Raynaud's Disease. Pain in one foot, very rarely both feet or a hand, associated with redness, swelling, increased local temperature, hyperhidrosis, and local hemorrhages. Symptoms subside when the patient reclines and supports the extremity; they are relieved by cold and aggravated by warmth. Occurs mostly in men either alone or in association with other nervous affections.
Erythromelalgia. The pain comes and goes according to emotional changes or suggestion, disappearing or greatly diminishing when attention is engaged elsewhere. Often combined with neurasthenia.
Hysteria. Pain felt in a joint, most commonly the hip, knee, shoulder, or ankle, out of proportion to any objective signs of disease. Joint may be held in fixed position by spasm but relaxes during sleep and can often be overcome if patient's attention is distracted. Local temperature generally normal or sub-normal.
Vertigo. The patient experiences a false sense of motion of their own body or objects around them, sometimes causing actual movement. Vertigo can result from coarse organic disease of the brain or membranes (e.g., hemiplegia), degenerative disease of the central nervous system, diseased cerebral vessels, toxic causes, lesions of the middle or external ear, and other conditions.
<Callout type="important" title="Critical Diagnosis">Vertigo must be carefully diagnosed to rule out serious underlying conditions such as brain tumors, syphilis, or vascular diseases.</Callout>
Nystagmus, diplopia, vomiting, and severe prostration may occur secondary to an attack of vertigo. Labyrinthine Vertigo (including Meniere's Disease) is a disease of adult life twice as frequent among men.
Neurasthenia. The patient's nervous energy has been exhausted by prolonged worry or overwork. Common symptoms include painful or tender spots in the head, unreasonable fears, and various morbid sensations described as queer rather than painful.
Key Takeaways
- Vertigo can be caused by various conditions including organic brain disease, toxic causes, and psychological factors.
- Symptoms of vertigo may include nystagmus, diplopia, vomiting, and severe prostration.
- Hysterical symptoms such as joint pain out of proportion to any objective signs are common in neurasthenic patients.
Practical Tips
- Maintain a calm environment for those experiencing vertigo attacks.
- Identify and manage stressors that may exacerbate conditions like neurasthenia.
- Ensure proper hydration and nutrition to prevent toxic causes of vertigo.
Warnings & Risks
- Vertigo can be a symptom of serious underlying medical conditions such as brain tumors or syphilis.
- Ignoring persistent symptoms of vertigo could lead to severe complications including loss of balance, falls, and injuries.
Modern Application
While the diagnostic criteria provided in this chapter are valuable for understanding historical approaches to diagnosing nervous disorders like vertigo, modern medical practices have advanced significantly. However, recognizing early signs and seeking professional help remains crucial. The psychological aspects discussed still hold relevance today, emphasizing the importance of mental health support alongside physical treatment.
Frequently Asked Questions
Q: What are common symptoms of vertigo?
Common symptoms include nystagmus, diplopia, vomiting, and severe prostration.
Q: How is neurasthenia characterized in this chapter?
Neurasthenia is characterized by exhaustion of nervous energy due to prolonged worry or overwork, with common symptoms including painful spots in the head, unreasonable fears, and various morbid sensations described as queer rather than painful.
Q: What distinguishes hysterical joint pain from other conditions?
Hysterical joint pain is out of proportion to any objective signs of disease. The joint may be held in a fixed position by spasm but relaxes during sleep and can often be overcome if the patient's attention is distracted.