Wydawnictwo Medyczne Mediton

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the Polish Society of Audiology and Phoniatrics


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Diagnostic controversies of the otolaryngologist and neurologist over patients with balance disorders diagnosed at hospital emergency wards
Ireneusz Kantor 1/, Stanisław Szlufik 2/, Marzena Kubiczek-Jagielska 1/, Monika Woźniak 1/
  • 1/ Klinika Otolaryngologii CMKP
  • 2/ Klinika Neurologii Wydziału Nauki o Zdrowiu WUM

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.

Otorynolaryngologia vol 13. no 1. Marchpages: from 17to 25
full version