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"code": "R55",
"name": "Обморок [синкопе] и коллапс",
"icd_name": "Обморок [синкопе] и коллапс",
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"slug": "r55_obmorok_sinkope_i_kollaps",
"lead": "Нарушение здоровья, относящееся к группе общие симптомы и признаки",
"description": "Обморок - потеря сознания, возникающая в результате недостаточности кровообращения головного мозга. \r\nКоллапс - остро развивающаяся недостаточность сосудов, сопровождающаяся снижением артериального давления, при этом больной не теряет сознание.",
"etiology": "<p>Острая сосудистая недостаточность способна провоцировать обморок и коллапс может развиваться из-за ряда факторов: </p>\r\n<ul>\r\n<li>потеря большого количества крови из-за внутренних разрывов, серьезных внешних повреждений; </li>\r\n<li>быстрая смена положения лежачего пациента; </li>\r\n<li>время полового созревания у девушек; </li>\r\n<li>перенесение всевозможных инфекционных болезней (дизентерии, ОРВИ, вирусного гепатита, пневмонии); </li>\r\n<li>отравление организма от злоупотребления лекарственными препаратами или же пищевая интоксикация; </li>\r\n<li>сбой сердечного ритма: ИМ, тромбоз, миокардит; </li>\r\n<li>поражение электрическим током; </li>\r\n<li>сильно повышенная внешняя температура: тепловой шок. </li>\r\n</ul>",
"pathogenesis": "<p>В основе патогенеза острой сосудистой недостаточности лежит снижение тонуса гладкой мускулатуры сосудистой стенки, приводящее к нарушению адекватного соотношения между объемом циркулирующей крови и емкостью сосудистого русла. В результате развивается гипоксия головного мозга и угнетение жизненно важных функций организма. </p>",
"diagnostics": "<p>В диагностике важно определить наличие и характер продромальных явлений, состояние вне обморока и коллапса, наличие заболевания сердца, нарушения ритма и проводимости. Может быть полезной электрокардиография, исследование крови на сахар. При повторяющихся коллапсах применяются ортостатическая проба, суточное мониторирование АД и ЭКГ. </p>",
"treatment": "<p>Обморок часто не нуждается в медикаментозном лечении. Достаточно уложить больного, лучше приподнять ноги, расстегнуть стесняющую грудь и шею одежду. Можно сбрызнуть лицо водой, похлопать по щекам, поднести ватку, смоченную нашатырным спиртом. Если это не помогает, можно сделать инъекции сосудосуживающих препаратов. </p>\r\n<p>Лечение коллапса направлено на устранения причин его возникновения. Его проводят в условиях стационара. Больного необходимо уложить, приподнять ноги, согреть. Перед транспортировкой делают инъекцию сосудосуживающего препарата. </p>\r\n<p>В условиях стационара назначают лекарственные вещества, действующие как на механизмы возникновения острой сосудистой недостаточности, так и на устранение причины, вызвавшей ее развитие. </p>\r\n<ul>\r\n<li>Препараты, возбуждающие сосудистый и дыхательный центры. Повышают тонус сосудов, увеличивают ударный объем сердца. </li>\r\n<li>Сосудосуживающие вещества. Внутривенное капельное введение адреналина, норадреналина допамина или других гормонов. </li>\r\n<li>Дезинтоксикационная терапия. Включает введение антидотов и детоксикационных растворов. Они обязательны при отравлениях и инфекционных заболеваниях. </li>\r\n<li>Кровь и кровезаменители. Применяют при кровопотере и анемии. При введении необходимо провести пробу на совместимость с кровью больного, а то это может привести к развитию геморрагического шока. </li>\r\n<li>Противовоспалительные средства. Антибиотики назначаются при инфекционных заболеваниях. </li>\r\n<li>Оксигенотерапия. Назначается с целью улучшения обмена веществ и насыщения крови кислородом. </li>\r\n<li>Восстановление объема крови. Вводятся коллоидные растворы, плазма и солесодержащие препараты. </li>\r\n</ul>\r\n<p> </p>",
"prevention": "<p>Лучшей профилактикой недостаточности функции сосудов является предупреждение заболеваний, которые могут ее вызывать. Рекомендуется следить за состоянием сосудов, употреблять меньше холестерина, проходить регулярные обследования системы кровоснабжения и сердца. В отдельных случаях гипотоникам назначают профилактический курс поддерживающих давление препаратов.</p>",
"clinical_picture": "<p>Обмороки проявляются внезапной слабостью, дурнотой, головокружением, онемением рук и ног с последующей кратковременной полной или частичной потерей сознания. Кожа бледная, конечности холодные, дыхание редкое, поверхностное, зрачки узкие, реакция на свет сохранена, пульс малый, артериальное давление низкое, мышцы расслаблены. Продолжается несколько минут, после чего обычно проходит самостоятельно. </p>\r\n<p>Симптомы коллапса: </p>\r\n<p>беспричинный приступ слабости и усталости, головокружение, бледность кожи, озноб, ледяные конечности, холодный липкий пот, пульс сбивчивый, учащенный, цианоз, резкое снижение АД, обморок, судороги. </p>",
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"description": "Нарушения голоса - это отсутствие или расстройство фонации вследствие патологических изменений голосового аппарата. \r\n\r\nАфония - полное отсутствие голоса и дисфония - частичные нарушения высоты, силы и тембра. ",
"etiology": "<p>К нарушениям голоса часто приводят следующие факторы: </p>\r\n<ul>\r\n<li>параличи и парезы голосообразующих органов; </li>\r\n<li>патологические процессы в коре или структуре головного мозга, в проводящих нервных путях; </li>\r\n<li>ДЦП; </li>\r\n<li>наличие воспалительных процессов в голосовых связках; </li>\r\n<li>неправильное строение голосового аппарата; </li>\r\n<li>воспаление гортани хронического характера; </li>\r\n<li>травмы или ожоги верхней части дыхательного горла; </li>\r\n<li>наличие новообразований в горле; </li>\r\n<li>наличие рубцов в гортани после операции; </li>\r\n<li>операция по удалению верхней части дыхательного горла; </li>\r\n<li>психическая травма; </li>\r\n<li>заболевания эндокринной сферы; </li>\r\n<li>вредные привычки; </li>\r\n<li>операции, в ходе которых удаляются гортань и голосовые связки; </li>\r\n<li>принадлежность к женскому полу. </li>\r\n</ul>",
"pathogenesis": "<p>В патогенезе функциональных нарушений голоса выделяют 3 основных момента: </p>\r\n<ol>\r\n<li>наличие невротического фона </li>\r\n<li>наличие пускового момента (различные невротические реакции - страх, горе, предшествующие воспалительные заболевания, перенапряжение голоса) </li>\r\n<li>фиксации нервной системой механизмов неправильного голосообразования по типу патологических условных рефлексов </li>\r\n</ol>\r\n<p>Для возникновения центральных функциональных нарушений голоса необходимо сочетание всех трех компонентов. </p>\r\n<p>Периферические функциональные нарушения голоса: чаще всего это результат перенапряжения голосовой функции. Невротический фон отсутствует. </p>\r\n<p>Для функциональных нарушений голоса характерно: </p>\r\n<ul>\r\n<li>часто резко возрастает двигательная функция гортани, может наблюдаться дискоординация между речевым дыханием, голосообразованием и артикуляцией </li>\r\n<li>могут быть нарушения сенсорной функции (чувствительности в голосовом аппарате), возникать неприятные ощущения в гортани (першение и т. п.) </li>\r\n<li>возможны нарушения секреторных функций, которые иногда сопровождаются ощущением инородного тела в области гортани. </li>\r\n<li>(нарушения моторных, сенсорных, секреторных функций) </li>\r\n<li>неврологическая симптоматика (высокие сухожильные рефлексы, неустойчивый фон настроения, депрессии, нарушения сна). </li>\r\n</ul>\r\n<p> </p>",
"diagnostics": "<p>Для выявления анатомических или воспалительных изменений голосового аппарата выполняется ларингоскопия; с целью оценки функции голосовых складок — стробоскопия. В диагностике опухолевых поражений незаменимы рентгенография и МСКТ гортани. Для получения сведений о функции мышц гортани проводится электромиография. С помощью электроглоттографии оцениваются изменения голосового аппарата в динамике. </p>\r\n<p>Логопедическое обследование включает оценку анамнеза, жалоб, особенностей голоса, характера голосообразования и голосовой атаки, физиологического и фонационного дыхания, темпо-ритмических и интонационных характеристик речи; определение времени максимальной фонации. </p>",
"treatment": "<p>При функциональных нарушениях голоса решающее значение придается общеукрепляющему лечению, массажу передней поверхности шеи, ЛФК, физиотерапии, соблюдению голосового режима. При органических нарушениях голоса проводится общая и местная медикаментозная терапия (эндоларингеальное введение лекарственных препаратов, ингаляции), по показаниям – хирургическое лечение ЛОР-патологии (удалении избыточной ткани голосовых складок, резекция гортани, ларингэктомия и др.). </p>\r\n<p>Логопедическую работу по восстановлению нарушений голоса следует начинать как можно раньше, чтобы предупредить фиксацию патологической голосоподачи, добиться лучших результатов, предотвратить развитие невротических реакций на дефект. Основные направления коррекционной работы включают психотерапию, коррекцию дыхания, развитие координации фонации и артикуляции, автоматизацию достигнутых навыков и введение голоса в свободное речевое общение. </p>",
"prevention": "<p>С целью предупреждения нарушений голоса необходимо воспитание правильных голосовых привычек (не форсировать голос), профилактика простудных заболеваний, отказ от курения и алкоголя, приема чрезмерно охлажденной и горячей пищи. Лица голосоречевых профессий должны владеть навыками диафрагмального дыхания и правильной голосоподачи. Любую, даже самую малую, простуду недопустимо переносить на ногах; в период болезни следует соблюдать щадящий голосовой режим.</p>",
"clinical_picture": "<p><strong>Симптомы органических нарушений голоса </strong></p>\r\n<p>Нарушения голоса при хронических ларингитах выражается утратой нормального звучания, сильной утомляемостью, иногда - невозможностью выполнения голосовой нагрузки. Характерны неприятные субъективные ощущения в горле – царапанье, першение, саднение, ощущение «комка», боль, давление. </p>\r\n<p>В случае периферических параличей и парезов гортани голос может отсутствовать совсем или иметь хриплое звучание. Нарушение голоса сопровождается сильным речевым утомлением, рефлекторным кашлем, поперхиванием, расстройством дыхания. </p>\r\n<p>Нарушения голоса, связанные с доброкачественными и злокачественными опухолями гортани развиваются постепенно, по мере роста образований. После любого, даже щадящего оперативного вмешательства на гортани возникают преходящие голосовые нарушения. При удалении гортани человек полностью лишается голоса; при этом резко нарушается функция дыхания, поскольку происходит разобщение трахеи и глотки. </p>\r\n<p>При центральных парезах и параличах гортани голос становится слабым, тихим, прерывистым, глухим, монотонным, нередко – с назальным оттенком. </p>\r\n<p>Органические нарушения голоса, возникшие у ребенка раннего возраста, сопровождаются отставанием в речевом развитии, задержкой накопления словаря и развития грамматических структур, нарушением звукопроизношения, трудностями коммуникации и ограничением социальных контактов. Нарушения голоса, развившиеся во взрослом возрасте, могут обусловливать профессиональную непригодность. </p>\r\n<p><strong>Симптомы функциональных нарушений голоса </strong></p>\r\n<p>Будучи периферическим функциональным нарушением голоса, нарушение голоса является профессиональным «заболеванием» лиц голосоречевых профессий. К проявлениям болезни относятся невозможность произвольно регулировать звучание голоса, (усиливать или ослаблять), прерывание (осечки) и быстрая утомляемость голоса, охриплость. В остром периоде голос может пропадать совсем. В большинстве случаев голос восстанавливается самостоятельно после периода отдыха. </p>\r\n<p>При гипотонусной дисфонии вследствие пареза внутренних мышц гортани развивается несмыкание голосовых складок, что проявляется осиплостью голоса, голосовым утомлением, болями в мышцах шеи и затылка; в тяжелых случаях возможна только шепотная речь. При гипертонусной дисфонии, обусловленной тоническим спазмом гортанных мышц, голос искажается, становится глухим, грубым; при афонии – не голос отсутствует совсем. </p>",
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},
"code": "R42",
"name": "Приступ головокружения и нарушение устойчивости",
"icd_name": "Головокружение и нарушение устойчивости",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
3,
0
],
"periodicity": 1,
"slug": "r42_pristup_golovokruzheniya_i_narushenie_ustoychivosti",
"lead": "патологическое состояние, проявляющееся в ощущении вращения либо окружающих предметов вокруг человека, либо самого человека вокруг собственной оси",
"description": "",
"etiology": "<p>Причинами головокружения могут быть повреждение ядер вестибулярного нерва в продолговатом мозге, повреждение периферических волокон вестибулярного нерва, наличие патологического процесса в вестибулярных рецепторах. <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">Головокружение</a> также является симптомом болезни Меньера, опухолей задней черепной ямки, невротических состояний.</p>",
"pathogenesis": "<p>А. Вестибулярное <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a> (истинное <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a>, вертиго) обычно обусловлено поражением периферического или центрального отдела вестибулярной системы. Оно проявляется иллюзией движения собственного тела или окружающих предметов. При этом возникают ощущения вращения, <a href=\"/symptom/narushenie_koordinacii/\" title=\"Перейти на страницу симптома Нарушение координации\">падения</a>, наклона или раскачивания. Острое <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a> часто сопровождается вегетативными симптомами (тошнотой, рвотой, повышенным потоотделением), чувством страха, нарушением равновесия и нистагмом (последний иногда приводит к нечеткости зрения).</p>\r\n<p>Б. <a href=\"/symptom/obmorok/\" title=\"Перейти на страницу симптома Обморок\">Обморок</a> и предобморочное состояние. Этими терминами обозначают временную потерю сознания или ощущение приближающейся потери сознания. В предобморочном состоянии часто наблюдаются <a href=\"/symptom/potlivost/\" title=\"Перейти на страницу симптома Потливость\">повышенное потоотделение</a>, <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома Тошнота\">тошнота</a>, чувство страха и потемнение в глазах. Непосредственная причина обморока - <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">падение</a> мозгового кровотока ниже уровня, необходимого для обеспечения мозга глюкозой и кислородом. <a href=\"/symptom/obmorok/\" title=\"Перейти на страницу симптома Обморок\">Обморок</a> и предобморочное состояние обычно развиваются на фоне артериальной гипотонии, заболеваний сердца или вследствие вегетативных реакций, и тактика при этих состояниях совершенно иная, чем при вестибулярном головокружении.</p>\r\n<p>В. Нарушение равновесия характеризуется неустойчивостью, шаткой («пьяной») походкой, но не истинным головокружением. Причина этого состояния - поражения различных отделов нервной системы, обеспечивающих пространственную координацию. Однако больные с мозжечковыми, зрительными, экстрапирамидными и проприоцептивными расстройствами часто определяют ощущение неустойчивости как «<a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a>».</p>\r\n<p>Г. Неопределенные ощущения, часто описываемые как <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a>, возникают при эмоциональных расстройствах, таких, как гипервентиляционный синдром, ипохондрический или истерический <a href=\"/symptom/nervoznost/\" title=\"Перейти на страницу симптома Нервозность\">невроз</a>, <a href=\"/symptom/depressiya/\" title=\"Перейти на страницу симптома Депрессия\">депрессия</a>. Больные обычно жалуются на «туман в голове», чувство легкого опьянения, дурноту или <a href=\"/symptom/strah/\" title=\"Перейти на страницу симптома Страх\">страх</a> <a href=\"/symptom/narushenie_koordinacii/\" title=\"Перейти на страницу симптома Нарушение координации\">падения</a>. Эти ощущения достаточно четко отличаются от ощущений при вестибулярном головокружении, обморочных состояниях и нарушениях равновесия. Поскольку любое <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a>, независимо от его причины, может вызвать <a href=\"/symptom/trevozhnost/\" title=\"Перейти на страницу симптома Тревожность \">тревожность</a>, она не может служить доказательством психогенной природы заболевания.</p>\r\n<p>Д. Некоторые больные с жалобами на <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a> затрудняются описать свои ощущения. В этом случае целесообразно провести провокационные пробы.</p>\r\n<p>1. Стандартный набор провокационных проб на <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a> включает:</p>\r\n<p>а. Ортостатическую пробу.<br />б. Форсированную гипервентиляцию в течение 3 мин.<br />в. Резкие повороты во время ходьбы или круговое вращение в положении стоя.<br />г. Пробу Нилена-Барани на позиционное <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a>.<br />д. Пробу Вальсальвы, которая усиливает <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a>, обусловленное краниовертебральными аномалиями (например, синдромом Арнольда-Киари) или перилимфатической фистулой, а также вызывает предобморочное состояние у больных сердечно-сосудистыми заболеваниями.</p>\r\n<p>2. После каждой пробы необходимо спросить, напоминает ли возникшее <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a> то ощущение, которое беспокоит больного. При ортостатической гипотонии, гипервентиляционном синдроме, позиционном головокружении и многих вестибулярных нарушениях результаты проб хорошо воспроизводятся, что позволяет получить важную диагностическую информацию.</p>",
"diagnostics": "<p>Проводится на основании жалоб, данных анамнеза, объективного осмотра.</p>",
"treatment": "<p>Патогенетическую терапию при головокружении проводят с учетом механизмов возникновения вестибулярного синдрома. При дисциркуляторных расстройствах назначают вазоактивные препараты, соответствующие типу ангиодистонии, антиагреганты и препараты, улучшающие микроциркуляцию. Специфическое лечение при системном головокружении известно лишь для ограниченного круга заболеваний. <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">Головокружение</a> в рамках вертебробазилярной недостаточности требует назначения антиагрегантов (ацетилсалициловая кислота 75–330 мг/сут., тиклопедин 500 мг/сут.), а при нарастании симптоматики — антикоагулянтов. Эффективность противовирусных препаратов и глюкокортикоидов не доказана.</p>\r\n<p>Лечение приступов болезни Меньера симптоматическое. Наиболее эффективен бетагистин, который является ингибитором диаминоксидазы — фермента, инактивирующего гистамин. Стабилизируя образующийся в организме гистамин, бетагистин оказывает гистаминоподобное действие. Препарат эффективен при пероральном применении. Основными показаниями для применения являются болезнь Меньера, водянка лабиринта внутреннего уха, синдромы, характеризующиеся приступами головокружения, шумом в ушах, понижением слуха, тошнотой, рвотой. Препарат оказывает расслабляющее действие на прекапиллярные запирательные мышцы в системе микроциркуляции внутреннего уха, увеличивая таким образом приток крови к сосудистой полоске лабиринта. Снижает частоту и интенсивность головокружений, уменьшает <a href=\"/symptom/shum_v_ushah/\" title=\"Перейти на страницу симптома Шум в ушах\">шум в ушах</a>, улучшает слух в случае его снижения. Средняя суточная доза по 1 таблетке 3 раза в день. С осторожностью следует назначать препарат больным, имеющим в анамнезе язвенную болезнь желудка или двенадцатиперстной кишки. Бетагистин не показан при беременности, бронхиальной астме, наличии феохромоцитомы.</p>\r\n<p>Для профилактики назначают диету с пониженным содержанием соли и диуретики. Для симптоматического лечения системного головокружения применяют вестибулолитические средства, действующие на вестибулярные рецепторы либо на центральные вестибулярные структуры, главным образом вестибулярные ядра. К первым относятся антигистаминные препараты: меклозин назначают 12,5–25 мг внутрь 4 раза в сутки, прометазин — 25–50 мг внутрь 4–6 раз в сутки. Центральным вестибулолитическим эффектом обладают бензодиазепины: оксазепам — 10–15 мг внутрь 4 раза в сутки, диазепам — 5–10 мг внутрь, в/м или в/в 4–6 раз в сутки. Также применяют стимулятор гистаминовых рецепторов бетагистин — 8–16 мг внутрь 2–3 раза в сутки, антагонисты кальция (циннаризин 25–50 мг внутрь или в/м 4 раза в сутки, флунаризин 10 мг в сутки во второй половине дня).</p>\r\n<p>Эффективным средством для лечения головокружений является комбинированный препарат, содержащий 400 мг пирацетама и 25 мг циннаризина. Его назначают по 2 капсулы 3 раза в день в течение 3–6 недель.</p>\r\n<p>Для купирования тошноты и рвоты назначают прохлорперазин 5–10 мг внутрь или в/м 4 раза в сутки или метоклопрамид 5–50 мг внутрь, в/м или в/в 4–6 раз в сутки. Центральным вестибулолитическим и противорвотным действием обладает тиэтилперазин. Назначают 6,5 мг внутрь, ректально, п/к, в/м или в/в 1–3 раза в сутки. Эффективно сочетание антигистаминных препаратов и бензодиазепинов. Для уменьшения седативного эффекта вестибулолитических средств рекомендуется назначение метилфенидата гидрохлорида 5 мг внутрь 2 раза в сутки (в первой половине дня). Вестибулолитические средства следует назначать лишь при остром системном головокружении. Их прием должен быть максимально кратким, так как длительное применение замедляет процесс центральной компенсации дефекта.</p>\r\n<p>При всех формах вестибулярного синдрома назначают лекарственные средства, снижающие возбудимость центральных и периферических отделов вестибулярного анализатора и подавляющие сопутствующие вегетативные реакции. Антигистаминные препараты применяют как для лечения, так и для профилактики головокружения. Назначают дифенгидрамин 2–3 раза в день внутрь (0,02–0,05 г), в свечах (0,01–0,02) или по 1 мл 1% раствора в мышцу; прометазин 2–3 раза в день внутрь (0,025 г) или по 2 мл 5% раствора в мышцу; дименгидринат по 50–100 мг внутрь 2–3 раза в день. Нейролептики подавляют возбудимость центральных вегетативных образований. При головокружении предпочтительнее назначать тиэтилперазин по 1 таблетке (0,0065 г) 1–2 раза в день внутрь, в свечах (0,0065 г) или по 1 мл в вену или мышцу; алимемазин внутрь по 0,005 г 2–4 раза в день; метоклопрамид по 0,01 г 2–3 раза в день внутрь или по 1–2 мл в мышцу или вену. При выраженных сопутствующих вегетативных реакциях назначают хлорпромазин, галоперидол, левомепромазин. При хроническим вестибулярном синдроме проводят этиотропную терапию, эффективны повторные курсы биостимуляторов (алоэ, ФИБС, стекловидное тело, апилак, кокарбоксилаза, витамины группы В) и ноотропные препараты.</p>\r\n<p>При лечении тяжелых пароксизмов больному внутримышечно вводят 2 мл тиэтилперазина или метоклопрамида, 1–2 мл диазепама, 1–2 мл дифенгидримина или прометазина, под кожу 0,5–1 мл платифиллина, дают внутрь 1 таблетку беллатаминала. При приступе болезни Меньера рекомендуется приложить грелку к ногам, на шейно-затылочную область — горчичник, внутримышечно вводят 1–2 мл тиэтилперазина и 2 мл метоклопрамида, 1 мл прометазина, в вену — 5 мл 0,5% раствора новокаина на 20 мл 40% раствора глюкозы, 40 мг фуросемида. При неэффективности этих мер вводят внутримышечно 1 мл аминазина, под кожу — 1 мл 0,1% раствора атропина сульфата и 1 мл 10% раствора кофеина-бензоата натрия.</p>\r\n<p>Вестибулярная <a href=\"/symptom/migren/\" title=\"Перейти на страницу симптома Мигрень\">мигрень</a> купируется при сочетании холинолитиков и альфа-адреноблокаторов, дифенина и транквилизаторов. Для межприступного лечения мигрени назначают курсы бета-блокаторов, антисеротониновые средства, антагонисты кальция. При головокружении, возникшем на фоне повышения ВЧД или отека лабиринта, применяют диуретики, ограничивают прием жидкости, назначают бессолевую диету. Больным, страдающим головокружением инфекционно-токсического генеза, проводят противовоспалительную, дегидратирующую и дезинтоксикационную терапию. При головокружении вследствие медикаментозной интоксикации отменяют или уменьшают дозу препарата, вызвавшего <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a>, назначают дезинтоксикационную терапию, витамины и вазоактивные средства. При головокружении, вызванном эндогенной интоксикацией в случаях нарушения метаболизма, необходимы коррекция электролитов плазмы и КОС, дезинтоксикационная терапия, препараты витаминов. Психогенное <a href=\"/symptom/golovokruzhenie/\" title=\"Перейти на страницу симптома Головокружение\">головокружение</a> купируется психотропными средствами.</p>",
"prevention": "",
"clinical_picture": "<p>Приступ головокружения сопровождается чувством вращения окружающих предметов вокруг человека либо вращения самого человека вокруг собственной оси. Больные предъявляют жалобы на повышенную <a href=\"/symptom/potlivost/\" title=\"Перейти на страницу симптома потливость\">потливость</a>, тошноту, рвоту. В период приступа у больных отмечаются <a href=\"/symptom/tahikardiya/\" title=\"Перейти на страницу симптома Тахикардия\">тахикардия</a>, повышение артериального давления, а также <a href=\"/symptom/nistagm/\" title=\"Перейти на страницу симптома Нистагм\">нистагм</a> глаз. Различают ротаторный или диагональный <a href=\"/symptom/nistagm/\" title=\"Перейти на страницу симптома Нистагм\">нистагм</a>, а также вертикальный и горизонтальный <a href=\"/symptom/nistagm/\" title=\"Перейти на страницу симптома Нистагм\">нистагм</a>.</p>",
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