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頭暈

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Dizziness
古文篆书中的「暈」字
类型sensation disorder[*]神經內科與生理學的症狀[*]
分类和外部资源
醫學專科耳鼻喉科
ICD-11MB48
ICD-10R42
ICD-9-CM780.4
DiseasesDB17771
MedlinePlus003093
eMedicineneuro/693
MeSHD004244
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頭暈(dizziness)是一不精确术语,为主观的感觉异常,可以指空间定向障碍英语Orientation_(mental)#Disorientation眩暈晕厥前期英语Syncope (medicine)、头昏眼花、头重脚轻的任何一种感觉[1],也可指平衡障碍[2],或其他非特异感(如:虚弱感、飘然感、痴傻感)[3]

头晕属一種空間認知和穩定度的功能性障礙[4]。每個人都會有頭暈的時候,例如在原地旋轉,久了就可能會頭暈。

  • 眩暈是人在靜止時有周圍轉動的感覺。眩暈非常擾人。常伴隨著噁心嘔吐。大約25%的頭暈屬於眩暈[5]
  • 重心不穩英语equilibrioception#Dysfunction是一種失去平衡的感覺,常常被形容為「往某個方向傾倒」。這種類型的頭暈較少伴隨著噁心嘔吐
  • 不明的頭暈常常是起因於精神/心理因素。有時則是起因於過度換氣[6]

中風大概佔所有單純因為頭暈而送到急診室的患者中的0.7%[5]

分類

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頭暈時,腦海中可能出現的扭曲畫面(distorted view)

頭暈通常有四種主要的可能:

  1. 眩暈(50%)
  2. 暈厥前期英语presyncope(少於15%)[i]
  3. 頭重腳輕(10% 左右)[ii]
  4. 重心不穩英语disequilibrium(少於15%)[7]

成因

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很多疾病都會使一個人頭暈。事實上,頭暈可能是很多嚴重問題的前兆,例如:腦震盪脑出血癲癇癲癇發作驚厥中風腦膜炎腦炎(又名大腦腫脹)。

然而這些成因大概可歸納為四大類(%百分比):[8]

  1. 外周前庭功能障礙 = 10%
  2. 中樞神經損傷 = 5 %
  3. 精神/心理疾患 = 5 %
  4. 昏昏欲墜、重心不穩 = 5%
  5. 不明原因(病因未定)的頭暈 = 5 %
  6. 宿醉 (Hangover) = 70%

一些前庭功能的生理可能有一些症狀與精神疾患類似。 以下列出可能與頭暈共病的疾病: [9][8][10][11][12]

機制

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許多問題都可能導致頭暈,因為身體的許多部位都是身體能否維持平衡的必要條件(例如:內耳眼睛肌肉骨骼、和中樞神經系統)。 [11]

常見的頭暈之生理因素:

盛行率

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報告指出,大約20%~30%的人曾在前一年的某個時間點歷經頭暈。 [5]

參見

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註解

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  1. ^ 昏厥 (syncope) 為已經昏厥
  2. ^ Definition: If you feel light-headed, you feel weak and as if you are going to lose your balance.

參考資料

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  1. ^ 醫學主題詞表(MeSH)Dizziness
  2. ^ Reeves AG, Swenson RS. Chapter 14: Evaluation of the Dizzy Patient. Disorders of the Nervous System: A Primer. Dartmouth Medical School. 2008 [2011-05-24]. (原始内容存档于2011-09-02). 
  3. ^ Branch Jr WT, Barton JJ. Approach to the patient with dizziness. UpToDate. February 10, 2011 [2017-07-11]. (原始内容存档于2022-01-29). 
  4. ^ 道兰氏医学词典中的dizziness
  5. ^ 5.0 5.1 5.2 Neuhauser HK, Lempert T. Vertigo: epidemiologic aspects. Semin Neurol. November 2009, 29 (5): 473–81. PMID 19834858. doi:10.1055/s-0029-1241043. 
  6. ^ Branch Jr WT, Barton JJ. Approach to the patient with dizziness. UpToDate. February 10, 2011 [2017-07-11]. (原始内容存档于2022-01-29). 
  7. ^ Post RE, Dickerson LM. Dizziness: a diagnostic approach. Am Fam Physician. August 2010, 82 (4): 361–8, 369. PMID 20704166. 
  8. ^ 8.0 8.1 Chan Y. Differential diagnosis of dizziness. Curr Opin Otolaryngol Head Neck Surg. June 2009, 17 (3): 200–3. PMID 19365263. doi:10.1097/MOO.0b013e32832b2594. 
  9. ^ Lawson, B. D., Rupert, A. H., & Kelley, A. M. (2013). Mental Disorders Comorbid with Vestibular Pathology. Psychiatric Annals, 43(7), 324.
  10. ^ Tusa RJ. Dizziness. Med. Clin. North Am. March 2009, 93 (2): 263–71, vii. PMID 19272508. doi:10.1016/j.mcna.2008.09.005. 
  11. ^ 11.0 11.1 11.2 11.3 11.4 11.5 11.6 Dizziness and Vertigo. Merck Manual. 2009 [2017-07-11]. (原始内容存档于2018-07-05). 
  12. ^ Bronstein AM, Lempert T. Management of the patient with chronic dizziness. Restor. Neurol. Neurosci. 2010, 28 (1): 83–90. PMID 20086285. doi:10.3233/RNN-2010-0530. 
  13. ^ O'Connor RE, Brady W, Brooks SC, et al. Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. November 2010, 122 (18 Suppl 3): S787–817 [2017-07-11]. PMID 20956226. doi:10.1161/CIRCULATIONAHA.110.971028. (原始内容存档于2013-02-23). 
  14. ^ Chu ECP; Chin WL. Cervicogenic dizziness. Oxford Medical Case Reports. 2019 Nov, 2019 (11): 476-478 [2020-01-03]. PMID 31844531. doi:10.1093/omcr/omz115. (原始内容存档于2020-05-17). 
  15. ^ Research, Center for Drug Evaluation and. Drug Safety and Availability - FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs). www.fda.gov. [2017-07-11]. (原始内容存档于2019-04-24). 
  16. ^ Common Side Effects of Coumadin (Warfarin Sodium) Drug Center - RxList. [2017-07-11]. (原始内容存档于2012-09-21). 

外部連結

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頭暈
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