El paciente mareado

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The document discusses the evaluation and diagnosis of vertigo and dizziness. It provides a matrix for classifying cases based on symptoms over time and presence of hearing loss. Common causes discussed include Meniere's disease, benign paroxysmal positional vertigo, vestibular neuronitis, and labyrinthitis. Additional diagnoses mentioned are migraine-associated dizziness and cervical vertigo. Referral to a neurologist or psychologist is recommended if no clear diagnosis is established to evaluate potential panic or emotional components.

Education

el oido y el
equilibrio
prof dra graciela pepe
facultad de medicine unne argentina

Tuesday, May 8, 12

oido procesamiento
interno centralizado

armonia
simetria

Tuesday, May 8, 12

oido VERTIGO
interno

NISTAGMO

DESEQUILIBRIO

Tuesday, May 8, 12

oido VERTIGO
interno

VOMITOS

NISTAGMO

DESEQUILIBRIO

Tuesday, May 8, 12

UN MAPA
PARA EL
TERRITORIO

Tuesday, May 8, 12

1 QUE SIENTE EL PACIENTE ?

Tuesday, May 8, 12

OIDO INTERNO

SINCOPE PSICOGENOS

DESEQUILIBRIO
VERTIGO
si es sincope o desmayo
es un problema
cardiovascular o
neurovascular

Tuesday, May 8, 12

OIDO INTERNO

PSICOGENOS

DESEQUILIBRIO
VERTIGO
si es sincope o desmayo
es un problema
cardiovascular o
neurovascular

Tuesday, May 8, 12

OIDO INTERNO

DESEQUILIBRIO
VERTIGO
si es sincope o desmayo
es un problema
cardiovascular o
neurovascular

Tuesday, May 8, 12

2 TRAYECTORIA DE LOS
SINTOMAS EN EL TIEMPO

Tuesday, May 8, 12

100

86

71

57

43

29

14

0

TRAYECTORIA :SINTOMATICO DESDE
MINUTOS A HORAS, EN CRISIS,
MULTIPLES EPISODIOS, DETERIORO
LENTAMENTE PROGRESIVO

Tuesday, May 8, 12
MENIERE

100
86
71
57
43
29
14
0

TRAYECTORIA : un episodio
inicial,SINTOMATICO POR DIAS, MEJORA
PROGRESIVAMENTE

NEURONITIS
VESTIBULAR
Tuesday, May 8, 12

100

86

71

57

43

29

14

TRAYECTORIA :SINTOMATICO POR
SEGUNDOS, EN CRISIS, VUELVE A LA
NORMALIDAD

VERTIGO POSICIONAL
PAROXISTICO BENIGNO
Tuesday, May 8, 12

2 DONDE LO UBICAMOS EN LA
“MATRIX”
(DR RAUCH . HARVARD USA)

Tuesday, May 8, 12

VERTIGO

EN CRISIS PERSISTENTES
EPISODICOS

SI LABERINTITIS

HIPOACUSIA VERTIGO
POSICIONAL NEURONITIS
NO PAROXISTICO
BENIGNO VESTIBULAR

Tuesday, May 8, 12

VERTIGO

EN CRISIS PERSISTENTES
EPISODICOS

MENIERE
SI LABERINTITIS

HIPOACUSIA VERTIGO
POSICIONAL NEURONITIS
NO PAROXISTICO
BENIGNO VESTIBULAR

Tuesday, May 8, 12

VERTIGO

EN CRISIS PERSISTENTES
EPISODICOS

MENIERE
SI FISTULA PL LABERINTITIS

HIPOACUSIA VERTIGO
POSICIONAL NEURONITIS
NO PAROXISTICO
BENIGNO VESTIBULAR

Tuesday, May 8, 12

3 LOS DIAGNOSTICOS
EXTRA “MATRIX ”

Tuesday, May 8, 12

MIGRAÑA
ASOCIADA
AL MENOS 5 EPISODIOS A MAREO
DURANDO 4 A 72HS

AL MENOS DOS DE ESTAS
CARACTERISTICAS:
UNILATERAL
PULSATIL
MODERADA A SEVERA INTENSIDAD
AGRAVADA POR ACTIVIDAD FISICA

AL MENOS UNA DE ESTAS:
NAUSEAS Y VOMITO
FOTOFOBIA
FONOFOBIA

Tuesday, May 8, 12

VERTIGO CERVICAL

DESEQUILIBRIO
ASOCIADO A LA EDAD

SI NO SE AJUSTA A NINGUNA DE ESTAS SITUACIONES : DERIVE A
NEUROLOGO Y/ O PSICOLOGO.EL PANICO, LA ANGUSTIA Y LAS
EMOCIONES ESTAN SIEMPRE PRESENTES Y ES MUY DIFICIL
DIFERENCIAR EL ROL EXACTO QUE CUMPLEN EN CADA PACIENTE.

Tuesday, May 8, 12

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El paciente mareado

1. el oido y el equilibrio prof dra graciela pepe facultad de medicine unne argentina Tuesday, May 8, 12

2. oido procesamiento interno centralizado armonia simetria Tuesday, May 8, 12

3. oido procesamiento interno centralizado armonia simetria Tuesday, May 8, 12

4. oido procesamiento interno centralizado armonia simetria Tuesday, May 8, 12

5. oido procesamiento interno centralizado armonia simetria Tuesday, May 8, 12

6. oido procesamiento interno centralizado armonia simetria Tuesday, May 8, 12

7. oido procesamiento interno centralizado armonia simetria Tuesday, May 8, 12

8. oido VERTIGO interno NISTAGMO DESEQUILIBRIO Tuesday, May 8, 12

9. oido VERTIGO interno NISTAGMO DESEQUILIBRIO Tuesday, May 8, 12

10. oido VERTIGO interno NISTAGMO DESEQUILIBRIO Tuesday, May 8, 12

11. oido VERTIGO interno NISTAGMO DESEQUILIBRIO Tuesday, May 8, 12

12. oido VERTIGO interno NISTAGMO DESEQUILIBRIO Tuesday, May 8, 12

13. oido VERTIGO interno VOMITOS NISTAGMO DESEQUILIBRIO Tuesday, May 8, 12

14. UN MAPA PARA EL TERRITORIO Tuesday, May 8, 12

15. 1 QUE SIENTE EL PACIENTE ? Tuesday, May 8, 12

16. OIDO INTERNO SINCOPE PSICOGENOS DESEQUILIBRIO VERTIGO si es sincope o desmayo es un problema cardiovascular o neurovascular Tuesday, May 8, 12

17. OIDO INTERNO PSICOGENOS DESEQUILIBRIO VERTIGO si es sincope o desmayo es un problema cardiovascular o neurovascular Tuesday, May 8, 12

18. OIDO INTERNO DESEQUILIBRIO VERTIGO si es sincope o desmayo es un problema cardiovascular o neurovascular Tuesday, May 8, 12

19. 2 TRAYECTORIA DE LOS SINTOMAS EN EL TIEMPO Tuesday, May 8, 12

20. 100 86 71 57 43 29 14 0 TRAYECTORIA :SINTOMATICO DESDE MINUTOS A HORAS, EN CRISIS, MULTIPLES EPISODIOS, DETERIORO LENTAMENTE PROGRESIVO Tuesday, May 8, 12 MENIERE

21. 100 86 71 57 43 29 14 0 TRAYECTORIA : un episodio inicial,SINTOMATICO POR DIAS, MEJORA PROGRESIVAMENTE NEURONITIS VESTIBULAR Tuesday, May 8, 12

22. 100 86 71 57 43 29 14 TRAYECTORIA :SINTOMATICO POR SEGUNDOS, EN CRISIS, VUELVE A LA NORMALIDAD VERTIGO POSICIONAL PAROXISTICO BENIGNO Tuesday, May 8, 12

23. 2 DONDE LO UBICAMOS EN LA “MATRIX” (DR RAUCH . HARVARD USA) Tuesday, May 8, 12

24. VERTIGO EN CRISIS PERSISTENTES EPISODICOS SI LABERINTITIS HIPOACUSIA VERTIGO POSICIONAL NEURONITIS NO PAROXISTICO BENIGNO VESTIBULAR Tuesday, May 8, 12

25. VERTIGO EN CRISIS PERSISTENTES EPISODICOS MENIERE SI LABERINTITIS HIPOACUSIA VERTIGO POSICIONAL NEURONITIS NO PAROXISTICO BENIGNO VESTIBULAR Tuesday, May 8, 12

26. VERTIGO EN CRISIS PERSISTENTES EPISODICOS MENIERE SI FISTULA PL LABERINTITIS HIPOACUSIA VERTIGO POSICIONAL NEURONITIS NO PAROXISTICO BENIGNO VESTIBULAR Tuesday, May 8, 12

27. 3 LOS DIAGNOSTICOS EXTRA “MATRIX ” Tuesday, May 8, 12

28. MIGRAÑA ASOCIADA AL MENOS 5 EPISODIOS A MAREO DURANDO 4 A 72HS AL MENOS DOS DE ESTAS CARACTERISTICAS: UNILATERAL PULSATIL MODERADA A SEVERA INTENSIDAD AGRAVADA POR ACTIVIDAD FISICA AL MENOS UNA DE ESTAS: NAUSEAS Y VOMITO FOTOFOBIA FONOFOBIA Tuesday, May 8, 12

29. VERTIGO CERVICAL DESEQUILIBRIO ASOCIADO A LA EDAD SI NO SE AJUSTA A NINGUNA DE ESTAS SITUACIONES : DERIVE A NEUROLOGO Y/ O PSICOLOGO.EL PANICO, LA ANGUSTIA Y LAS EMOCIONES ESTAN SIEMPRE PRESENTES Y ES MUY DIFICIL DIFERENCIAR EL ROL EXACTO QUE CUMPLEN EN CADA PACIENTE. Tuesday, May 8, 12

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