Skip to main content
Mijn bibliotheek
Shop
Nieuws Boeken Tijdschriften E-learning Web-tv Video Audio
Tips voor Mijn BSL
UITGEBREID ZOEKEN
Inloggen
Top
Gepubliceerd in:
Verantwoording hoofdstuk lezen eerste hoofdstuk lezen

2021 | OriginalPaper | Hoofdstuk

11. Duizeligheid

Auteurs : Dr. O. R. Maarsingh, Dr. H. Stam, Dr. V. A. van Vugt

Gepubliceerd in: Diagnostiek van alledaagse klachten

Uitgeverij: Bohn Stafleu van Loghum

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail
    Link delen
publish
Publiceer nu

Samenvatting

Uitgangspunt bij de diagnostiek zijn de karakteristieken van de duizeligheid, zoals aard, beloop en uitlokkende factoren. Bij draaiduizeligheid is het evenwichtsorgaan meestal de bron van de klacht. Acute, heftige en langer durende draaiduizeligheid kan wijzen op neuritis vestibularis, de ziekte van Ménière of – zelden – een CVA. Bij herhaalde, korte aanvallen gaat het dikwijls om benigne paroxismale positieduizeligheid. Vaak vormt het uitlokkend moment de sleutel voor de diagnose: provocatie van klachten door opstaan (orthostatische hypotensie), bij opstaan en gaan lopen (desequilibrium), bij schrik of pijn (vasovagale syncope) of bij inspanning (cardiovasculaire aandoening). Een licht gevoel in het hoofd kan ook continu aanwezig zijn (angststoornis, medicatiegebruik). Bij draaiduizeligheid wordt vaak de kiepproef van Dix-Hallpike aanbevolen. Een nuttige aanvulling hierop bij acute, continue draaiduizeligheid is de Head Impulse Test. Alarmsignalen zijn langdurige duizeligheid met eenzijdig gehoorverlies (acusticusneurinoom), acute doofheid (ischemie evenwichtsorgaan of hersenstam), nieuwe hoofdpijn (subarachnoïdale bloeding of dissectie arteria vertebralis) en neurologische symptomen zoals diplopie, dysartrie, ataxie of parese (aandoeningen cerebellum of hersenstam).
vorige hoofdstuk Wegraking
volgende hoofdstuk Vallen bij ouderen
Literatuur
1.
2.
3.
Colledge NR, Barr-Hamilton RM, Lewis SJ, et al. Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study. BMJ. 1996;313(7060):788–92.PubMedPubMedCentralCrossRef
4.
Sloane P, Blazer D, George LK. Dizziness in a community elderly population. J Am Geriatr Soc. 1989;37:101–8.PubMedCrossRef
5.
Stam H, Harting T, Van der Sluijs M, et al. Usual care and management of fall risk increasing drugs in older dizzy patients in dutch general practice. Scand J Prim Health Care 2016:1-7.
6.
Maarsingh OR, Dros J, Schellevis FG, et al. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics. BMC Fam Pract. 2010;11:2.PubMedPubMedCentralCrossRef
7.
Bailey KE, Sloane PD, Mitchell M, Preisser J. Which primary care patients with dizziness will develop persistent impairment? Arch Fam Med. 1993;2:847–52.PubMedCrossRef
8.
Kroenke K, Lucas CA, Rosenberg ML, et al. Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992;117:898–904.
9.
Therapeutics and Technology Assessment Subcommittee. Assessment: electronystagmography. Report of the Therapeutics and Technology Assessment Subcommittee. Neurology. 1996;46:1763–6.
10.
Nazareth I, Yardley L, Owen N, Luxon L. Outcome of symptoms of dizziness in a general practice community sample. Fam Pract. 1999;16:616–8.PubMedCrossRef
11.
Dros J, Maarsingh OR, Beem AL, et al. Impact of dizziness on everyday life in older primary care patients: a cross-sectional study. Health Qual Life Outcomes. 2011;9(44):1–7.
12.
Dros J, Maarsingh OR, Beem AL, et al. Functional prognosis of dizziness in older primary care patients: a prospective cohort study. J Am Geriatr Soc. 2012;60:2263–9.PubMedCrossRef
13.
14.
van Vugt VA, van der Bas G, Wouden JC, et al. Prognosis and survival of older patients with dizziness in primary care: a 10-year prospective cohort study. Ann Fam Med. 2020;18(2):100–9.PubMedPubMedCentralCrossRef
15.
Lamberts H. In het huis van de huisarts. Verslag van het Transitieproject. Lelystad: Meditekst; 1994.
16.
Stam H, van Vugt VA, Twisk JWR, et al. The prevalence and persistence of dizziness in older European home care recipients: a prospective cohort study. J Am Med Dir Assoc. 2020;21(3):338–43.PubMedCrossRef
17.
Stam H, Wisse M, Mulder B, et al. Dizziness in older people: at risk of shared therapeutic nihilism between patient and physician. A qualitative study. BMC Fam Pract. 2016;16(17):74.CrossRef
18.
van der Linden MW, Westert GP, de Bakker D, et al. Tweede Nationale Studie naar ziekten en verrichtingen in de huisartspraktijk: klachten en aandoeningen in de bevolking en in de huisartspraktijk. Utrecht: Nivel; 2004.
19.
20.
Hilton MP, Pinder DK. Benign paroxysmal positional vertigo. A safe and effective treatment is available for this well defined condition. BMJ. 2003;326:673.
21.
22.
Tinetti ME, Williams CS, Gill TM. Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med. 2000;132:337–44.PubMedCrossRef
23.
Kao AC, Nanda A, Williams CS, Tinetti ME. Validation of dizziness as a possible geriatric syndrome. J Am Geriatr Soc. 2001;49:72–5.PubMedCrossRef
24.
25.
Yardley L, Owen N, Nazareth I, Luxon L. Prevalence and presentation of dizziness in a general practice community sample of working age people. Br J Gen Pract. 1998;48(429):1131–5.PubMedPubMedCentral
26.
van der Plas JPL, Tijssen CC. Benigne paroxysmale positieduizeligheid. Ned Tijdschr Geneeskd. 1998;142:2669–74.PubMed
27.
Kim JS, Zee DS. Clinical practice. Benign paroxysmal positional vertigo. N Engl J Med 2014;370:1138-47.
28.
Lopez-Escamez JA, Carey J, Chung WH, et al. Diagnostic criteria for Menièreʼs disease. J Vestib Res. 2015;25:1–7.PubMedCrossRef
29.
James AL, Burton MJ. Betahistine for Meniere’s disease or syndrome. Cochrane Database Syst Rev. 2001;(1):CD001873.
30.
van Leeuwen RB, Bruintjes TD, Kingma H. Vestibulaire migraine. Ned Tijdschr Geneeskd. 2013;158(52):A6310.PubMed
31.
Hiitola P, Enlund H, Kettunen R, et al. Postural changes in blood pressure and the prevalence of orthostatic hypotension among home-dwelling elderly aged 75 years or older. J Hum Hypertens. 2009;23:33–9.PubMedCrossRef
32.
NVKNO, NVN, NVKG, NIV. Richtlijn Duizeligheid bij ouderen. Utrecht: NVKNO; 2015.
33.
Brignole M, Alboni P, Benditt DG, et al. Guidelines on management (diagnosis and treatment) of syncope-update 2004. Europace. 2004;6:467–537.PubMedCrossRef
34.
Arbogast SD, Alsheklee A, Hussain Z, et al. Hypotension unawareness in profound orthostatic hypotension. Am J Med. 2009;122:574–80.PubMedCrossRef
35.
Hackel A, Linzer M, Anderson N. Cardiovascular and cathecholamine responses to head-up tilt in the diagnosis of recurrent unexplained syncope in elderly patients. J Am Geriatr Soc. 1991;39:663–8.PubMedCrossRef
36.
37.
Kroenke K, Lucas CA, Rosenberg ML, Scherokman BJ. Psychiatric disorders and functional impairment in patients with persistent dizziness. J Gen Intern Med. 1993;8:530–5.PubMedCrossRef
38.
39.
Sloane PD, Dallara J, Roach C, et al. Management of dizziness in primary care. J Am Board Fam Pract. 1994;7:1–8.PubMed
40.
Eckhardt-Henn A, Breuer P, Thomalske C, et al. Anxiety disorders and other psychiatric subgroups in patients complaining of dizziness. J Anxiety Disord. 2003;17:369–88.PubMedCrossRef
41.
42.
43.
Asmundson GJG, Larsen DK, Stein MB. Panic disorder and vestibular disturbance: an overview of empirical findings and clinical implications. J Psychosom Res. 1998;44:107–20.PubMedCrossRef
44.
Rascoll O, Hain TC, Brefel C, et al. Antivertigo medications and drug-induced vertigo. Drugs. 1995;50:777–91.CrossRef
45.
Stam H, van der Horst HE, Smalbrugge M, Maarsingh OR. Chronische duizeligheid bij ouderen: een multifactoriële benadering is gewenst. Ned Tijdschr Geneeskd. 2014;159:A8301.PubMed
46.
Menant JC, Migliaccio AA, Sturnieks DL, et al. Reducing the burden of dizziness in middle-aged and older people: A multifactorial, tailored, single- blind randomized controlled trial. PLoS Med 2018: 15(7).
47.
Bösner S, Schwarm S, Grevenrath P, et al. Prevalence, aetiologies and prognosis of the symptom dizziness in primary care - a systematic review. BMC Fam Pract. 2018;19:33.PubMedPubMedCentralCrossRef
48.
Hanley K, O’Dowd T. Symptoms of vertigo in general practice: a prospective study of diagnosis. Br J Gen Pract. 2002;52:809–12.PubMedPubMedCentral
49.
Madlon-Kay DJ. Evaluation and outcome of the dizzy patient. J Fam Pract. 1985;21:109–13.PubMed
50.
Oghalai JS, Manolidis S, Barth JL, et al. Unrecognized benign paroxysmal positional vertigo in elderly patients. Otolaryngol Head Neck Chir. 2000;122:630–4.CrossRef
51.
Wiener-Vacher SR. Vestibular disorders in children. Int J Audiol. 2008;9:578–83.CrossRef
52.
Sloane PD, Coeytaux RR, Beck RS, Dallara J. Dizziness: state of the science. Ann Intern Med. 2001;134:823–36.PubMedCrossRef
53.
Cheung CS, Mak PS, Manley KV, et al. Predictors of important neurological causes of dizziness among patients presenting to the emergency department. Emerg Med J. 2010;27:517–21.PubMedCrossRef
54.
Maarsingh OR, Dros J, van der Windt DA, et al. Detecting anxiety and depression in older dizzy patients: a cross-sectional diagnostic study in general practice. J Geriatr Psych Neurol. 2011;24:98–107.CrossRef
55.
Linstrom CJ. Office management of the dizzy patiënt. Otolaryngol Clin N Am. 1992;25:745–80.CrossRef
56.
Newman-Toker DE, Cannon LM, Stofferahn ME, et al. Imprecision in patient reports of dizziness symptom quality: a cross-sectional study conducted in an acute care setting. Mayo Clin Proc. 2007;82:1329.PubMedCrossRef
57.
Stanton VA, Hsieh YH, Camargo CA Jr, et al. Overreliance on symptom quality in diagnosing dizziness: results of a multicenter survey of emergency physicians. Mayo Clin Proc. 2007;82:1319.PubMedCrossRef
58.
Vugt VA Van, Vet HCW de Wouden JC, van der, et al. The 25-item Dizziness Handicap Inventory was shortened for use in general practice by 60 percent. J Clin Epidemiol 2020 Jun 18:S0895-4356(20)30306-1
59.
Stam H, Maarsingh OR, Heymans M, et al. Het beloop van duizeligheid bij ouderen voorspellen. Huisarts Wet. 2019;11:36–8.CrossRef
60.
61.
Tarnutzer AA, Berkowitz AL, Robinson KA, et al. Does my dizzy patient have a stroke? A systematic review of bedside diagnosis in acute vestibular syndrome. CMAJ. 2011;183(9):E571–92.PubMedPubMedCentralCrossRef
62.
Chan TP. Is benign paroxysmal positional vertigo underdiagnosed in hospitalised patients? Hong Kong Med J. 2008;14:198–202.PubMed
63.
64.
Frith J. Diagnosing orthostatic hypotension. A narrative review of the evidence. Br Med Bull 2015;115:123-34.
65.
Dros J, Maarsingh OR, van der Horst HE, et al. Tests used to diagnose dizziness in primary care. CMAJ. 2010;11:2.
66.
Eggers SDZ, Bisdorff A, von Brevern M, et al. Classification of Vestibular Signs and Examination Techniques: Nystagmus and Nystagmus-Like Movements. J Vestib Res. 2019;29(2–3):57–87.PubMedCrossRef
67.
Krishnan K, Bassilious K, Eriksen E, et al. Posterior circulation stroke diagnosis using HINTS in patients presenting with acute vestibular syndrome: A systematic review. Eur Stroke J. 2019 Sep;4(3):233–9.
68.
Wertelaers A, Govaerts F. WVVH-aanbeveling voor goede medische praktijkvoering: preventie van letsels ten gevolge van vallen bij 65-plussers. Berchem: WVVH; 2002.
69.
Podsialo D, Richardson S. The timed ‘up and go’ test: a test of basic functional mobility for frail elderly persons. JAGS. 2000;48:104–5.
70.
Brinkman DMC, Kuipers-Upmeijer J, Oosterhuis HJGH. Kwantificering en evaluatie van 5 neurologische evenwichtstests bij proefpersonen en patiënten. Ned Tijdschr Geneeskd. 1996;140:2176–80.PubMed
71.
Kuipers-Upmeijer J, Oosterhuis HJGH. De proef van Unterberger niet bruikbaar om de vestibulaire functie te testen. Ned Tijdschr Geneeskd. 1994;138:136–9.PubMed
72.
Welgampola MS, Taylor RL, Halmagyi GM. Video head impulse testing. Adv Otorhinolaryngol. 2019;82:56–66.PubMed
73.
Colledge N, Lewis S, Mead G, et al. Magnetic resonance brain imaging in people with dizziness: a comparison with non-dizzy people. J Neurol Neurosurg Psychiatry. 2002;72:587–9.PubMedPubMedCentralCrossRef
74.
Boulton J, Vinik A, Arezzo J, et al. Diabetic neuropathies, a statement by the American Diabetes Association. Diabetes Care. 2005;28:956–62.PubMedCrossRef
75.
Persoons P, Luyckx K, Desloovere C, et al. Anxiety and mood disorders in otorhinolaryngology outpatients presenting with dizziness: validation of the self-administered PRIME-MD Patient Health Questionnaire and epidemiology. Gen Hosp Psychiatry. 2003;25:316–23.PubMedCrossRef
76.
Spitzer RL, Williams JB, Kroenke K, et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA. 1994;272:1749–56.
Metagegevens
Titel
Duizeligheid
Auteurs
Dr. O. R. Maarsingh
Dr. H. Stam
Dr. V. A. van Vugt
Copyright
2021
Uitgeverij
Bohn Stafleu van Loghum
Boek
Diagnostiek van alledaagse klachten

Print ISBN: 978-90-368-2619-8

Elektronisch ISBN: 978-90-368-2620-4

Copyright: 2021

DOI
https://doi.org/10.1007/978-90-368-2620-4_11