末梢性めまい疑いにて耳鼻咽喉科を受診した危険なめまい症例の検討

抄録

　Introduction: The diagnosis of dizziness is important because it is sometimes associated with fatal conditions such as cerebrovascular and cardiac diseases. We report several cases of “dangerous” dizziness that were initially referred to our otolaryngology clinic as peripheral dizziness and were subsequently found to be associated with central nervous system (CNS) and cardiac diseases.

　Subjects: Eight (3 male and 5 female) patients out of a total of 211 patients who visited our clinic between June 2016 and June 2017 were studied.

　Results: Six (2.8% overall) patients had CNS disorders and 2 (1.0% overall) had cardiac diseases. Four (50% of the studied patients) were referred to our clinic from the ER, and 4 (50% of the studied patients) were referred from the Department of Internal Medicine. Two (25% of the studied patients) of the patients complained of vertigo, and 6 (75% of the studied patients) complained of dizziness. Five (60% of the studied patients) of the patients had high blood pressure and cardiac diseases. All the cases had orthostatic symptoms.

　Conclusion: MRI examination was useful for the diagnosis of CNS disorders, but it also included false-negative DWI cases. The Schellong test was useful for the diagnosis of cardiac diseases. For accurate diagnosis and appropriate treatment, changes in symptoms and physical signs should be closely monitored and appropriate diagnostic tools should be applied in a timely fashion.