Differential diagnosis of vertigo

Vrtoglavica je jedan od najčešćih razloga koji pacijente dovodi liječniku. Učestalost neprestano raste, a sve češće obolijevaju mlađi, radno sposobni ljudi. Vertigo, odnosno vrtoglavica u užem smislu opisuje se kao lažan osjećaj vrtnje prostora oko bolesnika ili kao osjećaj kretanja bolesnika u prostoru. Obično je praćena mučninom, povraćanjem i gubitkom ravnoteže. Poremećaji vestibularnog sustava čine glavninu uzroka vrtoglavice. Periferne vrtoglavice daleko su najčešće. Uzrokovane su promjenama u bilo kojem dijelu od vestibularnog organa do razine vestibularnih jezgara. Najčešće se radi o BPPV-u, Menierovoj bolesti te vestibularnom neuronitisu. Osim perifernih, na umu treba imati i središnje i funkcionalne vrtoglavice. Središnje vrtoglavice izazivaju poremećaji SŽS-a od kojih su najčešći: vestibularna migrena, vrtoglavice vaskularnog podrijetla te tumori stražnje lubanjske jame. Zbog brojnih uzroka, preklapanja simptoma i znakova, otkrivanje pravog uzroka vrtoglavice ponekad može biti pravi dijagnostički problem. Precizno uzimanje podataka vezanih uz povijest bolesti i temeljit osnovni otoneurološki klinički pregled uvelike suzuju diferencijalnu dijagnostiku vrtoglavice te pomažu u otkrivanju većine uzroka vrtoglavica.Vertigo is one of the most common reasons that lead patients to a physician. The incidence of vertigo is constantly rising, and younger, working-age population is being affected by vertigo more and more often. Vertigo is a false sense of rotation of space around the patient or vice versa. It is usually accompanied by nausea, vomiting and loss of balance. Vestibular system disorders make up for most causes of vertigo. Peripheral vertigo is by far the most common type of vertigo. It is caused by changes in any part from the vestibular organ to the level of the vestibular nuclei.The most common causes of peripheral vertigo are BPPV, Meniere's disease and vestibular neuronitis. Except for peripheral, central and functional vertigo should also be kept in mind. Central vertigo is caused by CNS disorders, the most common of which are: vestibular migraine, vertigo of vascular origin and tumors of the posterior cranial fossa. Due to a number of causes, overlapping symptoms and signs, finding the true cause of vertigo can sometimes be a real diagnostic problem. Accurate collection of data related to medical history and thorough basic otoneurological clinical examination greatly narrows the differential diagnosis of vertigo and helps to identify most causes of vertigo