Avaliação de distúrbios do equilíbrio

Última revisão: 18 Jun 2025
Última atualização: 29 Jan 2025

Resumo

Diagnósticos diferenciais

comuns

  • Neurite vestibular/labirintite
  • Doença de Ménière
  • Deficiência de vitamina B1 (tiamina)
  • Vestibulopatia ototóxica
  • Vertigem posicional paroxística benigna (canalitíase)
  • AVC hemorrágico
  • Acidente vascular cerebral (AVC) isquêmico
  • Degeneração cerebelar relacionada ao álcool
  • Enxaqueca vestibular
  • Doença de Parkinson idiopática
  • Neuropatia periférica
Detalhes completos

Incomuns

  • Schwannoma vestibular (neuroma acústico)
  • Neurite vestibular sequencial bilateral
  • Hipofunção vestibular bilateral idiopática
  • Hipofunção vestibular bilateral congênita
  • Doença degenerativa (relacionada à idade) da orelha interna
  • Doença autoimune da orelha interna
  • Deiscência do canal superior (DCS)
  • Meningite
  • Síndrome do mal do desembarque
  • Ataxia espinocerebelar
  • Esclerose múltipla (EM)
  • Cerebelite/encefalite do tronco encefálico
  • Encefalopatia de Wernicke
  • Tumor da fossa posterior
  • Malformação de Chiari
  • Mielinólise pontina central
  • Síndrome paraneoplásica
  • Deficiência de vitamina E
  • Doença celíaca
  • Degeneração cerebelar primária
  • Parkinsonismo secundário
  • Hidrocefalia de pressão normal
  • Degeneração corticobasal
  • Paralisia supranuclear progressiva
  • Atrofia de múltiplos sistemas (AMS; degeneração nigroestriatal, síndrome de Shy-Drager)
  • Trauma da medula espinhal
  • Síndrome de Guillain-Barré (GBS)
  • Espondilose espinhal
  • Tumor da medula espinhal
  • Neuromielite óptica (NMO)
  • Degeneração combinada subaguda da medula
  • Sífilis, tabes dorsalis
  • Tuberculose da coluna vertebral (doença de Pott)
  • Mielopatia infecciosa associada ao vírus da imunodeficiência humana (HIV)
  • Mielopatia infecciosa pelo vírus linfotrópico de células T humanas (HTLV) tipo 1
  • mielopatia inflamatória no lúpus eritematoso sistêmico (LES)
  • Transtorno de ansiedade
  • Toxicidade medicamentosa
Detalhes completos

Colaboradores

Autores

Adrian Priesol, MD, FRCPC
Adrian Priesol

Assistant Professor of Laryngology

Harvard Medical School

Medical Director of Auditory Evoked Testing

Massachusetts Eye and Ear Infirmary

Boston

MA

Declarações

AP declares that he has no competing interests.

Nurhan Torun, MD, FRCSC
Nurhan Torun

Assistant Professor in Ophthalmology

Director of Neuro-ophthalmology

Beth Israel Deaconess Medical Center

Harvard Medical School

Boston

MA

Disclosures

NT declares that she has no competing interests.

Peer reviewers

Joel A. Goebel, MD, FACS

Professor and Vice-Chairman

Department of Otolaryngology-Head and Neck Surgery

Director

Dizziness and Balance Center

Washington University School of Medicine

Saint Louis

MO

Disclosures

JAG has been reimbursed for conference speaking and clinical research support by NeuroCom Intl, Inc. and for conference speaking by MicroMedical Technologies, Inc.

Stephen P. Cass, MD

Associate Professor

Department of Otolaryngology

University of Colorado

Aurora

CO

Disclosures

SPC declares that he has no competing interests.

Daniel J. Costello, MD

Instructor in Neurology

Department of Neurology

Massachusetts General Hospital

Boston

MA

Disclosures

DJC declares that he has no competing interests.

Doris Bamiou, MD, MSc, PhD

Clinical Senior Lecturer & Consultant in Audiovestibular Medicine

UCL Ear Institute

UCL

London

UK

Disclosures

DB declares that she has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Goebel JA. 2015 Equilibrium Committee Amendment to the 1995 AAO-HNS guidelines for the definition of Ménière's disease. Otolaryngol Head Neck Surg. 2016 Mar;154(3):403-4. Abstract

Bhattacharyya N, Gubbels SP, Schwartz SR, et al. Clinical practice guideline: benign paroxysmal positional vertigo (update). Otolaryngol Head Neck Surg. 2017 Mar;156(suppl 3):S1-47.Full text  Abstract

Expert Panel on Neurologic Imaging:, Sharma A, Kirsch CFE, et al. ACR appropriateness criteria(®) hearing loss and/or vertigo. J Am Coll Radiol. 2018 Nov;15(11s):S321-31.Full text  Abstract

Expert Panel on Neurologic Imaging:, Salmela MB, Mortazavi S, et al. ACR appropriateness criteria(®) cerebrovascular disease. J Am Coll Radiol. 2017 May;14(5s):S34-61.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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