Clinical lectures on important symptoms. On giddiness / by Thomas Grainger Stewart.

  • Thomas Grainger Stewart
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on important symptoms. On giddiness / by Thomas Grainger Stewart. Source: Wellcome Collection.

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    becoming so under conditions in which previously no giddiness would have occurred. The nervous system has acquired a new mobility of this and of other kinds. You will find that patients who have suffered from sunstroke, even to a slight extent, often exhibit the same peculiarity. A very distressing form of vertigo is that which is associ¬ ated with epilepsy. One often meets with such cases in practice. Take as illustration a case regarding which I was recently consulted. A lady, aged forty, sustained an injury to the head about seven years ago. From that time she became subject to attacks, usually merely of giddiness, but occasionally of complete unconsciousness. On examination, nothing was found in the state of the ear or of the alimentary tract to account for the condition, and the only satisfactory explanation was that which referred the process to the category of epilepsy. Such a diagnosis as this can scarcely, of course, be established in the absence of more typical epileptic attacks. The treatment in such a case must consist of careful regulation of diet, the administration of bromides and bella¬ donna, and, in rare cases, operative interference at the seat of injury in the skull. You must also note that the epileptic may have giddiness as a warning at the onset of his attack, sometimes as an aura, sometimes merely as one of the early phenomena of the attack. In other nervous affections, such as migraine, giddiness occurs. It is not in my experience a frequent symptom, but is met with occasionally towards the end of the first stage, when the ocular or other sensory troubles are nearly passed, and the headache is about to commence. Some¬ times it occurs later, when the headache is fairly developed, and the nausea or vomiting has come on. The diagnosis of the cause of the form of vertigo is easy to any one who is acquainted with the features of migraine. The treatment in such a case is of course that applicable to migraine generally; and that again is guided by a study of the cause, whether it be connected with gastric and hepatic derangements, with constipation, or with nervous exhaustion. The mention of each of these causes will suggest to our minds the appropriate remedies; but, in addition, you will find that, in many