Patología del equilibrio. Vértigos periféricos

Abstract

Vertigo is defined as the illusion of movement of oneself or one's surroundings, although each patient may experience different sensations. It can be classified according to the duration of the crisis, how often it occurs, the time it has been ongoing, or the triggers. Many diseases that affect the inner ear do not have a defined pathophysiological mechanism that causes them. However, it is known that viral infections can cause serous labyrinthitis or vestibular neuritis, that cranial trauma or abnormal postures can cause benign paroxysmal positional vertigo (BPPV), and that aging of the vestibular receptors can trigger presbyvertigo.The diagnosis is based on a detailed case history; a physical examination that explores the vestibulo-ocular and vestibulo-spinal reflexes; additional tests such as audiometry or videonystagmography; and finally imaging tests, mainly magnetic resonance imaging.The acute phase will be treated with drugs that decrease nausea and vomiting. The main drugs are vestibular sedatives, which should not be used for more than three days. There are specific treatments for each disease, such as in the case of BPPV, in which repositioning maneuvers are performed.In the emergency department, examinations are performed at the patient's bedside. The HINTS examination has been demonstrated to have the greatest sensitivity and specificity.