Program explanation to education course “differential diagnostics of dizziness types and treatment

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Scientific and technological progress of recent years is related to significant informational loading at the human brain. Velocity of jet propulsion flight is 200 times exciding the velocity of running human, modern civilization lives in electro-magnetic smog,  changes in the chemical environment are evident, even the structure of alimentary products is altered, the amounts of information proceeded by human being now cannot be compared even with the ones of 30-50 years ago. All this is considered to be the reason of the increase of chronic diseases amount.
Modern medicine is based at the management of delayed results of stresses named: cardio-vascular, metabolic, etc. disturbances and not the overexcited nuclei in the nervous system.  Early signs of the stresses survived are different types of dizziness, which are noted in 20 % of total population in the developed countries, at some ecologically compromised countries they report this figure to reach 40 %. Modern life requires wide implementation of functional neurological disturbances correction. Presence of developed neurological methods provides the chance to precise the topics of pathological process as well as to choose corresponding management procedures.
The aim of education course “differential diagnostics of dizziness types and their treatment” is to inform the doctors about differential diagnostic and therapeutic methods for management of patients with different types of Dizziness, as well as to study the basic level of the problem.
Mastering the subject requires deep knowledge of anatomy, physiology, neurology, otolaryngology, and also therapy, cardiology, endocrinology, basis of electronics and other fundamental clinical disciplines. According to the latter only the persons with higher medical education might use diagnostic methods and subscribe the treatment procedures. This PROGRAM includes necessary minimum of knowledge and practices necessary to every doctor to provide the dizzy patient with qualified first level medical aid.
In the PROGRAM the bedside examination methods and principles are accentuated. From the other side modern investigation methods, their indications, limitations and interpretation of results are overviewed. Nystagmography, posturography, cranio-corpography, cardiography, encephalography, - are now the tools which allow the doctor to estimate even early functional disturbances, differentiate and precise the diagnosis and subscribe adequate therapy.
PROGRAM consists of 39 academic hours (10 hours lectures, 21 practical sessions, 8 seminar sessions). At the end of the course the listeners are passing examination.

PLAN
of education course “differential diagnostics of dizziness types and their treatment”

for neurologists, otolaryngologists, cardiologists, endocrinologists, internists and pediatricians, family, aviation, sea, transport medical specialists, both hospital and ambulatory practices. Course duration - 1 weak (39 hours).
Aim of the course: upgrading of theoretical and clinical knowledge by neurologists, otolaryngologists, cardiologists, endocrinologists, internists and pediatricians, family, aviation, sea, transport medical specialists, both hospital and ambulatory practices, obtaining of practical skills.

CodesChaptersHoursCourseChapterLecturesPracticalSeminarsTotal1234567Introduction conference111.Vestibular system1.1.Vestibular system221.2.Dizziness types and related symptoms2681.3.Brain vestibular projections262101.4.Methods of patient examination262101.5.Treatment224Examination22Final conference22Total 1021839

Program of education course “differential diagnostics of dizziness types and their treatment”

CodesName of the chaptercoursechapter12300Types of dizziness01Concept of vestibular system02Methods of investigation, complaints, bedside examination.03Methods of investigation. Posturography, Cranio-corpo-graphy.05Nystagmography: characteristics and clinical use.06Electrocardiography, pupillometry, audiometry, evoked potentials in dizzy patient07Treatment of dizzy patient

Program of education course “differential diagnostics of dizziness types and their treatment”
Diagnostic methods.
Anamnesis: inquiry and questionnaires.
Bedside examination: oto, ophthalmo, pharyngoscopy, coordination tests: Romberg, Uemura, Unterberger, Fukuda, indicating (past-pointing), tracking, Garcia, Benson, 20-score battery of coordination tests.
Instrumental investigation: posturography, cranio-corpography, nystagmography, electroencephalography with evoked potentials, electrocardiography with neurological tests, audiometry, pupillometry.

Basic concepts
 Sensors of vestibular periphery:

1. acceleration
2. gravitation
3. low-frequency-vibration
4. sounds
5. magnetic impulses
6. metabolism

Space orientation sensory tetrad:

1. vestibular
2. visual
3. somatosensory
4. hearing

Vestibular projections in brain:

1. vestibulo-sensory
2. vestibulo-motor
3. vestibulo-vegetative
4. vestibulo-limbic

Cortical vestibular representations:

1. vestibular itself
2. vestibular in somatosensory cortex
3. vestibular in visual cortex
4. vestibular in auditory cortex

 
Diagnostic methods: subjective and objective, direct and indirect.
Studies of vestibulo-sensory projection: complaints, EEG, evoked potentials. Performance, parameters, interpretation.
Dizziness is distortion of perception of space, movement and time.
Types of dizziness and related symptoms: dizziness, subjective vertigo, objective vertigo, pseudovertigo (giddiness), disequilibrium, orthostatics, kinetosis, acrophobia, agoraphobia, nictophobia, claustrophobia, ascendophobia, descendophobia, optokinesis, nausea, vomiting, headache, black-outs, tinnitus and numbness.

Vestibulo-motor projection study: complaints, nystagmography, posturography, cranio-corpo-graphy. Performance, parameters, interpretation.
Vestibulo-vegetative projection study: complaints, ECG with neurological tests, pupillometry. Performance, parameters, interpretation. Vegetative storm.
Vestibulo-limbic projection study: complaints, audiometry
Chronic fatigue and sopit-syndrome

Nosologies: Meniere disease and syndrome, vestibular neuronitis, BPPV and MPPV, vibration disease, head trauma, radiation disease, intoxications, metabolic disorders.
Long-lasting consequences of vestibular dysfunction.

Factors of progress and their influence at vestibular system. Positive effects of vestibular stimulation, vestibular tolerance and overloading.
Therapy: physical and chemical methods. Basic mechanisms of the human compensation of disequilibrium: restitution, adaptation, supression, habituation, compensation.
Vestibular rehabilitation: Jajura Veda, Italian protocols, biofeedback.
Pharmacotherapy of dizziness: systemic approach.

Pleasant dizziness - its physiological and pathophysiological manifestations. Beauty and health: influence of environment, music, architecture, dressing, arts at human wellbeing.