Diagnosis and pathology of vertigo

Abstract

1) Detailed history taking, routine otologic examination, audiometry and vestibular function tests were performed on 151 patients without vertigo who were hospitalized for periodic physical checkups and in 303 patients with vertigo. Two hundred and twenty of them also received blood pressure measurements and funduscopy as the tests for cerebral arteriosclerosis. 2) From the viewpoint of otological diagnosis, vertigo can be divided into three, Menieres disease in a narrow sense, Meniere's disease in a broad sense and “idiopathic vertigo”. Vertigo of known cerebral causation such as brain tumor and other specific disorders was excluded from our present study. 3) Perceptive deafness and CP were common findings in Meniere's disease in a narrow sense, while CP was comparatively rare in the group of Meniere's disease in a broad sense. Both types of Meniere's disease, however, were sometimes accompanied with concomitant cerebral disorders. 4) Many cases of “idiopathic vertigo” showed DP, circulatory disturbance in the nystagmus system and the bilateral disturbance of the central nystagmus system associated with an appearance of fixation difficulty of eye ball in a high percentage and the prolongation of post-rotatoric nystagmus. These findings are known to be clear signs of arteriosclerosis; these facts indicating the importance of vestibular function tests for an early detection of cerebral arteriosclerosis. 5) The examination results were interpreted as abnormal in 15% in non-vertigo group and in 10% of 83 patients in whom cerebral arteriosclerosis was ruled out. 6) Pathology of vertigo can be more easily understood when an assumption is made that vertigo contains a reversible component of functional nature and an irreversible component due to organic disorders. © 1963, The Oto-Rhino-Laryngological Society of Japan, Inc. All rights reserved.