3 years ago

Republication de : Comment prendre en charge un vertige chez l'adulte ?

Hella Vuong Chaney, Dominique Rohmer, Anne Charpiot

Publication date: June 2018

Source: Journal Européen des Urgences et de Réanimation, Volume 30, Issues 1–2

Author(s): Hella Vuong Chaney, Dominique Rohmer, Anne Charpiot

Points essentiels

L'interrogatoire et l'examen clinique sont rois dans l'enquête étiologique d'un vertige.

Dans le cadre de vertiges, les urgences vitales sont d'étiologies neurologiques et vasculaires. Il faut donc pouvoir les identifier rapidement et simplement.

Le vertige est un symptôme à soulager et la cause est à diagnostiquer.

Un interrogatoire minutieux associé à une examen neurologique, une étude du nystagmus, un test d'Halmagyi et une recherche de skew deviation sont plus fiables que l'imagerie dans les 48 premières heures pour dépister un accident vasculaire cérébral.

On retrouve 12 % de faux négatifs à l'IRM cérébrale et 74 % de faux négatif au TDM cérébral dans les 48 premières heures d'un accident vasculaire ischémique.

Les urgences labyrinthiques sont la labyrinthite infectieuse, la fistule périlymphatique et l'aéroembolisme du vestibule.

Key points

The interrogation and the clinical examination are critical in the research of vertigo etiology.

In the context of vertigo, the vital emergencies are of neurological and vascular origins. It is therefore necessary to be able to identify them quickly and simply.

Vertigo is a symptom to relieve and the cause is to be diagnosed.

Careful questioning combined with neurological examination, nystagmus study, Halmagyi test and skew deviation search are more reliable than imaging in the first 48 hours to detect a stroke.

There are 12% false negatives in cerebral MRI and 74% false negative in cerebral CT-scan in the first 48 hours of an ischemic stroke.

Labyrinth emergencies are infectious labyrinthitis, perilymphatic fistula and aeroembolism of the vestibule.

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