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EVALUATION OF VERTIGO FOLLOWING HEAD INJURIES

EVALUATION OF VERTIGO FOLLOWING HEAD INJURIES Abstract Dizziness is frequently encountered after head injuries. When associated with other neurologic signs, as it often is shortly after the trauma, it leaves no doubt concerning its organic origin. This discussion however will be limited to those cases in which months or even years after a head injury, frequently of a mild type, dizziness is the outstanding or the sole complaint. This dizziness almost always occurs either spontaneously or as a result of certain movements or positions. Examination of the patients usually reveals no clinical signs to explain this complaint of dizziness, and therefore these patients are usually labeled as having some type of neurosis. The most common diagnoses are traumatic neurosis, traumatic hysteria, encephalopathy and traumatic encephalitis—obviously, all diagnoses of embarrassment. The physician's predicament is due to his omission of the examination of the only organ capable of producing this symptom, i. e., the vestibular apparatus. The examination of References 1. Brunner, H., in Alexander, G., and Marburg, O.: Handbuch der Neurologie des Ohres , Berlin, Urban & Schwarzenberg, 1923, vol. 1. 2. Babinski, J., and Nageotte, J.: Rev. neurol. 10:358, 1902. 3. The reverse of that dictum, i. e., that nystagmus is always associated with vertigo, is not always true. In cases of multiple sclerosis, for example, there is frequently nystagmus without dizziness. 4. Seiferth, L. B.: München. med. Wchnschr. 83:310, 1936. 5. The classification of nystagmus used here is Alexander's, based on the physiologic fact that nystagmus becomes intensified by a look in the direction of the quick component and that, on the other hand, it is decreased or inhibited by a look in the direction of the slow component. First degree nystagmus is visible only when the person looks to one side with the quick component to the same side. Second degree nystagmus is already noticeable when the patient looks straight ahead. Third degree nystagmus is one which can still be observed when the patient is looking to the side of the slow component. 6. Jones, I. H., and Fisher, L.: Equilibrium and Vertigo , Philadelphia, J. B. Lippincott Company, 1918. 7. Lorente de Nó, R.: Tr. Am. Laryng., Rhin. & Otol. Soc. 42:1936. 8. Brünings, W.: Ztschr. f. Ohrenh. 63:20, 1911. 9. Frenzel, H.: Nervenarzt 4:21, 1931. 10. Grove, W. E.: Laryngoscope 49:678 and 833, 1939.Crossref 11. Dusser de Barenne, J. G., and de Kleyn, A.: Arch. f. Ophth. 111:374, 1923. 12. Vogel, K.: Ztschr. f. Hals-, Nasen- u. Ohrenh. 23:39, 1929. 13. Lorente de Nó, R.: Die Labyrinthreflexe auf die Augenmuskeln nach einseitiger Labyrinthexstirpation nebst einer kurzen Angabe über den Nervenmechanismus der vestibularen Augenbewegungen , Berlin, Urban & Schwarzenberg, 1928. 14. Koch, J.: Arch. f. Ohren-, Nasen- u. Kehlkopfh. 137:105, 1934.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology American Medical Association

EVALUATION OF VERTIGO FOLLOWING HEAD INJURIES

Archives of Otolaryngology , Volume 33 (2) – Feb 1, 1941

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Publisher
American Medical Association
Copyright
Copyright © 1941 American Medical Association. All Rights Reserved.
ISSN
0003-9977
DOI
10.1001/archotol.1941.00660030207005
Publisher site
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Abstract

Abstract Dizziness is frequently encountered after head injuries. When associated with other neurologic signs, as it often is shortly after the trauma, it leaves no doubt concerning its organic origin. This discussion however will be limited to those cases in which months or even years after a head injury, frequently of a mild type, dizziness is the outstanding or the sole complaint. This dizziness almost always occurs either spontaneously or as a result of certain movements or positions. Examination of the patients usually reveals no clinical signs to explain this complaint of dizziness, and therefore these patients are usually labeled as having some type of neurosis. The most common diagnoses are traumatic neurosis, traumatic hysteria, encephalopathy and traumatic encephalitis—obviously, all diagnoses of embarrassment. The physician's predicament is due to his omission of the examination of the only organ capable of producing this symptom, i. e., the vestibular apparatus. The examination of References 1. Brunner, H., in Alexander, G., and Marburg, O.: Handbuch der Neurologie des Ohres , Berlin, Urban & Schwarzenberg, 1923, vol. 1. 2. Babinski, J., and Nageotte, J.: Rev. neurol. 10:358, 1902. 3. The reverse of that dictum, i. e., that nystagmus is always associated with vertigo, is not always true. In cases of multiple sclerosis, for example, there is frequently nystagmus without dizziness. 4. Seiferth, L. B.: München. med. Wchnschr. 83:310, 1936. 5. The classification of nystagmus used here is Alexander's, based on the physiologic fact that nystagmus becomes intensified by a look in the direction of the quick component and that, on the other hand, it is decreased or inhibited by a look in the direction of the slow component. First degree nystagmus is visible only when the person looks to one side with the quick component to the same side. Second degree nystagmus is already noticeable when the patient looks straight ahead. Third degree nystagmus is one which can still be observed when the patient is looking to the side of the slow component. 6. Jones, I. H., and Fisher, L.: Equilibrium and Vertigo , Philadelphia, J. B. Lippincott Company, 1918. 7. Lorente de Nó, R.: Tr. Am. Laryng., Rhin. & Otol. Soc. 42:1936. 8. Brünings, W.: Ztschr. f. Ohrenh. 63:20, 1911. 9. Frenzel, H.: Nervenarzt 4:21, 1931. 10. Grove, W. E.: Laryngoscope 49:678 and 833, 1939.Crossref 11. Dusser de Barenne, J. G., and de Kleyn, A.: Arch. f. Ophth. 111:374, 1923. 12. Vogel, K.: Ztschr. f. Hals-, Nasen- u. Ohrenh. 23:39, 1929. 13. Lorente de Nó, R.: Die Labyrinthreflexe auf die Augenmuskeln nach einseitiger Labyrinthexstirpation nebst einer kurzen Angabe über den Nervenmechanismus der vestibularen Augenbewegungen , Berlin, Urban & Schwarzenberg, 1928. 14. Koch, J.: Arch. f. Ohren-, Nasen- u. Kehlkopfh. 137:105, 1934.Crossref

Journal

Archives of OtolaryngologyAmerican Medical Association

Published: Feb 1, 1941

References