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Gepubliceerd in:
2021 | OriginalPaper | Hoofdstuk
11. Duizeligheid
Auteurs : Dr. O. R. Maarsingh, Dr. H. Stam, Dr. V. A. van Vugt
Gepubliceerd in: Diagnostiek van alledaagse klachten
Uitgeverij: Bohn Stafleu van Loghum
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Samenvatting
Uitgangspunt bij de diagnostiek zijn de karakteristieken van de duizeligheid, zoals aard, beloop en uitlokkende factoren. Bij draaiduizeligheid is het evenwichtsorgaan meestal de bron van de klacht. Acute, heftige en langer durende draaiduizeligheid kan wijzen op neuritis vestibularis, de ziekte van Ménière of – zelden – een CVA. Bij herhaalde, korte aanvallen gaat het dikwijls om benigne paroxismale positieduizeligheid. Vaak vormt het uitlokkend moment de sleutel voor de diagnose: provocatie van klachten door opstaan (orthostatische hypotensie), bij opstaan en gaan lopen (desequilibrium), bij schrik of pijn (vasovagale syncope) of bij inspanning (cardiovasculaire aandoening). Een licht gevoel in het hoofd kan ook continu aanwezig zijn (angststoornis, medicatiegebruik). Bij draaiduizeligheid wordt vaak de kiepproef van Dix-Hallpike aanbevolen. Een nuttige aanvulling hierop bij acute, continue draaiduizeligheid is de Head Impulse Test. Alarmsignalen zijn langdurige duizeligheid met eenzijdig gehoorverlies (acusticusneurinoom), acute doofheid (ischemie evenwichtsorgaan of hersenstam), nieuwe hoofdpijn (subarachnoïdale bloeding of dissectie arteria vertebralis) en neurologische symptomen zoals diplopie, dysartrie, ataxie of parese (aandoeningen cerebellum of hersenstam).
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Metagegevens
- Titel
- Duizeligheid
- Auteurs
-
Dr. O. R. Maarsingh
Dr. H. Stam
Dr. V. A. van Vugt
- Copyright
- 2021
- Uitgeverij
- Bohn Stafleu van Loghum
- Boek
-
Diagnostiek van alledaagse klachten
Print ISBN: 978-90-368-2619-8
Elektronisch ISBN: 978-90-368-2620-4
Copyright: 2021
- DOI
- https://doi.org/10.1007/978-90-368-2620-4_11