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7/25/2019 Vertigo Dr.kurnia 2
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oleh
Dr.Kurnia Kusumastuti, SpS
7/25/2019 Vertigo Dr.kurnia 2
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VERTIGO = VERTERE = MEMUTAR
PUSING ( awam)Vrti!"
N#ri $pa%a
GO&ERS ' Vrti!" aa%a rasa !ra$an ari tu*u,atau
"*#$+"*#$ is$itarn#a #an! *rsan!$utan
n!an A%at Ksim*an!an Tu*u ( AKT )
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SUMER IN-ORMASI AKT '
/nis rspt"r
0. S% ram*ut ari $rista an "t"%it
( vestibulum)
1. S% 2"n an r" rtina ( mata)
. S% ra*a $u%it + sni + tn"n(proprioseptik)
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Rspt"r AKT
n.vestibularis
Pusat AKT "ta$
inti vestibularis,cerebelum,formatio reticularis
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S% ram*ut $rista, "t"%it
rangsang mekanik
3%$si s% ram*ut
prma*i%itas s% mm*ran *ru*a
4a in3%u5
p%pasan nur"transmitr $ 2%a sinaps
n.6sti*u%aris
pusat AKT
7 7
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8 A9a% pn!!unaan $a2amata
8$"r$si asti!mat
8pru*aan i"ptri
8parsis "t"t $stra "$u%r
rtina
pusat AKT
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Pr"pri"spt"r sni an "t"t %r
mm*ri in3"rmasi tntan! %ta$ $pa%a
traap *a!ian tu*u %ainn#a
Pr"pri"spt"r tu*u an $strmitas *a9a
*ru*un!an n!an in3"rmasi %ta$ tu*u
$aitann#a !n tina$an uu$ , *riri an *r:a%an
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Pr"pri"spt"r mus$u%us O$u%i
Dra:a a$"m"asi an $"n6r!nsi "$u%i
Mm3"$us$an *a#an!an tpat paa ma$u%a
Mm*ri in3"rmasi tntan! :ara$ *na ari mata
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Pauan K"ntra$si an r%a$sasi mus$u%us
"$u%i $strna
($"n:u!at "2u%ar 6iati"n)
Mm*ri in3"rmasi tntan! %ta$
suatu *na iatas, i*a9a, i$iri,atau i$anan $ita
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NORMA; PRO4ESSING
Vsti*u%ar s#stm
6isus
pr"pri"2psis
sns"r# in3"rmati"n
2""rinat
4ENTRA = $n"9n pattrn
"2u%"m"t"r 2ntra mus2%s "3 t *"#
sta*i%isati"n "3 6isua% 3i% stati2 an $inti2
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ANORMA; PRO4ESSING
Vsti*u%ar s#stm
6isuspr"pri"2psis
sns"r# in3"rmati"n
a*n"rma% stimu%i, 52ssi6 stimu%i
is2"rant in3"rmati"n
4ENTRA = un$n"9n pattrn"2u%"m"t"r 2ntra ' NSTAGMUS mus2%s ' DEVIATION
A;ARM
&ARNING
4ORTE>
Nur"6!
2ntra
2"m 2"ns2i"us
a332ti6 2"mp"nnt VERTIGO
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Pat"3isi"%"!i
0. T"ri K"n3%i$ sns"ris
1. T"ri Ran!san! *r%*ian
. T"ri "t"n"mi$
?. T"ri nura% mismat2
@. T"ri nur" + um"ra%. T"ri sinaps
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Ran!san!an tr%a%u *sar
iatas ni%ai am*an! $p$aan
Arus in3"rmasi $ pusat AKT
Mn:a%ar B *"2"r $ *r*a!ai pusat sistm sara3
%ain
( mabuk gerakan)
T"ri Ran!san! *r%*ian
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N"rma% M"ti"n Si2$nss Aapt
PAR SM
SM PAR
PAR SM
PAR' Paras#mpati2 Nr6"us S#stm. SM' S#mpati2 Nr6"us S#stm
(Dari &"", 4.D., Gra#*i9%, A. T"r# "3 Antim"ti"n Si2$nss Dru! M2anism.
Ar"spa2 M. 0C1 ?'1?C+1@1)
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T"ri nura% mismat2
Ktia$ssuaian antara'
Fpn!a%aman !ra$an #an! sua trsimpan i "ta$
F!ra$an #an! san! i aapi
!ra$an trasa an
A$ti3asi sistma sara3 "t"n"m
Vrti!"
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i%a !ra$an an itu iu%an! trus
mn:ai tia$ trasa an %a!i
6rti!" *r$uran! B i%an!
teradaptasi
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Vrti!" istamin
D"pamin
Sr"t"nin
En"r3inVrti!" i%an!' istamin
D"pamin
Sr"t"nin
En"r3in
O*at anta!"nis Vrti!"
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/"s"3 Hs t"r#
Ran!san!an !ra$an
Stss 3isi$ 7 psi$is
p%pasan 4R-
"minasi ss simpatis traap parasimpatis
6rti!"
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R2ipr"2a% ini*iti"n
"minasi ss parasimpatis
munta
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Gra$an i u%an! +u%an!
4a prasinaps$ana% 4a mn#mpit
4a in3%u5 su%it
pn!%uaran nur"transmittr
rsp"n :arin!an B !:a%a
aaptasi
+
7 7
7 7
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Gra$an i u%an! +u%an!
"minasi simpatis parasimpatis*r!antian *ru%an! +u%an!
:um%a rspt"rsnsiti3itas rspt"r
!:a%a
aaptasi
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Trapi Vrti!"
0. Trapi $ausa%
1. Trapi simt"matis4a Entr# %"2$r
Antiistamin, anti"paminr!i$, antisr"t"nin
Anti$"%inr!i$
Simpat"mimti$Tran
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.Trapi Ra*i%itasi
Tu:uan ' mnim*u%$an $"mpnsasi sntra%
mnim*u%$an a*ituasi
a. Mt"a ran Dar"33 ( PPV )
*. ;atian 6isua% + 6sti*u%r + pnrita #an! masi arus *r*arin!
+ pnrita #an! sua *isa uu$
+ pnrita #an! sua *isa *riri
2. ;atian *r:a%an
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