ti'(#$ a+i(at gangg#an te$inga tenga% &an &a$a' ata# gangg#an *eng$i%atan /P#tranta2004. Vertigo a&a$a% "en"a"i ata# *era"aan )ang 'e'*engar#%i orienta"i r#ang &an '#ng+in &a*at &i&eini"i+an "e(agai "#at# i$#"i gera+an. Ke$#%an ini 'er#*a+an gea$a )ang "iatn)a "#()e+ti &an +arenan)a "#$it &ini$ai. Wa$#*#n *engo(atan "e(ai+n)a $ang"#ng *a&a *en)e(a( )ang 'en&a"ari *en)e(a( ata# +e$ainann)a- a"a$ ata# *en)e(a( ,ertigo "ering ti&a+ &i+eta%#i ata#*#n ti&a+ '#ng+in &io(ati /DK- 2009 B. Jeni"5eni" Vertigo Vertigo &i+$a"ii+a"i+an 'ena&i &#a +ategori (er&a"ar+an "a$#ran ,e"ti(#$ar )ang 'enga$a'i +er#"a+an- )ait# 1. Vertigo Periera$ Vertigo *eriera$ tera&i i+a ter&a*at gangg#an &i "a$#ran )ang &i"e(#t +ana$i" "e'i"ir+#$ari"- )ait# te$inga (agian tenga% )ang (ert#ga" 'engontro$ +e"ei'(angan. angg#an +e"e%atan )ang (er%#(#ngan &engan ,ertigo *eriera$ antara $ain *en)a+it*en)a+it "e*erti (enign *aro:)"'a$ *o"itiona$ ,ertigo /gangg#an a+i(at +e"a$a%an *engiri'an *e"an- *en)a+it 'eniere /gangg#an +e"ei'(angan )ang "ering +a$i 'en)e(a(+an %i$ang *en&engaran- ,e"ti(#$ar ne#riti" /*era&angan *a&a "e$5"e$ "ara +e"ei'(angan- &an $a()rint%iti" /ra&ang &i (agian &a$a' *en&engaran.
2. Vertigo Sentra$ Sa$#ran ,e"ti(#$ar a&a$a% "a$a% "at# organ (agian &a$a' te$inga )ang "enantia"a 'engiri'+an inor'a"i tentang *o"i"i t#(#% +e ota+ #nt#+ 'enaga +e"ei'(angan. Vertigo "entra$ tera&i i+a a&a "e"#at# )ang ti&a+ nor'a$ &i &a$a' ota+- +%#"#"n)a &i (agian "ara +e"ei'(angan- )ait# &aera% *era(angan ota+ &an "ere(e$#' /ota+ +ei$. . Tan&a &an ea$a Vertigo 1. Vertigo Sentra$ ea$a )ang +%a" (agi gangg#an &i (atang ota+ 'i"a$n)a diplopia- paratesia *er#(a%an "eri"i(i$ita" &an #ng"i 'otori+. Bia"an)a *a"ien 'enge$#% $e'a%gangg#an +oor&ina"i- +e"#$itan &a$a' gera+ "#*ina"i &an *rona"i tan)an)e "eara (ert#r#t5t#r#t (dysdiadochokinesia- gangg#an (era$an &an gangg#an +a"ei'(angan. Pero(aan t#n#+ %i&#ng )ait# *a"ien &i"#r#% 'en#n#+ ari *e'eri+"a &an
+e'#&ian 'en#n#+ %i&#ngn)a 'a+a a+an &i$a+#+an &engan (#r#+ &an ter$i%at a&an)a ataksia. Na'#n *a&a *a"ien &engan vertigo perifer &a*at 'e$a+#+an *ero(aan t#n#+ %i&#ng "aara nor'a$. Pen)e(a( ,a"+#$er $a(i% "ering &ite'#+an &an 'ena+#* in"#i"ien"i ,a"+#$er (er#$ang- TIA &an "tro+. onto% gangg#an &i"entra$ /(atang ota+- "ere(e$#' )ang &a*at 'en)e(a(+an ,ertigo a&a$a% iskemia (atang ota+- t#'or difossa posterior - migren basiler . 2. Vertigo perifer 6a'an)a vertigo (er$ang"#ng ; a. E*i"o&e /Serangan vertigo )ang (er$ang"#ng (e(era*a &eti+. Vertigo perifer *a$ing "ering &i"e(a(+an o$e% vertigo *o"i"iona$ (erigna /VPB. Penet#"n)a a&a$a% *er#(a%an *o"i"i +e*a$a 'i"a$n)a (erg#$ing "ea+t# ti&#r ata# 'enenga&a% 'enga'(i$ (arang &ira+ )ang $e(i% tinggi. Vertigo (er$ang"#ng (e(era*a &eti+ +e'#&ian 'ere&a. Pen)e(a( ,ertigo *o"i"iona$ (erigna a&a$a% tra#'a +e*a$a- *e'(e&a%an &ite$inga ata# o$e% ne#roniti" ,e"ti(#$ar *rogno"i"n)a (ai+ gea$a a+an 'eng%i$ang "*ontan. (. E*i"o&e Vertigo )ang (er$ang"#ng (e(era*a 'enit ata# a'. Da*at &i#'*ai *a&a *en)a+it meniere ata# vestibulopati (er#$ang. Pen)a+it 'eniere 'e'*#n)ai tria" gea$a )ait# +etaa'an *en&engaran 'en#r#n /t#$i- vertigo &an tinitus. U"ia *en&erita (ia"an)a 305<0 ta%#n *a&a *er'#$aan '#n#$n)a *en)a+it. Pa&a *e'eri+"aan i"i+ &ite'#+an *en#r#naan *en&engaran &an +e"#$itan &a$a' (era$an Tandem! &engan 'ata tert#t#*. Bera$an tan&e' )ait# (era$an &engan te$a*a+ +a+i $#r#" +e&e*an- i+a 'ena*a+ t#'it +a+i )ang "at# 'en)ent#% ari +a+i $ainn)a &an 'e'(ent#+ gari" $#r#" +e&e*an. Se&ang+an *e'eri+"aan elektronistagmografi "ering 'e'(eri (#+ti (a%a ter&a*at *en#r#nan #ng"i vertibular perifer . Pera$anan )ang +%a" &ari *en)a+it 'eniere ia$a% ter&a*at +e$o'*o+ "erangan vertigo )ang &i"e$ingi o$e% 'a"a re'i"i. Ter&a*at +e'#ng+inan (a%a *en)a+it a+%irn)a (er%enti ti&a+ +a'(#% $agi *a&a "e(agian ter(e"ar *en&eritan)a &an 'eningga$+an aat *en&engaran (er#*a t#$i &an ti'it#" &an "ea+t# *en&erita 'enga$a'i disekuilibrium /gangg#an +e"ei'(angan na'#n (#+an ,ertigo. Pen&erita "ii$i" "ta&i#' 2 ata# 3 aa$ '#ng+in 'enga$a'i gea$a )ang "er#*a &engan *en)a+it
'eniere a&i +ita %ar#" 'e'eri+"a +e'#ng+inana "ii$i" *a&a "etia* *en&eri *en)a+it meniere. . Serangan Vertigo )ang (er$ang"#ng (e(era*a %ari "a'*ai (e(era*a 'ingg#. Neuronitis ,e"ti(#$ar 'er#*a+an +e$ainan )ang "ering &i#'*ai *a&a *en)a+it ini '#$an)a vertigo, nausea- &an '#nta% )ang 'en)ertain)a ia$a% 'en&a&a+. ea$a ini (er$ang"#ng (e(era*a %ari "a'*ai (e(era*a 'ingg#. Sering *en&erita 'era"a $e(i% $ega na'#n ti&a+ (e(a" "a'a "e+a$i &ari gea$a (i$a ia (er(aring &ia'. Pa&a Neuronitis
vestibular #ng"i
*en&engaran
ti&a+
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+e'#ng+inann)a &i"e(a(+an o$e% ,ir#". Pa&a *e'eri+"aan i"i+ &i#'*ai ni"tag'#" )ang 'ena&i $e(i% (a"ar a'*$it#&on)a. Ji+a *an&angan &igera++an 'ena#%i te$inga )ang ter+ena *en)a+it ini a+an 'ere&a "eara gra&#a$ &a$a' a+t# (e(era*a %ari ata# 'ingg#. Pe'eri+"aan elektronistagmografi /EN 'en#n#++an *en)e'(#%an tota$ *a&a (e(era*a *en)a+it na'#n *a&a "e(agian (e"ar *en&erita &i&a*at+an gangg#an ,erti(#$ar (er(agai ting+atan. Ka&ang ter&a*at *#$a vertigo posisional benigna. Pa&a *en&erita &engan "erangan vertigo 'en&a&a+ %ar#" &ite$#"#ri +e'#ng+inan "tro+e "ere(e$ar. Nistagmus )ang (er"iat "entra$ ti&a+ (er+#rang i+a &i$a+#+an ,i+"a"i ,i"#a$ )ait# 'ata 'e'an&ang "at# (en&a )ang ti&a+ (ergera+ &an nigtamus &a*at (er#(a% ara% (i$a ara% *an&angan (er#(a%. Pa&a nistagmus perifer - nigtagmus a+an (er+#rang (i$a +ita 'eni+"a"i *an&angan +ita "#at# (en&a onto% *en)e(a( vetigo o$e% gangg#an ")"te' vestibular perifer )ait# 'a(o+ +en&araan- *en)a+it meniere- ,ertigo *a"a tra#'a NO
1 2 3 = 4 < 7 8 9
VERTIGO PERIFERAL (VESTIBULOGENIK) Pan&angan ge$a* Ra"a $e$a% &an "ta'ina 'en#r#n Jant#ng (er&e(ar aa% >i$ang +e"ei'(angan Ti&a+ 'a'*# (er+on"entra"i Pera"aan "e*erti 'a(#+ ?tot tera"a "a+it @#a$ &an '#nta%5'#nta% @e'ori &an &a)a *i+ir 'en#r#n
VERTIGO SENTRAL (NON-VESTIBULER) Peng$i%atan gan&a S#+ar 'ene$an Ke$#'*#%an otot5otot Sa+it +e*a$a )ang *ara% Ke"a&aran tergangg# Ti&a+ 'a'*# (er+ata5+ata >i$angn)a +oor&ina"i @#a$ &an '#nta%5'#nta% T#(#% tera"a $e'a%
10 11
Sen"iti *a&a a%a)a terang &an S#ara Ber+eringat
3. Po%on @a"a$a% Trauma cerebellum
Ukuran lensa mata tidak sama
Gangguan aliran darah ke
Infeksi telinga dalam
VERTIGO
Penurunan fungsi
Cemas
Tekanan intracranial
Nyeri Akut
Stres meningkat Pusing
Intolera nsi
=. Pe'eri+"aan Diagno"ti+ a. Pe'eri+"aan i"i+ ; 1 Pe'eri+"aan 'ata 2 Pe'eri+"aan a$at +e"ei'(angan t#(#% 3 Pe'eri+"aan ne#ro$ogi+
Tekanan pada otot
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Pe'eri+"aan oto$ogi+ Pe'eri+"aan i"i+ #'#'. (. Pe'eri+"aan +%#"#" ; 1 EN 2 A#&io'etri &an BAEP 3 P"i+iatri+ . Pe'eri+"aan ta'(a%an ; 1 6a(oratori#' 2 Ra&io$ogi+ &an I'aging 3 EE- E@- &an EK = 4
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