blok 13 tinjauan umum vertigo.ppt

7/25/2019 BLOK 13 TINJAUAN UMUM VERTIGO.ppt

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TINJAUAN UMUM VERTIGO

Muhammad Naharuddin Jenie


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DEFINISI

VERTIGO

DIZZINESS

GIDDINESS

UNSTEADINESSVERTERE : MEMUTAR (LATIN)

VERTIGO : ILUSI SENSASI ROTASI

DIZZINESS : ILUSI TAK JELAS ROTASI

SINKOPE : RASA ILANGN!A KESADARANDISEKUILIBRIUM: ILANGN!A "ALANS TAN#A RASA

DIZZINESS

ILL DEFINED PSYCHOGENIC DIZZINESS

SEMAKIN RINGAN


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SEJARA Marie Jean Pierre Flourens($%&'$*')

Di #eran+i, : Jean Marc Gaspar I!ar($%%'$-). Sa/ah ,a0u expert101/12i 3er0ama. $4$ : 5u6u a7ar 3en8a6i0 0e/in2a 3er0ama. Guru 5e,ar ana01mi 61m3ara0i9 di #ari,. Sara9 a6u,0i6 : +1+h/ea ;e,0i5u/um. Sere5e/um : men2enda/i6an 611rdina,i 2era6an2era6an 0u5uh. #eranan 6ana/i, ,emi,ir6u/ari,

Prosper Meniere($%&&$*4). Ver0i21 a6i5a0 3en8a6i0 /a5irin #en8a6i0 Meniere

Jean Mar!in "#arco!($4


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SEJARA

%al!er E& Dan'($*$&'*)> ah/i 5edah ,ara9 dariAmeri6a Seri6a0. Un0u6 ;e0i21 /a5irin 8an2 in0ra+0a5/e 3em101n2an ner;u,

;e,0i5u/ari,

#aruh 3er0ama a5ad 4= ($&==$& dimenhidrina0e> me+/i@ine> 3irid16,ine. O5a0 an0i hi,0amin : di3henhidramin> 0ri3e/ennamine>

+h/1r3heniramine

. Tranui/i@er : dia@e3am. Seda0i9

#ada $&-> "#arles S& (allpi)e($&==$&%&) dan (u*#%B& "airns($&*$&


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SEJARA

Ernes! Glen %e+er(Lahir $&


6/36

SEJARA

E&G %EVER:

. Te/in2a ada/ah ,a/ah ,a0u dari 1r2an1r2an

0u5uh 8an2 3a/in2 ,u/i0 un0u6 5e6er7a

den2ann8a. Te/in2a mem3un8ai 0u/an2 8an2 3a/in2 3ada0

0a3i 7arin2ann8a 3a/in2 ra3uh> dan

men7a2an8a den2an ,ua0u +ara 8an2

me8a6in6an dan rea/i,0i6> memer/u6an Ca60u

dan 6e,a5aran 8an2 +u6u3 5an8a6

Rogers FB, 198


7/36

SEJARA

#eri,0iCa3eri,0iCa den2an ;er0i21 :$ The lo"'e#( )ay: 3endara0an ,e6u0u di N1rmandia

(* Juni $&'') 3ada 3eran2 dunia 6e4

-T.e gre+test /+ss $o/iting e$er *no0n in t.e .istor%o' /+n*in

4 Man0an 3re,iden AS : Geral For: ;er0i21

O5a0 7a/an3u/an25er15a0 /a2i0ern8a0a ,0r16e

- O3era,i 3a,u6an 61mand1 AS di Teheran> Iran un0u6mem5e5a,6an di3/1ma0di3/1ma0 AS 8an2 di,andera3en2aCa/ re;1/u,i Iran #a,daran dari A8a0u//ahRuhu//ah Kh1meini2a2a/ 6arena ,eran2an ;er0i21

(4< A3ri/ $&=)


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E#IDEMIOLOGI

Ke/uhan 8an2 ,an2a0 umum ,e0e/ah n8eri 6e3a/a dan5a0u6

Ra,a 3u,in2 : 0er5an8a6 3ada 3ra60e6 d160er umum $< H 3enderi0a 8an2 di61n,u/0a,i6an 6e ah/i ,ara9

(handra> $&=)B TT (!1e,/am A6, Ver0i21 ada/ah ,a/ah ,a0u ma,a/ah 6e,eha0an 3ada

1ran2 deCa,a 8an2 3a/in2 umum Di USA : '= H men2a/ami ;er0i21 ,e0ida60ida6n8a ,a0u

6a/i 3ada ma,a hidu3n8a

Sedi6i0 /e5ih 5an8a6 3ada Cani0a dari3ada /a6i/a6i In,iden, dan 3re;a/en, : menin26a0 den2an

5er0am5ahn8a u,ia

(CCChea/0h+1mmuni0ie,+1m)


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E#IDEMIOLOGI

Ver0i21 : uru0an 6e< dari 2an22uan 3en8a6i0 8an2diraCa0 di 5an2,a/ ,ara9 RSU# Dr Kariadi

#a,ien ;er0i21 8an2 diru7u6 6e uni0 EMG un0u6

3emeri6,aan A"R4= H : 2an22uan 9un2,i 5a0an2

10a6 (mun26in ;er0e5r1 5a,i/er in,u9i,ien,i)(Ari, "> 4===)

Ma-u) *era)an .MG/. MG : -' H 3en2endara m15i/ 6ere0a a3i. ML : &= H 1ran2 8an2 5e/um 5er3en2a/aman

5er/a8ar. MU: H 3enum3an2 3e,aCa0 0er5an2 den2an +ua+a

5uru6. M0: -= 4==4)


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MEKANISME ALAT

KESEIM"ANGAN TU"U (AKT)B0GI0N PERIFER K0N0N 1 KIRIB0GI0N PERIFER K0N0N 1 KIRI B0GI0N SENTR0LB0GI0N SENTR0L

2&2& VESTIBULUMVESTIBULUM - 6ri,0a am3u/ari,

4 1r2an 101/i0i6 ma6u/a

Nu6/ei ;e,0i5u/ari, 5a0an210a6

Sere5e/um

F1rma0i1 re0iu/ari, 5a0an2

10a6 (/16u, ,eru/eu,)Si,0em /im5i6

K1r0e6, 3re9r1n0a/

i310a/amu,

3& VISU0L3& VISU0L Re,e301r di re0ina

4& PROPRIOSEPSI4& PROPRIOSEPSI Re,e301r 3r13ri1,e3,i di 0end1n>,endi> ,en,i5i/i0a, da/am

Gera6an 0u5uh 6e3a/a da3a0 men7adi 3en8e5a5 ,indr1m ;er0i21

Gera6an 6endaraan (m15i/> KA> 6a3a/ /au0> 3e,aCa0 0er5an2>

3e,aCa0 an0ari6,a) da3a0 men7adi 3en8e5a5 ;er0i21

AKT da3a0 di/a0ih ,ehin22a da3a0 5erada30a,i 0erhada3

3eru5ahan /in26un2an


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NEUROFISIOLOGI AKTSTIMULUS 5STIMULUS 5

GERAKAN

Resep!orResep!or

Ve,0i5u/um :

(me6ani,)

TR0NDUKSITR0NDUKSI

N Ve,0i5u/ari,

OUTPUTOUTPUT

Resep!orResep!or

Vi,u, :

(+aha8a)

Trans6isiTrans6isi

Resep!orResep!or

#r13ri1,e3,i :

(/e0a6> 0em3a0)

NS3in1;e,0i5u/ari,

INPUTINPUT

MoulasiMoulasiNu6/eu, ;e,0i5u/ari, 5a0an2 10a6Sere5e/umi310a/amu, (3u,a0 mun0ah di 5a0an2 10a6

F1rma,i1 re0i6u/ari, (/16u, ,eru/eu,)K1r0e6, /im5i6 3re9r1n0a/

Kor!e)s sere-riKor!e)s sere-ri : Ke,adaran 2era6 6e3a/a0u5uh

Meulla spinalisMeulla spinalis : K1n0r1/ m101r,6i// K1n0r1/ 31,0ure

FLMFLM : K1n0r1/ ;a,a

N O30i6u,


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#ATOFISIOLOGI

GERAKAN DA#AT SE"AGAI #EN!E"A" TIM"ULN!ASINDROM KELAINAN FUNGSI AKT

ADA U"UNGAN ANTARA KEMAJUAN DALAM"IDANG ALAT TRANS#ORTASI DENGAN

#ERKEM"ANGAN ILMU #ENGETAUAN DI "IDANGAKT

RANGSANGAN GERAKAN !GSINDROM VERTIGOTIDAK DITENTUKAN OLE KEE#ATAN DAN ATAU"ESARN!A GERAKAN GONANGAN> TA#I LE"IDITENTUKAN OLE KEANEAN N23E&T4DARIGERAKAN DAN LAMAN!A TER#A#AR OLEGERAKAN TERSE"UT


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#ATOFISIOLOGI

$ Te1ri 1;er,0imu/a,i (a/a0 ,0imu/u, : 6ur,i 3u0ar

"aran8> 9aradi,a,i> 2a/;ani,a,i> iri2a,i 0e/in2a>

6edaraan dara0> /au0> udara)

4 Te1ri 61n9/i6 ,en,1ri, (a/a0a/a0 ,0imu/u, :s0ings, ro+l #o+ster, +##eler+tor, sti/ul+tor)

- Te1ri neur+l /is/+t#.

' Te1ri 101n1mi6


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TEORI SIN0PSTEORI SIN0PS Ran*san* *era)anRan*san* *era)an

S0re, 9i,i6S0re, 3,i6i,

i310a/amu,

#e/e3a,an RF

Lim91,i0 i31,9i,i,

i316am3u,

K1r0e6, ,ere5riK1r0e6, /im5i6

L16u, ,eru/eu,

Si,0em,im3a0i6,en0ra/

D1mina,i ,im3a0i6

D1mina,i3ara,im3a0i6

AT

K1r0e6, adrena/

S0er1id

Re,31n, 7arin2an

#eru5ahan3eri/a6u

Re#ipro#+lin.i5ition

"eru/an2u/an2

#/a,0i,i0a, SS# :

Re,31n 7arin2an Ada30a,ia5i0ua,i

Re,31n imun1/12i6Immun1,u33re,i1n

Medu//a adrena/

Respon 7arin*an 5Respon 7arin*an 5Ver0i21"+llorKerin2a0 din2in

Mua/Mun0ahRet#.ingi3er,a/i;a,i

#enurunanin9/u6, a

#enin26a0anin9/u6, a

An,ie0a,De3re,i


15/36

#ATOFISIOLOGITEORI SINA#S

Ter7adin8a ada30a,i ha5i0ua,i

#a3aran 5e/e5ihan(mi,a/n8a den2an 5ahan a21ni,n8a neur1h1rm1n)

#eru5ahan? me6ani,me ,ina3, #/a,0i,i0a, ,i,0em ,ara9 3u,a0 :$ Re,e301r : hi3er,en,i0;i0a,4 Re,e301r : o0n6regul+te (7um/ahn8a )

- #enu0u3an #.+nnel #+l#iu/,e+ara3r12re,i9in9/u6, 6a/,ium

Re,31n 7arin2an 2e7a/a? /a/umen2hi/an2

Ada30a,i ha5i0ua,i


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#ATOGENESIS Ver0i21 3en8a6i0

2e7a/a

Gan22uan 0ran,du6,i0ran,mi,im1du/a,i ;er0i21 "ia,an8a 1r2an 8an2 0er2an22u /a5irin Se5a5 dari ;er0i21 da3a0 0er/e0a6 di :

$ Ve,0i5u/um

4 N VIII (N ;e,0i5u/ari,)

- Re0i6u/um dari 5a0an2 10a6' Re,e301r 3r13ri1,e30i9 di 1010 dan /en2an

K1/umna 31,0eri1r di m8e/um

mi,a/n8a 3ada#l+ustrop.o5i+

* Ver0i21 ,e6under 6arena 3en8a6i03en8a6i0 umum 8an2men22an22u 9un2,i ;e,0i5u/umB

Mi,a/n8a In9e6,i 5era0 Anemia 5era0

In016,i6a,i

% Ma0a : mi,a/n8a : Di3/13ia

A,0i2ma0i,me 5era0


17/36

ETIOLOGI Ver0i21 6arena 2an22uan /an2,un2 ,i,0em 6e,eim5an2an

. Ves!i-uler peri,er

3esti5ulu/ : #en8a6i0 Meniere#erdarahan /a5irin (0rauma 6a3i0i,)

In9ar6 /a5irin

Eig.t. ner$e : Neuri0i, ;e,0i5u/ari,

Menin2i0i, 0u5er6u/1,a

Menin2i0i, /ue0i+a

Neurin1ma a6u,0i6u,. Ves!i-uler sen!ral: S0r16e 5a0an2 10a6 10a6 ,ere5e/um

#erdarahan ,ere5e/um

Trauma 5a0an2 10a6 10a6 ,ere5e/um

Tum1r 5a0an2 10a6 10a6 ,ere5e/um

Mu/0i3/e ,6/er1,i,> mi2raine

Trauma /eher

. Ves!i-uler peri,er "ropriosepsi : 0a5e, d1r,a/i,

3isu+l : di3/13ia> 6e/ainan /en,a 5era0> 2era6an 13016ine,i,


18/36

ETIOLOGI

Ver0i21 6arena 2an22uan 0a6 /an2,un2 ,i,0em

6e,eim5an2an. #en8a6i0 umum (gener+li7e) 8an2 5era0B

In9e6,i : #neum1nia

T83hu, I,6emia 10a6 : 3ada anemia 5era0

Dru2 : S0re301m8+in A,3irinKinine a99ein

"ar5i0ura0 An0i61n;u/,an

A/61h1/ An0ihi3er0en,i

Tranui/i@er #,i610r13i6

OO Me0a51/i6 : Uremia

Gan22uan ha0i

. #,i612eni6 Ke3ri5adian hi,0er13,i613a0i,

S0re, em1,i1na/


19/36

KAUSA DIZZINESS

Da3a0 di,e5a56an$ S0imu/a,i 9i,i1/12i6 0erhada3 ,i,0em 6e,eim5an2an n1rma/

i77iness9i,i1/12i6

4 Di,9un2,i 3a01/12i6i77iness 3a01/12i6

Di77iness3a01/12i6

$ Di@@ine,, ;e,0i5u/er : true $ertigo

4 Di@@ine,, n1n ;e,0i5u/er :pseuo $ertigo

Di77iness;e,0i5u/er (true $ertigo!$ Ver0i21 ;e,0i5u/er 3eri9er

4 Ver0i21 ;e,0i5u/er ,en0ra/ Ver0i21 ;e,0i5u/er 3eri9er : 3a01/12i da3a0 0er/e0a6 di :

$ La5irin

4 Ner;u, ;e,0i5u/ari,

(Kim Sun2> $&&*)


20/36

KAUSA DIZZINESS Ver!i*o +es!i-uler peri,er

. Pen'a)i!8pen'a)i! i la-irin

"##V #en8a6i0 Meniere Fi,0u/a 3eri/8m3h O5a015a0 10101i+ : ,0re301m8+in> 6inine> 5ar5i0ura0> a/61h1/> a,3irin> +a99ein>

an0i61n;u/,an> an0ihi3er0en,i> 0ranui/i@er> 3,i610r13i6> 15a0 hi312/i6emi6 1ra/(OO)

La5irin0i0i,

. Pen'a)i!8pen'a)i! i ner+us +es!i-ularis Neuri0i, ;e,0i5u/ari, Neur1ma a6u,0i6u,

Ver!i*o +es!i-uler sen!ral

#en8a6i03en8a6i0 di 10a6 5a0an2 10a6 ,ere5e/um

. In9ar6 5a0an2 10a6 3erdarahan ,ere5e/um. Ne13/a,ma. Mu/0i3/e ,+/er1,i,. #eradan2an : menin2i0i, T"> menin2i0i, /ue0i+a. E3i/e3,i ;e,0i5u/er. Mi2raine ;er0e5r15a,i/er

. Trauma 5a0an2 10a6> 0rauma /eherKim Sun $&&*


21/36

KAUSA DIZZINESS Di@@ine,, n1n ;e,0i5u/er (pseuo $ertigo)

1 S%n#ope

4 Di,e6ui/i5rium Di77iness ill e'ine

1 S%n#ope. Ari0mia 7an0un2. i310en,i 31,0ura/. Sin613 ;a,1;a2a/. i312/i6emia

4 Di,e6ui/i5rium. A3ra6,ia dari 2ai0. #ar6in,1ni,me. A0r19i mu/0i ,i,0em

Di77iness ill e'ine. i3er;en0i/a,i. Neur1,i, anie0a,. Neur1,i, hi,0eri6. A21ra3h15ia. De3re,i

(Kim Sun2> $&&*)


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KLINIS

Ver0i21 : 3era,aan ,ea6ana6an 3a,ien mera,a dirin8a 5er3u0ar di

ruan2an a0au ,e5a/i6n8a ruan2an 5er3u0ar 0erhada3 di,e6e/i/in2n8a 8an2 5er3u0ar 0erhada3 dirin8a(:.+nr+, 198;!

Ver0i21 ,u58e60i9 Ve0i21 158e60i9

( i77iness, giiness, lig.t .e+ness Di@@ine,, 3u,in2 8an2 0a6 ,3e,i9i6

Mi,a/n8a ra,a 218ah unst+5le

unstes+iness

"er5a/i6an turning"er3u0ar 0.irling(>usu', ;;!

Kau,a :. Di77iness8an2 n1n ,3e,i9i6

. Ver0i21 8an2 ,3e,i9i6 6au,an8a re/a0i9 ,edi6i0


23/36

KLINIS

VERTIGO

Ind1ne,ia : 0u7uh 6e/i/in2> mume0> 6e7un26e/

7un26e/> 7em3a/i6an

S0imu/u, : 2era6an ,indr1m ;er0i21

Sindr1m ;er0i21 : ;er0i21> 6erin2a0 din2in> 6u/i0

3u+a0 dan din2in (p+llor)> mua/> ni,0a2mu,>

unste+iness> mun0ah> hi3er,a/i;a,i A60i;i0a, ,im3a0i, : 3ada 3a3aran aCa/;er0i21

3ada 3a3aran /an7u0 p+llor +n #ol s0e+t(>usu', ;;!


24/36

KLINIS

Mua/ (n+use+) 3en2a/aman 3,i6i, : ra,a 0ida6 ena6 di /am5un2 8an2

menun0un 0im5u/n8a 2e7a/a mun0ah

ra,a a0au 3en2ha8a0an (#ons#ious +0+reness)0erhada3 6e2ia0an 0ida6 Ca7ar dari 3u,a0 mun0ah($o/itting #luster)

Mua/ di,er0ai inhi5i,i 01nu, in0e,0inum dan 2era63eri,0a/0i6 u,u, dan /am5un2

Nau,ea didu2a a6i5a0 6e2ia0an ,i,0em ,ara9,im3a0i6

(>usu', ;;!


25/36

KLINIS

Mun0ah (;1mi0u,> eme,i,)

3en2e/uaran i,i 2a,0r1in0e,0inum me/a/ui mu/u0

Ret#.ing

6e2ia0an 1010 5era0uran 8an2 men2arah 6e mun0ahnamun da/am 61ndi,i 2/100i, 0er0u0u3

Mun0ah meru3a6an 6e2ia0an ,i,0em ,ara9

3ara,im3a0i6

Saa0 mua/ : 01nu, m10i/i0a, 1010 GI

Saa0 mun0ah : 01nu, m10i/i0a, 1010 GI

(>usu', ;;!


26/36

KLINIS

Ni, : 0anda 158e60i9 ;er0i21 "er5a2ai 7eni, ni,

$ Ni, ,31n0an

4 Ni, 5an26i0an

- Ni, //iri6an

' Ni, 61n2eni0a/

? @iners n%st+g/us

Tr+in isp+t#.ers n%st+g/us

* Sess+0 n%st+g/us

% Re5oun n%st+g/us "erioi# +ltern+ting n%st+g/us

(up 5e+ting n%st+g/us!

& Do0n Be+ting n%st+g/us

$= N8,0a2mu, 3ada internu#le+r op.t+l/oplegi+

KLINIS


27/36

KLINISNi,0a2mu, (Ni,)

2era6an 51/a ma0a in;1/un0er (di /uar 6ehenda6)>

ri0mi, (5era0uran)> u/an2a/i6> 8an2 arahn8a 5i,a :. 1ri,1n0a/ (6e 6anan a0au 6e 6iri). Ver0i6a/ (6e a0a, a0au 6e 5aCah). "er3u0ar (,earah 7arum 7am a0au 5er/aCanan 7arum 7am)

Sedan2 6e+e3a0an u/an2a/i6n8a 5i,a :

>er*%(5er5eda 6e+e3a0ann8a) 2s#ill+tion> 3endu/ar (,ama 6e+e3a0ann8a)

Ni, 8an2=er*%di,e5u0 ,e,uai den2an arah 9a,e+e3a0n8a Ni, 6e 6anan 6e 6iri 6e a0a, 6e 5aCah ,earah 7arum 7am

5er/aCanan arah 7arum 7am #emeri6,aan ni,in,3e6,i$ Ni, 8an2 6a,ar in0en,i9 : 7aran2

4 Ni, 8an2 haru, 0a6 0am3a6 : ,erin2 (6a/ah 1/eh 9i6,a,i ma0a) #er/u 5an0uan :

I Ka+a ma0a Fren7el

II ENG


28/36

KLINIS

Sindr1m ;er0i21. Ke2ia0an ,i,0em ,ara9 ,im3a0i6 8an2

5er/e5ihan 2e7a/a aCa/ : ;er0i21> 3a//1r>

nau,ea3enderi0aan 8an2 he5a0

mun+u/n8a : ;1mi0u, menim5u/6an ra,a0a6u0 ,e0e/ah ,e/e,ai ;1mi0u, ,e2a/a

6e/uhan hi/an23a,ien mera,a /e5ih ,e2ar

(>usu', ;;)


29/36

KLINIS

Anamne,i,$ Ada6ah ,en,a,i 2era6an

Ada6ah nau,ea> ;1mi0u,> ,Cea0in2 2era6an ma0aa5n1rma/

4 "era3a /ama ;er0i21n8a

K1n,0an a0au hi/an2 0im5u/Sim01m ;er0i21 0im5u/ 5i/a 5er2era6 a0au 5eru5ah 31,i,i

Minum 15a0 5aru Trauma 6e3a/a 5aru ederaChi3/a,h

- Ada 2an22uan 3enden2aranTinni0u,> 6e0u/ian

' Ada6ah 6e/emahan Gan22uan ;i,ua/ #enurunan6e,adaran Su/i0 5er7a/an Gera6 ma0a a5n1rma/ Su/i05i+ara


30/36

DIAGNOSIS KLINIS

"##V. Di77iness 8an2 mendada6 ,in26a0 : $ 5er2u/in2 di0em3a0 0idur> mend1n2a6

La5irin0i0i, ;iru,. Ver0i21 8an2 mendada6> in0en,> 5er/an2,un2 5e5era3a hari

,am3ai $ min22u> ,erin2 di,er0ai nau,ea dan ;1mi0u,. Mun26in ada: .e+ring loss 0inni0u,

Neuri0i, ;e,0i5u/ari,. Miri3 /a5irin0i0i, ;iru,. Namun 0an3a .e+ring loss

#en8a6i0 Meniere. Seran2an ;er0i21 mendada6> 5er/an2,un2 : 5ermeni0meni0

,am3ai 5er7am7am. Kha, di,er0ai : .e+ring loss 0inni0u, 8an2 men+1/16

(Internet!


31/36

DIAGNOSIS KLINIS

In,u9i,ien,i ;er0e5r1 5a,i/er

. Meru3a6an Ptrue $ertigoQ

. Di,er0ai : Gan22uan ;i,ua/

Ke,u/i0an 5er5i+ara

Di,1rien0a,i

Gan22uan 611rdina,i


32/36

#EMERIKSAAN #ENUNJANG

Manu;er ;e,0i5u/er

Te, audi01ri

Te, 0e6anan darah : 5er5arin2 5erdiri

ENG

MRI T S+an

Te, rot+tor% #.+ir

S0udi +uitor% e$o*e potenti+l

(000$ertigoup/##o/re#ei$er.t/!


33/36

#ENGO"ATAN

Medi6amen01,a : OAV$An0ihi,0amine : Dimenhidrina0e

Di3henhidramine

4 An0i6h1/iner2i6 : S+131/amine TD

- #hen10ia@ine : h/1r3r1ma@ine> #r1+h/1r3hera@ine' A2en ,im3a01mime0i6

a Am3he0amine

5 E3hedrine


34/36

#ENGO"ATAN

Non rug tre+t/ent$ "er5arin2 diam da/am ruan2 8an2 2e/a3 $4 hari 3er0ama

4 Fi6,a,i ;i,ua/

- Re/a6,a,i men0a/

' airan i; un0u6 men+e2ah dehidra,i

? Re+ssur+n#e5enign sel' li/iting ise+seC 3esti5ul+r exer#ise

()eiss!

3esti5ul+r ex#er#ises1 :+n+lit. repositioning pro#eure

3esti5ul+r .+5itu+tion tr+ining

B+l+n#e #oorin+tion tr+ining

(Din+r )i+n+rti!


35/36

#ROGNOSIS

Ter2an0un2 3en8a6i0 6au,an8a

Ver0i21 3ada ma5u6 /au0 3enum3an2

3erahu 3en8e/ama0,an2a0 he5a0

da3a0 men8e5a56an 6ema0ian

Sel' li/iting ise+se

Ver0i21 6r1ni,

Kam5uhan ;er0i21


36/36

#ROGNOSIS

DAM#AK KLINIS

. 2' +ll li'es /iseries, $ertigo see/s to 5e+t t.e +#/e o' .u/+n su''ering

(A Ear a/6er)

Neuro#.irurgist>o.n $&*%

blok 13 tinjauan umum vertigo.ppt

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