medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2023-21-23-29medalphabet-3306Research ArticleСтатьиДиагностика и лечение головокружения в клинической практикеDiagnosis and treatment of dizziness and vertigo in clinical practicehttps://orcid.org/0000-0002-5663-6628МакаровС. А.MakarovS. A.

Макаров Сергей Антонович, к. м. н., доцент, кафедра нервных болезней Института профессионального образования

Москва

Makarov Sergey A., PhD Med, associate professor

Moscow

makarov_s_a@staff.sechenov.ruhttps://orcid.org/0000-0002-7988-4229ГусеваА. Л.GusevaA. L.

Гусева Александра Леонидовна, к. м. н., доцент,  кафедра оториноларингологии имени академика Б. С. Преображенского лечебного факультета

Москва

Guseva Alexandra L., PhD Med, associate professor

Moscow

ФГАОУ ВО «Первый Московский государственный медицинский университет имени И. М. Сеченова» Минздрава России (Сеченовский университет)РоссияI. M. Sechenov First Moscow State Medical UniversityRussian FederationФГАОУ ВО «Российский Национальный Исследовательский Медицинский Университет имени Н. И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian Federation202306112023021Неврология и психиатрия (3)2329Copyright © Макаров С.А., Гусева А.Л., 20232023Макаров С.А., Гусева А.Л.Makarov S.A., Guseva A.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3306

В статье обсуждается современный алгоритм диагностики головокружения. Описаны основные принципы выделения острого, приступообразного и хронического вестибулярных синдромов, оценка длительности приступов, провоцирующих факторов и сопутствующих заболеваний. Представлены основные тесты при отоневрологическом обследовании и их трактовка при оценке спонтанного нистагма, результатов стато-координаторных тестов, теста поворота головы и позиционных проб. Обсуждаются диагностические критерии и основные подходы к лечению наиболее часто встречаемых расстройств, проявляющихся головокружением, в том числе доброкачественного пароксизмального позиционного головокружения, вестибулярного нейронита, болезни Меньера, вестибулярной мигрени, персистирующего постурально-перцептивного головокружения, двусторонней вестибулопатии и др.

The article describes vertigo diagnostic algorithm. Acute, paroxysmal, and chronic vestibular syndromes determination, attacks duration assessment, provoking factors and comorbid diseases are described. The otoneurologic examination main tests and their interpretation in assessing of spontaneous nystagmus, the results of stato-coordination tests, the head rotation test and positional tests are presented. Diagnostic criteria and basic approach to the most common disorders manifested by vertigo treatment are discussed, including benign paroxysmal positional vertigo, vestibular neuronitis, Meniere's disease, vestibular migraine, persistent postural-perceptual vertigo, bilateral vestibulopathy and others.

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The authors declare that there are no conflicts of interest present.