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DIFFERENTIAL DIAGNOSIS OF RECURRENT VESTIBULAR
DISORDERS IN PATIENTS WITH CHRONIC CEREBRAL
CIRCULATORY INSUFFICIENCY
Bozorov Uktam Naim ugli
Bukhara State Medical University
https://doi.org/10.5281/zenodo.13842210
Abstract:
Dizziness is one of the most frequent reasons for seeking
medical help among patients of different ages and is encountered in the practice
of a doctor of any specialty. About 5 to 30% of people in the population suffer
from dizziness. In outpatient practice of domestic health care, dizziness is the
main reason for seeking medical help in at least 20% of cases. Women apply 2
times more often than men. The prevalence of this symptom increases with age.
Key words:
differential diagnosis, vestibular disorders, vertigo, chronic
cerebral circulatory insufficiency.
Introduction.
Chronic cerebrovascular accidents are very common among
the population, being one of the causes of disability and deterioration of the
quality of life of patients, and remain an extremely important scientific and
practical problem. Chronic cerebrovascular accidents, with which multifocal or
diffuse ischemic brain damage develops, is manifested by a complex of
neurological and neuropsychological diseases and has a tendency to gradually
increase .The development of the cerebral vascular process produces persistent
neurological manifestations, which include vestibuloatactic syndrome,
manifested by dizziness, excitement and instability during walking . Dizziness is
one of the most common complaints among patients and is the second most
common symptom after headaches, affecting quality of life, causing falls and
injuries. A fall due to dizziness once or several times a year is observed in 30%
of people over 65 years of age.The prevalence of vestibuloatactic syndrome, the
variety of its manifestations, the difficulties of differential diagnosis, long-term,
sometimes permanent disability determine the medical and social significance,
new diagnostic methods and the feasibility of further study and search for
correction of these diseases. The subjective nature of dizziness and the frequent
absence of objective signs of damage to the vestibular system make it difficult to
identify the causes of this pathology [1]. There are many diseases in which
dizziness is mentioned as one of the main or secondary symptoms. At the same
time, the relationship between the underlying disease and dizziness is often
assumed. In this regard, a syndromological diagnosis of peripheral or central
vestibular vertigo, vestibular vertigo, is used in medicine, which indicates only
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the assumed anatomical level of the lesion and does not have a nosological
affiliation [2]. The practice of using a syndromic diagnosis can be justified only
at the initial stage of the differential diagnosis of vertigo, but cannot be
considered correct when formulating a final diagnosis. Nevertheless, the
syndromic diagnosis of the so-called "peripheral" and "central" causes of
dizziness determines the further sequence and scope of examination of patients,
as well as the tactics of their treatment, which is important. In this regard, the
development of an algorithm for differential diagnosis of vertigo that is available
for use in primary care is very relevant [3]. In Russian medicine, dizziness is
traditionally and primarily associated with vascular pathology of the brain,
which contributes to the formation of ideas about the priority role of chronic
cerebral circulatory insufficiency in the vertebral-basilar artery basin in the
development of this syndrome. Overestimation of the role of degenerative
changes in the cervical spine and the results of ultrasound examination of the
vertebral arteries (PA) contributes to the overdiagnosis of this cause of dizziness
[4]. At the same time, in the last decade there has been a significant
transformation of ideas about the origin of most vestibular disorders. According
to a number of clinical and epidemiological studies, the most common causes of
dizziness are the so-called peripheral vestibulopathies resulting from pathology
of the inner ear or nerve [5]. In about 30-40% of cases, the origin of vertigo
remains unclear [23; 25; 27; 70; 101; 108]. This is largely due to the lack of clear
regulated standards for the diagnosis of vestibular disorders and an insufficient
number of clinical studies [6].
Conclusions: thus, the development of an algorithm for the differential diagnosis
of peripheral and central vestibular disorders in patients diagnosed with chronic
cerebral ischemia seems to be a very relevant problem of neurology and the
basis for this study.
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CURRENT APPROACHES AND NEW RESEARCH IN
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