1例颈椎病并前庭神经炎眩晕患者病因漏诊思考
Reflections on a patient misdiagnosed with cervicogenic vertigo combined with vestibular neuritis vertigo
王紫衣 1韩雨宇 1刘宇凯 1王青松1
作者信息
摘要
回顾分析1例眩晕患者诊疗过程,该患者以头昏为主诉来院就诊,既往MR提示颈椎病病史,按眩晕病(气血亏虚证)行针灸治疗后疗效欠佳,经过补充查体Romberg征(+),后行前庭功能检查提示,左侧水平半规管功能低下;考虑补充诊断周围性前庭神经炎,在常规药物治疗基础上调整针灸治疗方案配合前庭康复训练,患者症状改善.该案例体现了中医同病异治的原则,虽然都属于中医眩晕病范畴,但是疾病辨证分型不同,治疗方法也有差异;同时也提醒临床医生重视病史询问及体格检查,注意鉴别诊断,避免病因漏诊.
Abstract
This article reviews the diagnosis and treatment process of a patient with vertigo.The patient reported diz-ziness when she came to the hospital,and a prior MR1 indicated cervical spondylosis.Consequently,her condition was treat-ed as vertigo disease,a Qi and blood deficiency syndrome,with acupuncture.However,the therapeutic effects were limited.A complementary physical examination revealed the Romberg sign(+),and a posterior vestibular function examination indi-cated that the patient's left horizontal semicircular canal function was low.Considering the supplementary diagnosis of peripheral vestibular neuritis,the treating physician adjusted the acupuncture treatment plan but not routine drug therapy,and continued with vestibular rehabilitation training.After these treatments,the patient's symptoms improved.This case reflects the principle of using different treatments for the same disease in Chinese medicine.Although all treatments were categorized as traditional Chinese medicine therapies for vertigo disease,they involved different disease differentiation,clas-sification,and treatment methods.Moreover,the findings provide a reminder for clinicians to pay attention to medical history inquiry,physical examination,and differential diagnosis,to avoid missed diagnosis of causes.
关键词
颈椎病/前庭神经炎/眩晕病/病因漏诊Key words
Cervical spondylosis/Vestibular neuritis/Vertigo/Missed diagnosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据