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  Patronage of the Polish Society of Audiology and Phoniatrics

vol 13. no 1. March 2014  

 Review articles
Diagnostic controversies of the otolaryngologist and neurologist over patients with balance disorders diagnosed at hospital emergency wards
Ireneusz Kantor, Stanisław Szlufik, Marzena Kubiczek-Jagielska, Monika Woźniak

Balance disorders and vertigo are still significant diagnostic
problems for both otolaryngologists and neurologists. It relates
primarily to patients reporting at hospital emergency wards. It
is advisable that the diagnosis and decision on the treatment to
be applied is made simultaneously as a result of consultations
between both specialists, as many grave diseases are manifested
by a slight vertigo or minor balance disorders, while severe
symptoms may result from illnesses quickly disappearing without
leaving permanent defects. Therefore, doctor from the
emergency ward and both otolaryngologist or neurologist
consulting patients with balance disorders should remember
that the diagnoses in these cases should be based on history
and objective tests (including otoneurological examination).
During history taking, the doctor should try to determine
the cause of symptoms, their duration and character. The aim
of physical examination is to assess nystagmus, cranial nerve
function, muscle tonus and strength; the examination should
also comprise coordination tests, postural tests, and testing
for the pyramidal or the meningeal symptoms. Only after this
basic examination the doctor should consider the necessity to
perform additional, tests, in particular the imaging examinations.
Differences between peripheral and central causes of balance
disorders always need to be considered. Rare disorders or those
masked by symptoms from other organs and systems are most
difficult to diagnose.

keywords: zaburzenia układu równowagi, stany nagłe, diagnostyka, balance disorders, state of emergency, diagnosis

pages: from 17 to 25

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