Vertigo / pusing berputar

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vertigo atau pusing berputar adalah perasaan bahwa dirinya atau sekelilingnya berputar meskipun sebenarnya dalam keadaan diam.Vertigo harus dipisahkan dari sakit kepala, sebelum pingsan ataupun perasaan tidak seimbang ketika berjalan

Transcript of Vertigo / pusing berputar

Vertigo (Pusing berputar)

Vertigo(Pusing berputar)Ilmu Kesehatan Telinga Hidung Tenggorokan Bedah Kepala dan LeherRS Bhayangkara Sartika Asih Fakultas Kedokteran Universitas Kristen Maranatha2015Derrick 1115205Janice Chiquita Bella 1115141Debora Rumintang Marito 1115014Kamajaya Mulyana 1115176Carla Pramudita Susanto 1115007

Apa itu vertigo / pusing berputarMerasa keadaan sekitarnya berputar mengelilingi pasien atau sebaliknya meskipun sebenarnya keadaan sekitarnya dan pasien dalam keadaan diam.Pusing tidak sama dengan sakit kepala , Merasa ingin pingsan, tidak seimbang saat berjalan !!

Mempertahankan keseimbangan tergantung input dari berbagai sumber Goebel JA. Otolaryngol Clin North Am 2000;33:483-93Shepard NT, Solomon D. Otolaryngol Clin North Am 2000;33:455-69

KeseimbanganX3Maintaing balance is dependent on input from a number of sourcesBalance results from a complex interaction of sensory information from several sources.1. The inner ears, or vestibular system sensory hair cells within the inner ear monitor the position and motion of the head in the environment2. The eye visual cues are important in maintaining balance and oculomotor control3. Skin pressure receptors provide information about which part of the body is in contact with the ground4. Muscle and joint sensory receptors provide information on the position of the limbs in the environment.

Sensory information from all relevant sources is processed in the central nervous system (specifially the brain stem and cerebellum with additional input from the cerebral cortex). The output from this processing controls motor responses relating to eye movements, postural control and perceptual output, allowing the body to navigate in the environment. Contradictory or missing information from any of the sensory systems, or an impairment of the central processing of information can lead to forms of dizziness or imbalance, such as vertigo.

Sistem vestibular adalah input sensoris dominant yang mengatur keseimbanganSensor sel rambut di telinga dalam memberi informasi Tentang posisi dan gerakan kepala.Goebel JA. Otolarungol Clin North Am 2000;33:483-93

5The vestibular system is the dominant sensory input guiding balanceThe dominate input into the balance system is from the vestibular system of the inner ear. This structure consists of otolith organs (utricle and saccule maculae) and the semicircular canals, each in its own orientation (lateral, posterior and superior) (Goebel 2000; Shepard & Solomon 2000). Each semicircular canal originates form the utricle and terminates in the ampulla. Within each ampulla and otolith organ are a number of sensory hair cells that connect to the vestibular nerve, providing the brain with sensory information pertaining to the position and movement of the head.

Dysfunction of any aspect of the vestibular system will result in abnormal activation of the vestibular nerve, which may lead to vertigo.

Vertigo perifer (TEPI) : Beberapa penyakit yang menyebabkan vertigo perifer (TEPI)PenyakitPenjelasanBenign paroxysmal positional vertigoEpisode-episode berulang yang singkat dan diperberat dengan perubahan posisi kepala yang disebabkan oleh adanya batu kecil dalam saluran keseimbanganMenieres diseaseKelebihan cairan yang terdapat dalam saluran keseimbangan yang menyebabkan peregangan dari sistem cairan dalam saluran keseimbanganNeuronitis vestibularPeradangan syaraf pendengaran, tersering akibat infeksi virusLabirinitis akutInflamasi labirin akibat infeksi virus dan bakterialInfark labirinPenurunan aliran darah pada labirinGegar labirinKerusakan labirin akibat benturan kepalaFistula perilimfeDisebabkan oleh kerusakan selaput labirin akibat adanya kebocoran cairan dari sistem keseimbangan ke telinga tengahKelainan autoimun telinga dalamSel imun tubuh menyerang telinga tengah / berfungsi tidak normalSemakin jarangBaloh RW. Lancet 1998;352:18416. Mukherjee A et al. JAPI 2003;51:1095-101. Parnes LS et al. CMAJ 2003;169:681 93. Puri V, Jones E. J Ky Med Assoc 2001;99:31621. Salvinelli F et al. Clin Ter 2003;154:3418. 7Vertigo of peripheral origin: causesPeripheral causes of vertigo typically involve the structures of the inner earBenign paroxysmal positional vertigo: probably the most common cause of vertigo (e.g., Toupet et al 2003). It is characterised by brief, position-provoked vertigo episodes usually caused by freely floating particles in the semicircular canal (Parnes et al 2003). Menieres disease: Accounting for 1015% of vertigo cases (Mukherjee et al 2003), Menieres disease is often associated with hearing loss and tinnitus, and is usually chronic. Menieres disease occurs in the vestibular system and appears to result from distention of the membranous labyrinth and an excess of endolymph. Patients often complain of a feeling of fullness or pressure in the ear (Baloh 1998). Vertigo episodes may result from reversible mechanical dysfunction or from ruptures in the membrane separating the endolymph and perilymph. Vestibular neuronitis: refers to inflammation of the vestibular nerves, that may be the consequence of a virus, or have an ischaemic cause. (Strupp & Arbusow 2001). This type of vertigo is accompanied by nausea, vomiting and disequilibrium. Patients may present with a deep, burning ear pain. Acute labyrinthitis: inflammation of the labyrinth due to viral or bacterial infection. It often follows infections such as acute otitis media, chicken pox, mumps or measles.Labyrinthine infarct: The blood supply to the inner ear originates in the vertebrobasilar system. Infarct or haemorrhage in this system compromises blood flow to the labyrinthine and has a profound effect on labyrinthine function. Labyrinthine concussion: damage to the labyrinthine may occur after head trauma.Perilymph fistula: Leakage of the perilymph from the inner to the middle ear can result following damage to the labyrinth membranes. Such damage may result from head trauma, cholesteatoma, or a pressure altering event (Baloh 1998, Strupp & Arbusow 2001). Autoimmune inner ear disease: in some rare cases autoimmune disorders destroy inner ear cells, which may lead to hearing loss and/or vertigo. The autoimmune disease may only target the inner ear, or the inner ear damage may be a feature of a systemic disorder (Baloh 1998).

ReferencesBaloh RW. Vertigo. Lancet 1998;352:18416.Mukherjee A, Chatterjee SK, Chakravarty A. Vertigo and dizziness a clinical approach. JAPI 2003;51:109101. Parnes LS, Agrawal SK, Atlas J. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ 2003;169:681 93.Puri V, Jones E. Childhood vertigo: a case report and review of the literature. J Ky Med Assoc 2001;99:31621.Salvinelli F, Firrisi L, Casale M, et al. What is vertigo? Clin Ter 2003;154:3418.Strupp M, Arbusow V. Acute vestibulopathy. Curr Opin Neurol 2001;14:1120.Toupet M, Rothoft J, Bremaud des Ouilleres L. Prise en charge des plaintes vertigineuses en ORL de ville. Rev SFORL 2004;83:5763.Vertigo perifer (TEPI) : Beberapa penyakit yang menyebabkan vertigo perifer (TEPI)Vertigo Perifer

BPPVMenieres diseaseLabirinitis akutNeuronitis vestibular

Infark Labirin

Gegar labirin

Fistula perilimfe

AutoimunXVertigo sentral (PUSAT) : Beberapa penyakit yang menyebabkan vertigo sentral (pusat)PenyakitPenjelasanMigrainePusing dapat terjadi mendahului serangan migraine atau bersamaanKelainan pembuluh darahKekurangan darah / pendarahan pada batang otak dan otak kecilMultiple sclerosisKerusakan selubung syaraf yang menyebabkan pusing akibat gangguan fungsi syarafEpilepsi VestibularPusing yang disebabkan oleh pusat epilepsi pada otak yang mengurus bagian keseimbanganTumor sudut cerebelopontineTumor tumor jinak yang terdapat di daerah perbatasan otak dan telinga dalamSemakin jarangBaloh RW. Lancet 1998;352:18416. Mukherjee A et al. JAPI 2003;51:1095-101. Salvinelli F et al. Clin Ter 2003;154:3418. Solomon D. Otolaryngol Clin North Am 2000;33:579601. Strupp M, Arbusow V, Curr Opin Neurol 2001;14:1120.9Vertigo of central origin: causesCentral causes of vertigo originate in the central nervous systemMigraine: vertigo may occur separately or with migraines; migraines are one of the most common central causes of vertigo Vascular disease: ischaemia in the vertebrobasilar system can lead to infarction in the brain stem or cerebellum. The resultant reduced blood supply to these areas can result in vertigo symptoms. It should be noted that cerebrovascular disease can also cause peripheral infarctions (structures in the inner ear each have their own blood flow which also originates in the vertebrobasilar arterial system), or a combination of peripheral and central infarctions may occur. Multiple sclerosis: vertigo may be the presenting feature of multiple sclerosis in approximately 5% of cases, and 50% of patients with multiple sclerosis are likely to suffer from vertigo during the course of their disease (Solomon 2000)Vestibular epilepsy: a rare cause of vertigo related to focal epileptic discharges in the temporal or parietal association cortex (Strupp & Arbusow, 2001)Cerebellopontine tumours: a rare cause of vertigo, these are most often benign tumours in the internal auditory meatus.

ReferencesBaloh RW. Vertigo. Lancet 1998;352:18416.Mukherjee A, Chatterjee SK, Chakravarty A. Vertigo and dizziness a clinical approach. JAPI 2003;51:109101. Salvinelli F, Firrisi L, Casale M, et al. What is vertigo? Clin Ter 2003;154:3418.Solomon D. Distinguishing and treating causes of central vertigo. Otolaryngol Clin North Am 2000;33:579601. Strupp M, Arbusow V. Acute vestibulopathy. Curr Opin Neurol 2001;14:1120.

Vertigo sentral (PUSAT) : Beberapa penyakit yang menyebabkan vertigo sentral (pusat)Vertigo Sentral

MigraineStrokeTumor sudut cerebellopontineEpilepsi / ayanMultiple sclerosisPerbedaan Vertigo perifer dan Vertigo sentralGejalaPeny