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WORKSHOP VERTIGO
KASUS 1
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KASUS 1
• Pasien saat bangun pagi mengeluhpandangan berputar bila epalan!amiring eiri"""##
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$ata tambahan
% Rasa berputar hilang dalam &atu seitar '( deti#
% $isertai mual# Rasa berputar hilang dalam &atu
seitar '( deti#
%Tida ada eluhan pendengaran) esemutan di mua)bi*ara pel+) maupun elemahan m+t+ri#
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PERTA,-AA,
a# Apa .enis /ertig+ pada pasien ini#0
b# Apa $iagn+sis Ker.a asus ini 0
*# Apa pemerisaan bed%side untumenegaan diagn+sis 0
d# Apa terapin!a 0
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TERAPI PPV
1# Anti/ertig+
a. Vestibular suppressant
b) 2,S Stimulant'# Antiemeti
3# Vestibular Rehabilitati+n Therap!
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TREATMENTI. ANTIVERTIGO
1.Vestibular Suppressant
a# 2a antag+nist 4 5lunari6in
b# Vas+dilat+r 4 etahistine
*# Tran7uili6er 4 dia6epam) hal+perid+l) sulpiride)*l+na6epam
d# Antihistamine 4 $i8enhidramine) me*li6ine# 2. CNS stimulant
Ephedrin) amphetamin
II. ANTIEMETIC 1# Anti*h+linergi* 4 atr+pine) s*+p+lamine'# Antid+paminergi*4 4 Pr+*hl+rpera6ine)
met+*l+pramide# 3# Antihistamine4 $i8enhidramine
III. PSYCHOAFFECTIVE2l+na6epam) dia6epam 8+r an9iet! and pani* atta*
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a. Semont Maneuver
• Als+ *alled the liberatory maneuver
• The patient is rapidly moved from lying on oneside to lying on the other
• R+ughl! an :(; *ure rate #
• Taes ab+ut 1? minutes t+ *+mplete#
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Sem+nt @aneu/er
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! "e#
! "e#
! "e#
$. E%&e'maneuver
Other name4 2analith rep+siti+ning Parti*le rep+siti+ning
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#. (ran)t*Daro+ maneuver
1 repetiti+n B maneu/er d+ne t+ ea*h side in turn
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• ! "e#on)" or unt2& )2882ne"" "u$"2)e"
• Re%eat 1 9 : 0; 4Ta
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@ORKSHOP VERTIGOKASUS =
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KASUS '
• Tn @) D3 thn datang e IG$ denganeluhan utama pusing bbrp .amsmrs""#
• Lanjutkan anamnesis !!
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Si8at Vertig+
- Vertig+ timbul saat berbaringmaupun dudu tega#
- aman!a '%3 menit) hilang timbul#
% Rasa mual sediit#
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Keluhan tambahan
• Rasa tebal seitar mulut #
• Pandangan ganda #
•
Wa.ah miring eiri• i*ara *adel
• Tida ada elemahan pada
etremitas
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Ri&a!at Pen!ait danebiasaan
• Hipertensi #
• $@ disangal
•
Gangguan .antung disangal• @er++ se.a e*il )1%' bungus
sehari#
•
Str+e
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Pemerisaan 5isi
• KU bai) esadaran 2@) T$ 1?(1((), :(mnt) RR1D9mnt) a8ebris#
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Pemerisaan ,eur+l+gis
• Pupil slight anis++r ia) r8 *h! FF
• ,istagmus ) bidiresi+nal)eananiri#
• Paresis , VII a @,#
• @+t+ri paresis %%
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Pemerisaan tambahan
Head impulse test #
• $i9 J Hallpie test4
% atensi % laman!a 1 menit
% 5atigue
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Apa $iagn+sis asus ini 0
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Summar!
- Vertig+ tipe sentral
% ,!stagmus asar%lambat e anan sentralanan
- Hed thrust test VOR bai lesi sentral
- Ge.ala%ge.ala nulear SSP
- lesi sentral#
D2ano"2"
Stroke iskemik diPons kanan
@RI *+nrmed
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