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https://www.readbyqxmd.com/read/28145669/dizziness-approach-to-evaluation-and-management
#1
Herbert L Muncie, Susan M Sirmans, Ernest James
Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient's history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symptoms is of limited clinical usefulness. Patients have difficulty describing the quality of their symptoms but can more consistently identify the timing and triggers. Episodic vertigo triggered by head motion may be due to benign paroxysmal positional vertigo. Vertigo with unilateral hearing loss suggests Meniere disease...
February 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28131175/central-positional-nystagmus-associated-with-cerebellar-tumors-clinical-and-topographical-analysis
#2
Bang-Hoon Cho, Sang-Hoon Kim, Sung-Sik Kim, Yun-Ju Choi, Seung-Han Lee
PURPOSE: Positional nystagmus is usually caused by peripheral vestibular disorder, mostly benign paroxysmal positional vertigo (BPPV). However, positional nystagmus is also encountered in central lesions. We aimed to determine clinical characteristics of the structures responsible for central positional nystagmus (CPN) associated with brain tumors. METHODS: All four patients (3 men; range=19-77years) had an evaluation of spontaneous and positional nystagmus using video-oculography...
February 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28063321/clinical-implication-of-cervical-vestibular-evoked-myogenic-potentials-in-benign-paroxysmal-positional-vertigo
#3
Mun Young Chang, Ji Ho Shin, Kyung Hyun Oh, Young Ho Hong, Seog-Kyun Mun
OBJECTIVES: To evaluate the value of cervical vestibular evoked myogenic potential (cVEMP) as a prognostic factor for benign paroxysmal positional vertigo (BPPV). METHODS: We reviewed 65 patients with BPPV who underwent cVEMP. Patients were divided into two groups according to resistance to the repositioning maneuver. Univariable and multivariable analyses were performed with age, gender, affected semicircular canal, affected side and cVEMP parameters to find the associated factors for resistance to the repositioning maneuver...
February 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/27921448/efficacy-of-the-li-maneuver-in-treating-posterior-canal-benign-paroxysmal-positional-vertigo
#4
Jinrang Li, Shiyu Tian, Shizhen Zou
CONCLUSION: The Li maneuver is a safe, effective, and simple repositioning method for the treatment of BPPV. It is simple to master and exerts an exact effect. As a rapid repositioning method, the Li maneuver can result in reduced treatment times and increased treatment efficacy, and is, therefore, especially suitable for patients with limited cervical spine movement. OBJECTIVE: To compare the short-term efficacies of the Li and Epley maneuvers in treating posterior canal benign paroxysmal positional vertigo (PC-BPPV)...
December 6, 2016: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27897129/a-pilot-study-using-intratympanic-methylprednisolone-for-treatment-of-persistent-posterior-canal-benign-paroxysmal-positional-vertigo
#5
Paz Pérez, Virginia Franco, Manuel Oliva, José A López Escámez
OBJECTIVE: To assess the effect of intratympanic methylprednisolone (ITMP) in posterior canal benign paroxysmal positional vertigo (BPPV) that fails treatment involving repositioning maneuver in a case series. MATERIALS AND METHODS: Nine patients with persistent posterior canal BPPV after 6 or more repositioning maneuvers were treated by ITMP (two weekly doses of 0.3-0.4 mL at 40 mg/mL) before repeating the repositioning procedures. RESULTS: Following ITMP treatment, 7 out of 9 patients were relieved of their symptoms and did not exhibit positional nystagmus after 1 or 2 repositioning maneuvers...
November 28, 2016: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/27882604/the-dog-bone-technique-a-novel-easy-and-safe-catheter-maneuver-for-aortic-arch-and-coarctation-stenting
#6
Marinos Kantzis, Anja Lehner, Kai Thorsten Laser, Anca Racolta, Radka Vcasna, Marcus Fischer, Deniz Kececioglu, Nikolaus A Haas
BACKGROUND: Various techniques are described to facilitate stable stent implantation in aortic arch stenosis or coarctation. We describe an alternative technique, which due to its unique appearance during stent implantation, we have named "Dog Bone Technique" (DBT). TECHNIQUE: The stent/balloon assembly is placed across the stenosis, the long sheath is retrieved to uncover the distal 20-50% of the stent. The balloon is inflated with the pressure inflator just to expand slightly the stent...
February 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27746838/-positive-to-negative-dix-hallpike-test-and-benign-paroxysmal-positional-vertigo-recurrence-in-elderly-undergoing-canalith-repositioning-maneuver-and-vestibular-rehabilitation
#7
Karyna M O B de Figueiredo Ribeiro, Lidiane Maria de Brito Macedo Ferreira, Raysa Vanessa de Medeiros Freitas, Camila Nicácio da Silva, Nandini Deshpande, Ricardo Oliveira Guerra
Introduction Benign Paroxysmal Positional Vertigo is the most common cause of dizziness in elderly people. Recent studies have shown that the elderly present higher Benign Paroxysmal Positional Vertigo recurrence and that vertiginous symptomatology remission varies according to comorbidities and the therapeutic techniques applied. Objective To assess the short-term effectiveness of Vestibular Rehabilitation in addition to Canalith Repositioning Maneuver on positive to negative Dix-Hallpike test, on recurrence and number of maneuvers to achieve a negative test in elderly patients with chronic Benign Paroxysmal Positional Vertigo...
October 2016: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/27746123/subjective-visual-vertical-after-treatment-of-benign-paroxysmal-positional-vertigo
#8
Maristela Mian Ferreira, Maurício Malavasi Ganança, Heloisa Helena Caovilla
INTRODUCTION: Otolith function can be studied by testing the subjective visual vertical, because the tilt of the vertical line beyond the normal range is a sign of vestibular dysfunction. Benign paroxysmal positional vertigo is a disorder of one or more labyrinthine semicircular canals caused by fractions of otoliths derived from the utricular macula. OBJECTIVE: To compare the subjective visual vertical with the bucket test before and immediately after the particle repositioning maneuver in patients with benign paroxysmal positional vertigo...
September 28, 2016: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/27729765/single-suture-customized-loop-for-large-iridodialysis-repair
#9
Mohamed Omar Yousif
Managing large iridodialysis that may occur during phacoemulsification is challenging. I describe how a procedure to reposit a prolapsed iris while the anterior chamber is markedly inflated by a current of infusion fluid may inadvertently lead to large iridodialysis, and discuss how to avoid such a complication. I describe a fast and efficient technique for managing large iridodialysis both immediately, once it occurs, or as a secondary maneuver. My technique involved fixing the iris periphery back to its root at the anterior chamber angle using 10-0 polypropylene suture with two straight needles introduced directly through the cornea at distant points, and an insulin syringe as a guide track to a point 1...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27695437/determinants-for-a-successful-s%C3%A3-mont-maneuver-an-in-vitro-study-with-a-semicircular-canal-model
#10
Dominik Obrist, Andrea Nienhaus, Ewa Zamaro, Roger Kalla, Georgios Mantokoudis, Michael Strupp
OBJECTIVE: To evaluate the effect of time between the movements/steps, angle of body movements as well as the angular velocity of the maneuvers in an in vitro model of a semicircular canal (SCC) to improve the efficacy of the Sémont maneuver (SM) in benign paroxysmal positional vertigo. MATERIALS AND METHODS: Sémont maneuvers were performed on an in vitro SCC model. Otoconia trajectories were captured by a video camera. The effects of time between the movements, angles of motion (0°, 10°, 20°, and 30° below the horizontal line), different angular velocities (90, 135, 180°/s), and otoconia size (36 and 50 μm) on the final position of the otoconia in the SCC were tested...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27638065/bedside-examination
#11
REVIEW
D Straumann
In most dizzy patients a limited selection of bedside tests, together with the history, is adequate to establish a differential diagnosis and select the next diagnostic and therapeutic procedures. A set of basic bedside tests that should be applied in every patient with vertigo or imbalance allows identifying: (1) patients who need immediate referral for further assessment and treatment; (2) patients with nonthreatening disorders for which treatment can be started without more detailed testing; (3) patients with benign paroxysmal vertigo, in whom a detailed work-up is not required and who can immediately be treated with an appropriate particle-repositioning maneuver; and (4) patients who need a comprehensive neuro-otologic and neurologic work-up...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27564530/diagnostic-criteria-of-barotraumatic-perilymph-fistula-based-on-clinical-manifestations
#12
Ji Eun Choi, Il Joon Moon, Hankyeol Kim, Kieun Lee, Yang-Sun Cho, Won-Ho Chung
CONCLUSIONS: Patients with sudden hearing loss and dizziness after barotrauma should be suspected of barotraumatic perilymph fistula (PLF). Early surgical repair of PLF showed better hearing outcomes. Therefore, diagnostic criteria should help surgical indications of barotraumatic PLF. OBJECTIVES: The aim of this study was to establish diagnostic criteria for barotraumatic PLF. METHODS: Twenty-four patients (26 ears) underwent surgery on suspicion of barotraumatic PLF...
January 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27525623/experiences-engaging-healthcare-when-dizzy
#13
Jessica To-Alemanji, Cynthia Ryan, Michael C Schubert
OBJECTIVE: Dizziness is a common yet difficult symptom to manage in patients seeking medical care. The purpose of this study was to describe the experiences of participants with dizziness engaging the medical community for help. PATIENTS: Five hundred twenty one participants were recruited from the Vestibular Disorder Association (VEDA) website using the association's list-serve, social media (Facebook), and fliers distributed through healthcare providers. INTERVENTION: NA...
September 2016: Otology & Neurotology
https://www.readbyqxmd.com/read/27488837/a-safe-repositioning-maneuver-for-the-management-of-benign-paroxysmal-positional-vertigo-gans-vs-epley-maneuver-a-randomized-comparative-clinical-trial
#14
REVIEW
Alia Saberi, Shadman Nemati, Salah Sabnan, Fatemeh Mollahoseini, Ehsan Kazemnejad
Benign paroxysmal positional vertigo (BPPV) is the most common cause of peripheral vertigo. Some repositioning maneuvers have been described for its management. The aim of this study was comparing the therapeutic effect of Epley and Gans maneuvers in BPPV. This randomized clinical trial was performed from September to December 2015. 73 patients with true vertigo diagnosed as BPPV enrolled the study. They randomly assigned in quadripartite blocks to modified Epley maneuver group (E) or Gans maneuver group (G)...
August 3, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27486432/an-abbreviated-diagnostic-maneuver-for-posterior-benign-positional-paroxysmal-vertigo
#15
Pia Michael, Carolina Estibaliz Oliva, Marcia Nuñez, Cristian Barraza, Juan Pablo Faúndez, Hayo A Breinbauer
INTRODUCTION: Benign paroxysmal positional vertigo (BPPV) secondary to canalolithiasis of the posterior semicircular canal is perhaps the most frequent cause of vertigo and dizziness. One of its properties is a high response rate to canalith repositioning maneuvers. However, delays in the diagnosis and treatment of this entity can range from days to years, depending on the setting. Here, we present an abbreviated variation of the Dix-Hallpike maneuver, which can be used to diagnose this disease...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27408469/benign-paroxysmal-positional-vertigo-following-sinus-floor-elevation-in-patient-with-antecedents-of-vertigo
#16
Huseyin Akcay, Murat Ulu, Seyfi Kelebek, Ibrahim Aladag
Benign paroxysmal positional vertigo (BPPV) is an unfamiliar and rare complication occurring following osteotome sinus floor elevation (OSFE) and simultaneous implant placement. Etiology of this disorder is commonly displacement of otoliths by vibratory forces transmitted by osteotomes and mallet along with the hyperextension of the head during the operation, causing them to float around in the endolymph. This report presents a case of protracted BPPV following OSFE and simultaneous implant placement. A 43-year-old female suffered intense vertigo and nausea immediately after implant placement using an OSFE procedure...
July 2016: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/27382683/-the-assessment-of-sequential-treatment-for-subjective-and-objective-benign-paroxysmal-positional-vertigo
#17
COMPARATIVE STUDY
Shuang Li, Qing Wang, Jie Dong, Xuhong Zhou
OBJECTIVE: To compare the effectiveness of sequential treatment for subjective and objective benign paroxysmal positional vertigo(BPPV). METHOD: The efficacy of sequential treatment for nineteen vertical semicircular canal S-BPPV patients(Group A) and forty-five vertical semicircular canal O-BPPV patients(Group B) who were admitted to our hospital between January 2014 and July 2015 was retrospectively analyzed and compared, treatment of five cases with horizontal semicircular canal S-BPPV was reported here as well...
March 2016: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/27356946/subplatysmal-necklift-a-retrospective-analysis-of-504-patients
#18
André Auersvald, Luiz A Auersvald, Carlos Oscar Uebel
BACKGROUND: Improvement of neck contour is a primary goal of patients who seek rejuvenation of the face and neck. Subplatysmal structures, including fat, the digastric muscle, and the submandibular salivary glands (SMSGs), may contribute to the appearance of a disproportionately large neck. OBJECTIVES: The authors sought to evaluate the safety, effectiveness, and predictability of necklift combined with reshaping and repositioning of the subplatysmal structures...
January 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/27340993/the-role-of-oxidative-stress-and-inflammatory-mediators-in-benign-paroxysmal-positional-vertigo
#19
Mehmet Taylan Güçlütürk, Zeynep Nil Ünal, Onur İsmi, Mehmet Burak Yavuz Çimen, Murat Ünal
OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral cause of vertigo. It can be defined as transient vertigo induced by rapid changes in head position associated with a characteristic paroxysmal positional nystagmus. The aim of this study was to search for the possible role of oxidative stress and inflammatory mediators in the pathogenesis of BPPV. MATERIALS AND METHODS: Total antioxidant status as well as paraoxonase, tumor necrosis factor alpha, interleukin (IL) 6, and IL-1β levels were evaluated in peripheral venous serum samples of 30 BPPV and 30 control patients...
April 2016: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/27340939/effects-of-balance-vestibular-rehabilitation-therapy-in-elderly-with-benign-paroxysmal-positional-vertigo-a-randomized-controlled-trial
#20
Karyna Myrelly Oliveira Bezerra de Figueiredo Ribeiro, Raysa Vanessa de Medeiros Freitas, Lidiane Maria de Brito Macedo Ferreira, Nandini Deshpande, Ricardo Oliveira Guerra
PURPOSE: To evaluate short-term effects of balance Vestibular Rehabilitation Therapy (VRT) on balance, dizziness symptoms and quality of life of the elderly with chronic Benign Paroxysmal Positional Vertigo (BPPV). METHOD: In this randomized, single-blind and controlled trial, older adults with chronic BPPV were randomized into two groups, the experimental group (n = 7, age: 69 (65-78) years) and the control group (n = 7, age: 73 (65-76) years). Patients in the experimental group underwent balance VRT (50 min per session, two times a week) and Canalith Repositioning Maneuver (CRM) as required, for 13 weeks...
June 24, 2016: Disability and Rehabilitation
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