以眩暈為初始表徵之前庭神經鞘瘤－個案報告
 
李佳穎¹　蔡循典²　黃英庭³　林信惠¹

 
眩暈是病人就醫很常見卻難以明確表達的病徵，本個案以眩暈作為初期症狀，因頭痛及步態不穩求診，藉由神經學檢查及眼振型態懷疑中樞病灶，經影像學診斷為前庭神經鞘瘤，隨後才出現耳鳴。筆者藉此個案的診療經驗針對眩暈進行文獻回顧，期望建立簡明的評估流程，協助臨床醫師在廣泛的鑑別診斷中辨識出需緊急診治的病患。
（台灣家醫誌2019; 29: 196-202）DOI: 10.3966/168232812019122904005
 
關鍵詞：眩暈、頭暈、前庭神經鞘瘤
 

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¹馬偕紀念醫院家庭醫學科、²耳鼻喉科、³神經內科重症醫學科
受理日期：108年6月10日　　修改日期：108年7月3日　　同意刊登：108年7月17日
通訊作者：林信惠　　　　　通訊地址：台北市中山區中山北路二段92號　馬偕醫院家庭醫學科

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Vestibular Schwannoma Presenting as Vertigo: A Case Report
 
Chia-Ying Lee¹, Hsun-Tien Tsai², Ying-Ting Huang³ and Hsin-Hui Lin¹

 
Vertigo is a complaint common among patients but difficult for them to articulate. The article reported a case of a young woman with vertigo for years before developing headache and ataxic gait whose neurological examination and nystagmus type indicated central etiology. Tinnitus developed only after the diagnosis of vestibular schwannoma was made via further image study. In this case report, related previous studies were reviewed; based on the experience acquired from treating the patient, the authors proposed a refined diagnostic process to assist physicians in identifying those who require more aggressive management among vertiginous patients in outpatient settings.
(Taiwan J Fam Med 2019; 29: 196-202) DOI: 10.3966/168232812019122904005
 
Key words:dizziness, vertigo, vestibular schwannoma
 

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¹Departments of Family Medicine, ²Otorhinolaryngology, ³Neurology, Mackay Memorial Hospital, Taipei, Taiwan.
Received: June 10, 2019; Revised: July 3, 2019; Accepted: July 17, 2019.