestibular migraine Cinnarizin Dimenhydrinate
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