眩暈之鑑別診斷與臨床病例報告

眩暈是中醫臨床常見疾病，過去研究顯示約有20-30%的人曾經有此經驗，人口盛行率約5%-10%，40歲以上則達到40%^((1))，可能導致眩暈的原因很多，一般可區分為周邊型眩暈及中樞型眩暈，周邊型眩暈多與前庭系統有關，中醫可做良好的處置，但若眩暈伴隨有雙眼複視、咬字不清、任何部位麻木無力或意識形態改變等症狀，可能為中樞型眩暈，甚至是腦中風的前兆，為危急重症，需先鑑別診斷，必要時請病人至醫院做進一步的檢查。以下將常見引起眩暈的原因及症狀的特色，表列出來讓大家參考，並提出三例主訴為眩暈之病例，其原因及治療方法各異，與各位同道先進共同研究、討論。

關鍵字

眩暈；頭暈；中醫藥；良性陣發性姿勢性眩暈梅尼爾氏症

並列摘要

Vertigo is a common disease in Chinese medical clinic. Past studies have shown that about 20-30% of people have the experience of vertigo. The population prevalence of vertigo is 5%-10%, over 40-years-old is 40%. Vertigo may be induced by many diseases, that generally can be divided into peripheral vertigo and central vertigo. The peripheral vertigo can be well-treated by Traditional Chinese Medicine. But if the vertigo accompanied by diplopia, inarticulate, numbness in any part of the body, or conscious change, it might be the central vertigo, stroke or a precursor for emergency and severe, which should be differential diagnosed carefully. If necessary, ask the patient to the hospital for further examination. In this article, we list the common reasons and the characteristics of these diseases. Provide three cases which patients’ chief complaint is vertigo. The diagnosis and the treatments of the three cases are different. We hope this can provide reference for clinical physicians.