Documente Academic
Documente Profesional
Documente Cultură
Pendahuluan
Ad: perasaan berputar bedakan dg dizziness *rasa goyang/tidak stabil
True vertigo: Keluhan subyektif rasa berputar (px beputar/sekelilingnya berputar ggn vestibuler
Etiologi
Drugs
Alcohol Aminoglycosides Anticonvulsants Antidepressants Antihypertensives Barbiturates Cocaine
Central
Cerebellopontine
Peripheral
Acute
labrynthitis Vestibular neuritis BPPV Cholestotoma Meniers disease Ostosclerosis Perilymphatic fistula
Sesuai kejadian
spontan posisi kalori
Vertigo posisi
Timbul ok perubahan posisi kepala Perangsangan kupula kanalis semisirkularis ok debris kotoran yg menempel pd kanalis semisirkularis/kel.servikal
Vertigo kalori
Timbul saat tes kalori Agar dpt membandingkan vrtigo ini dg serangan yg pernah dialami sama keluhan benar beda keluhan sebelumnya diragukan
Diagnosi
Anamnesis :
Ciri-ciri, sifat dan lama vertigo, faktor pencetus Gejala yang menyertai Penyakit sistemik hipotiroid, DM, penyakit kardiovaskuler, gangguan penglihatan,dll.
*-Vertigo with early acute vestibular neuritis can last as briefly as two days or as long as one week or more.
Distinguishing Characteristics of Peripheral vs. Central Causes of Vertigo Feature Nystagmus Peripheral vertigo Combined horizontal and torsional; inhibited by fixation of eyes onto object; fades after a few days; does not change direction with gaze to either side Imbalance Nausea , vomiting Mild to moderate; able to walk May be severe Central vertigo Purely vertical, horizontal, or torsional ; not inhibited by fixation of eyes onto object; may last weeks to months ; may change direction with gaze Severe; unable to stand still or walk Varies
Common Rare
Rare Common
Pemeriksaan Fisik
Pmx THT umum Tes garpu tala (pemeriksaan fungsi pendengaran) Tes keseimbangan : romberg test, stepping gait. Pmx neurologi
Peripheral vertigo
Latency of symptoms and nystagmus 2 to 40 seconds Severe Usually< 1 minute Yes Yes
Central vertigo
None
*-Response remits spontaneously as position is maintained. -Attenuation of response as position repeatedly is assumed. Information from references 3 and 4.
Pemeriksaan
Penunjang :
Penatalaksanaan
1.
Vestibuler sedative
Derivat antihistamin (ant H1) Dimenhydrinate (dramamin) po bila muntah hebat inj Prometazine Cinnarizine Derivat fenotiazin (bila muntah) Prochlorperazine Bila muntah hebat dehidrasi
2.
Infus
Indikasi MRS :
Vertigo berat dan progresif Vertigo pertama kali dan berat curiga stroke