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https://www.readbyqxmd.com/read/30113791/-paradigm-shift-in-management-of-patients-with-vertigo-and-imbalance
#1
REVIEW
Andrea Mike, T László Tamás
Dizziness is one of the most common causes of medical visits. Management of the dizzy patient may be challenging both for the general practitioner, in emergency departments, and special clinics, as behind a seemingly homogeneous clinical presentation several very different etiologies may occur. Research of the last two century enriched our knowledge about physiology and pathophysiology of the vestibular system. Much knowledge is now available about the labyrinth being able to sense head motions and gravity, processing of afferent vestibular stimuli, reflectory oculomotor and postural control, or recovery of the vestibular system...
July 30, 2018: Ideggyógyászati Szemle
https://www.readbyqxmd.com/read/30099862/clinical-and-laboratory-factors-related-to-acute-isolated-vertigo-or-dizziness-and-cerebral-infarction
#2
Lian Zuo, Yiqiang Zhan, Feifeng Liu, Chen Chen, Luran Xu, Zeljka Calic, Dennis Cordato, Cecilia Cappelen-Smith, Yunfeng Hu, Gang Li
OBJECTIVE: To clarify the relationship of clinical factors with isolated vertigo or dizziness of cerebrovascular origin. METHODS: Clinical data of patients admitted in East Hospital from Jan. 2015 to Apr. 2016, whose complaint were acute vertigo or dizziness were retrospectively collected. All patients arrived at the emergency department within 24 hr of symptom onset, had no acute ischemic lesion first CT and NIHSS score of 0. Patients were divided into cerebral infarction group and noncerebral infarction group according to subsequent cerebral imaging results and clinical and laboratory factors related to cerebral infarction were analyzed...
August 11, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/30092562/factors-associated-with-stroke-misdiagnosis-in-the-emergency-department-a-retrospective-case-control-study
#3
Abhay Venkat, Cecilia Cappelen-Smith, Shabeel Askar, Peter R Thomas, Sonu Bhaskar, Amanda Tam, Alan J McDougall, Suzanne J Hodgkinson, Dennis J Cordato
BACKGROUND: Failure to recognise acute stroke may result in worse outcomes due to missed opportunity for acute stroke therapies. Our study examines factors associated with stroke misdiagnosis in patients admitted to a large comprehensive stroke centre. METHODS: Retrospective review comparing 156 consecutive stroke patients misdiagnosed in emergency department (ED) with 156 randomly selected stroke controls matched for age, gender, language spoken and stroke subtype for the period 2014-2016...
August 9, 2018: Neuroepidemiology
https://www.readbyqxmd.com/read/30079116/skywalking-in-the-city-glass-platforms-and-the-architecture-of-vertigo
#4
Davide Deriu
•The paper explores the ambivalent concept of vertigo and its significance for contemporary architecture.•It examines in particular the rise of elevated glass platforms through concepts of transparency, experience, and kinaesthesia.•Proposes that these emerging design features constitute a kind of 'sixth façade'.•Discusses this phenomenon as a spatial manifestation of the experience economy.•Concludes by highlighting the rise of 'architectures of vertigo' in relation to wider social imperatives.
August 2018: Emotion, Space and Society
https://www.readbyqxmd.com/read/29921359/aviation-fuel-exposure-resulting-in-otitis-externa-with-vertigo
#5
Robert J Long, Reese A Charles
BACKGROUND: Otitis externa secondary to irritant or chemical exposure is well documented; however, specifically secondary to jet fuel exposure and its associated toxicology is not. Over 2 million military and civilian personnel per year are occupationally exposed to aviation fuels. CASE REPORT: An aircraft maintainer presented with noninfectious acute otitis externa secondary to external ear canal exposure to JP-5 jet fuel. Proper exposure guidelines were followed, but it was not realized that the external ear canal was involved...
July 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29843902/non-inflammatory-causes-of-emergency-consultation-in-patients-with-multiple-sclerosis
#6
L A Rodríguez de Antonio, I García Castañón, M J Aguilar-Amat Prior, I Puertas, I González Suárez, C Oreja Guevara
OBJECTIVES: To describe non-relapse-related emergency consultations of patients with multiple sclerosis (MS): causes, difficulties in the diagnosis, clinical characteristics, and treatments administered. METHODS: We performed a retrospective study of patients who attended a multiple sclerosis day hospital due to suspected relapse and received an alternative diagnosis, over a 2-year period. Demographic data, clinical characteristics, final diagnosis, and treatments administered were evaluated...
May 26, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29807531/a-case-report-of-multiple-cervical-artery-dissection-after-peripheral-type-facial-palsy-and-use-of-steroids
#7
Sung Eun Chung, Tae Hwan Yoon, Kyung Mi Lee, Hyug-Gi Kim, Bum Joon Kim
BACKGROUND: Cervical artery dissection is one of the most important causes of ischemic stroke in young age patients. However, multiple cervical artery dissection simultaneously involving the anterior and posterior circulation is uncommon. Here, we would like to report a case of a patient with bilateral vertebral artery (VA) and internal carotid artery dissection (ICA) after a use of systemic steroid due to peripheral facial palsy. CASE PRESENTATION: A 44-year-old man with hypertension visited emergency department due to recurrent vertigo...
May 28, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29721613/identification-of-dizzy-patients-who-will-develop-an-acute-cerebrovascular-syndrome-a-descriptive-study-among-emergency-department-patients
#8
I Mármol-Szombathy, E Domínguez-Durán, L Calero-Ramos, S Sánchez-Gómez
PURPOSE: To calculate the incidence of subsequent acute cerebrovascular syndrome in emergency department patients with vertigo or dizziness symptoms and to determine predictors of subsequent acute cerebrovascular syndrome in these patients. METHODS: Descriptive and retrospective hospital based-population study among emergency department patients with vertigo or dizziness symptoms in 1 year. One year follow-up since the medical visit was performed. Chi-square and Fisher tests were used for qualitative variables; Mann-Whitney U test for quantitative variables...
July 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29627941/false-negative-diagnostic-imaging-of-wallenberg-s-syndrome-by-diffuse-weighted-imaging-a-case-report-and-literature-review
#9
Yanbin Wang, Yao Liu, Yu Wang, Yuchen Li, Pei Wu, Huaizhang Shi
Here, we report a case of a 64-year-old female with acute-onset vertigo, nausea, and vomiting. In an emergency imaging examination, the results of computed tomography (CT) and diffusion weighted imaging (DWI) were negative. However, on 1 day post-hospital admission, a small acute infarct in the posterolateral aspect of the left medulla was detected by DWI. Extra attention should be payed to the false-negative imaging results to avoid diagnosis and treatment delay.
April 7, 2018: Neurological Sciences
https://www.readbyqxmd.com/read/29623865/-stroke-mimicking-acute-peripheral-vertigo-how-to-avoid-misdiagnosis-importance-of-alarm-symptoms-and-assessment-of-eye-movements
#10
R B van Leeuwen, E van Wensen, B R Schudel
Identifying the occurrence of stroke in patients with isolated vertigo is difficult for general practitioners (GPs) as well as for physicians working in the Emergency Department. Three patients with acute vestibular syndrome are presented in this clinical lesson. The importance of an adequate neuro-otological examination is emphasised. However, many GPs lack knowledge of the nystagmus and the head impulse test. Alternative strategies for GPs are discussed.
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29500503/-management-of-acute-vertigo-and-dizziness-patients-in-emergency-departments-in-germany
#11
J Löhler, D Eßer, B Wollenberg, L E Walther
BACKGROUND: Dizziness and vertigo are some of the most common reasons for seeking medical help. Acute dizziness and vertigo require interdisciplinary cooperation. New diagnostic methods (the video head impulse test) and modern algorithms (HINTS: head impulse test/nystagmus [direction changing]/test-of-skew) are increasingly used in case of the acute vestibular syndrome in emergency care. METHODS: In a survey on the management and participation of the ENT specialist area, the authors interviewed 168 German ENT clinics during the spring of 2017 using an online survey...
June 2018: HNO
https://www.readbyqxmd.com/read/29496272/-management-of-vertigo-and-dizziness
#12
D Bouccara, F Rubin, P Bonfils, Q Lisan
Balance disorders presenting with symptoms of dizziness and vertigo are due to various diseases. Clinical approach gives the opportunity to identify emergency situations and most common causes, among them the first one being the benign paroxysmal positional vertigo. Oculomotor assessment is pertinent as major clinical orientation, particularly between peripheral and central diseases. These clinical findings support the respective indication of modern imaging and/or vestibular tests, focused on the direction of presupposed diagnosis...
February 26, 2018: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/29398242/utility-of-neutrophil-to-lymphocyte-ratio-nlr-as-a-predictor-of-acute-infarction-in-new-onset-acute-vertigo-patients-without-neurologic-and-computed-tomography-abnormalities
#13
Sun Hwa Lee, Seong Jong Yun, Seokyong Ryu, Seung Woon Choi, Hye Jin Kim, Tae Kyung Kang, Sung Chan Oh, Suk Jin Cho
BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) has been used as a predictive marker for various conditions. However, there are no previous studies about NLR as a prognostic marker for acute infarction. OBJECTIVE: To evaluate the potential utility of NLR as a predictor of acute infarction in acute vertigo patients without neurologic and computed tomography (CT) abnormalities. METHODS: We conducted a prospective, observational study in the Emergency Department (ED) between January 2015 and December 2016...
May 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29395695/a-new-diagnostic-approach-to-the-adult-patient-with-acute-dizziness
#14
Jonathan A Edlow, Kiersten L Gurley, David E Newman-Toker
BACKGROUND: Dizziness, a common chief complaint, has an extensive differential diagnosis that includes both benign and serious conditions. Emergency physicians must distinguish the majority of patients with self-limiting conditions from those with serious illnesses that require acute treatment. OBJECTIVE OF THE REVIEW: This article presents a new approach to diagnosis of the acutely dizzy patient that emphasizes different aspects of the history to guide a focused physical examination with the goal of differentiating benign peripheral vestibular conditions from dangerous posterior circulation strokes in the emergency department...
April 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29371896/the-effects-of-prognostic-factors-in-idiopathic-sudden-hearing-loss
#15
Suphi Bulğurcu, Behçet Şahin, Gökhan Akgül, İlker Burak Arslan, İbrahim Çukurova
Introduction  Sudden hearing loss is one of the otologic emergencies. The treatment of this disease is affected negatively by some prognostic factors. Objective  In this study, the effects of early treatment initiation in patients with idiopathic sudden hearing loss and of prognostic factors in early treated patients were investigated. Methods  Out of the 216 patients admitted between September 2007 and September 2015, 154 were identified as having idiopathic sudden hearing loss; they were followed-up for a mean time of 7...
January 2018: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29317012/prehospital-identification-of-patients-with-a-final-hospital-diagnosis-of-stroke
#16
Elin Andersson, Linda Bohlin, Johan Herlitz, Annelie J Sundler, Zoltán Fekete, Magnus Andersson Hagiwara
Introduction the early phase of stroke, minutes are critical. Since the majority of patients with stroke are transported by the Emergency Medical Service (EMS), the early handling and decision making by the EMS clinician is important. Problem The study aim was to evaluate the frequency of a documented suspicion of stroke by the EMS nurse, and to investigate differences in the clinical signs of stroke and clinical assessment in the prehospital setting among patients with regard to if there was a documented suspicion of stroke on EMS arrival or not, in patients with a final hospital diagnosis of stroke...
February 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29281198/alternobaric-vertigo-and-facial-baroparesis-caused-by-scuba-diving-and-relieved-by-chewing-pineapple-a-case-report
#17
Adam Bender-Heine, Zachary W Dillard, Matthew J Zdilla
Equalization of middle ear pressure is an important consideration for scuba divers. When middle ear pressure is asymmetric, a diver may experience alternobaric vertigo. Moreover, individuals with an underlying temporal bone dehiscence are predisposed to facial baroparesis. An understanding on behalf of fellow divers and emergency responders to recognize and differentiate facial baroparesis from decompression illness is critical. Misdiagnosis may lead to inappropriate treatment or unwarranted stoppage of diving...
November 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/29279722/current-diagnostic-procedures-for-diagnosing-vertigo-and-dizziness
#18
REVIEW
Leif Erik Walther
Vertigo is a multisensory syndrome that otolaryngologists are confronted with every day. With regard to the complex functions of the sense of orientation, vertigo is considered today as a disorder of the sense of direction, a disturbed spatial perception of the body. Beside the frequent classical syndromes for which vertigo is the leading symptom (e.g. positional vertigo, vestibular neuritis, Menière's disease), vertigo may occur as main or accompanying symptom of a multitude of ENT-related diseases involving the inner ear...
2017: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
https://www.readbyqxmd.com/read/29276136/duplex-sonography-of-vertebral-arteries-for-evaluation-of-patients-with-acute-vertigo
#19
Peiman Nazerian, Sofia Bigiarini, Rudi Pecci, Lucia Taurino, Marco Moretti, Andrea Pavellini, Elisa Capretti, Stefano Grifoni, Simone Vanni
We evaluated the role of vertebral artery extracranial color-coded duplex sonography (VAECCS) in predicting vertebrobasilar stroke in consecutive patients presenting to the emergency department with vertigo of suspected ischemic origin. The final diagnosis was established by a panel of experts consisting of an emergency physician, a neurologist, and an otoneurologist. Vertebrobasilar stroke was diagnosed when an acute brain ischemic lesion congruent with symptoms was detected by neuroimaging during the index visit or a stroke was diagnosed within a 3-mo period after emergency department presentation...
March 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29250967/-emergency-diagnosis-of-the-acute-vestibular-syndrome
#20
T László Tamás, Tibor Garai, István Király, Andrea Mike, Csaba Nagy, Ágnes Paukovics, Péter Schmidt, Ferenc Szatmári, Tamás Tompos, Árpád Vadvári, Ágnes Szirmai
INTRODUCTION AND AIM: To diagnose acute vestibular syndrome (AVS) in a prospective study by a new bedside test (providing 1A evidence) based on oculomotor analysis and assessment of hearing loss. To assess the frequency of central and peripheral causes of acute vestibular syndrome in the emergency room. To establish the diagnostic accuracy of acute cranial computed tomography as compared to oculomotor analysis done by video oculography goggles and audiometry. METHOD: Between 1st March 2016 and 1st March 2017 we documented 125 patients (62 women, 63 men, average age 53 years) in the emergency room of the Petz Aladár County Teaching Hospital using the above bedside and instrumental testing...
December 2017: Orvosi Hetilap
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