Dizzy and the Unsteadiness ’ are a very frequent problem, can affect both young and old, both healthy people who with Comorbidities and can be extremely disabling.
Our balance depends on a great number of factors, in fact, our brain processes much information coming from 2 organs of ’ balance (placed in the ’ inner ear), from view, from our touch and our joints. Integrating this information we are able to perceive our position in space. When one of the mechanisms at play or the brain's ability to integrate information are compromised here is that you can check the ’ instability and dizziness.
The shapes that depend on ’ organ of ’ balance ’ are framed and followed by Otolaryngologist, While those who depend on our brains are followed by neurologist. Only rarely do the shapes are quite separate so the patient often giddy is evaluated for the first time by ’ Otolaryngologist also for neurological forms.
L ’ Otolaryngologist has thereby the responsibility first of all to identify the shapes which can pose a real risk to the life of the patient (some forms of stroke may present with Vertigo) and then differentiate into shapes of Central and peripheral set a correct diagnosis.
L ’ otovestibolare examination consists of a series of clinical evaluations to search for signs of vestibular function.
The first step of the visit is the ’ otoscopy allowing exclude ’ external and middle ear disorders. Thereafter postural deviation signs will be evaluating the ability to maintain an upright position with your eyes closed (Romberg test) or walk the patient on the spot or by walking back and forth (proof of star gear), always with your eyes closed.
Then you will look for dell ’ eye movements (nystagmus) that you cannot emulate voluntarily and are a sign of vestibular problems and control units.
To better highlight the nystagmus, you can use a form from videonistagmografia. Nystagmus can be spontaneous (always present) or be triggered by certain positions or maneuvers.
Another important test for slatentizzare a ’ slatentizzando a vestibular deficit nystagmus is the head shaking test.
Once ruled out a spontaneous nystagmus will be conducting maneuvers to diagnose benign paroxysmal positional vertigo (Semont maneuver, Dix-Hallpike maneuver, head roll test) possibly followed by a disclaimer.
If the assessment is negative can be made more sophisticated maneuvers such as vibratory tests to try to slatentizzare a nystagmus or l’head impulse test (to assess the reflection vestiboloculare)
Based on the symptoms also may be useful to undertake an examination hearing test
The route described here may vary depending on the suspected diagnosis, the clinical condition of the patient and the available technology.
