Dizziness – pathogenesis, diagnosis and treatment

Abstract

Dizziness is a symptom of many diseases. Patients very frequently come with such ailment to the hospital emergency department. It is a state which may last a few seconds or minutes and increase or recede with time. Therefore, the admitted patients frequently cannot assess their own illness in a precise and objective way. The dizziness definition is also quite ambiguous. Dizziness is defined as the sensation of one own’s body movement or spinning and movement of the surrounding. It is very important to record the patient’s medical history since the diagnostic procedure may depend on the symptoms’ character. Dizziness may be a symptom of a serious disease, although it is not easy to find its cause. It appears not only in case of the labyrinth and nervous system disorders, but also in the systemic and functional diseases. Dizziness and balance disorder are the direct cause of admitting one in every thirty patients. The symptom indicated the directly life-threatening disease only within the 3-8.5% of patients (cerebral circulation insufficiency - 6%, cardiac dysrhythmia - 1.5%, brain tumour < 1%). Analyzing the data concerning the problem of dizziness occurrence within the general population, it has been noticed that this symptom has been reported two or three times more frequent by women than by men. Dizzinesses are classified pathogenetically and clinically into labyrinthine and non-labyrinthine, paroxysmal and permanent, acute and chronic. Dizziness is hard to diagnose because the symptoms reported by patients are only their own subjective sensations. The data presented in the article implicate the increasing number of patients with such disorders. Apart from dizziness, the patients complain also about the hearing disorders and nausea, which make their proper functioning impossible. It is inappropriate to start the treatment without knowing the cause. Establishing, on the basis of patient’s medical history and physical examination, whether the dizziness is of peripheral or central origin, is essential for the further diagnosis. After establishing the main diagnosis, the casual