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Peripherical vertigo

Chang-Hee Kim, Jung Eun Shin, Myung Hoon Yoo, Hong Ju Park
Objectives: Direction-changing positional nystagmus (PN) was considered to indicate the presence of benign paroxysmal positional vertigo involving lateral semicircular canal in most cases. We investigated the incidence of PN on the supine head-roll test and compared the characteristics of nystagmus in patients with vestibular neuritis (VN) and Meniere disease (MD). Methods: A retrospective review of patients, who were diagnosed with unilateral VN or unilateral definite MD between September 2005 and November 2011, was conducted...
December 5, 2018: Clinical and Experimental Otorhinolaryngology
Pablo Young, Melissa Castillo-Bustamante, Carlos J Almirón, Julio E Bruetman, Bárbara C Finn, María A Ricardo, Ana C Binetti
Vertigo is defined as an abnormal sensation of body motion or of its surrounding objects. It is a common chief complaint in emergency departments comprising 2 to 3% of these consultations worldwide. Vertigo is classified as peripheral or central, according to its origin, and can also be occasionally mixed, the most common cause of peripheral involvement being benign paroxysmal positional vertigo. The initial findings on clinical evaluation of patients are the clues for making a correct diagnosis. The differentiation between central and peripheral vertigo can be optimized by analysing nystagmus, by using the skew test and the head impulse test (HINTS), as also by performing the appropriate tests to evaluate the integrity of the vestibular-cerebellar pathway...
2018: Medicina
Anne Mucha, Sheri Fedor, Danielle DeMarco
The assessment and treatment of sport-related concussion (SRC) often requires a multifaceted approach. Vestibular dysfunction represents an important profile of symptoms and pathology following SRC, with high prevalence and association with prolonged recovery. Signs and symptoms of vestibular dysfunction may include dizziness, vertigo, disequilibrium, nausea, and visual impairment. Identifying the central and peripheral vestibular mechanisms responsible for pathology can aid in management of SRC. The most common vestibular disturbances after SRC include benign paroxysmal positional vertigo, vestibulo-ocular reflex impairment, visual motion sensitivity, and balance impairment...
2018: Handbook of Clinical Neurology
Pamela M Dunlap, Janene M Holmberg, Susan L Whitney
PURPOSE OF REVIEW: Rehabilitation for persons with vertigo and balance disorders is becoming commonplace and the literature is expanding rapidly. The present review highlights recent findings of both peripheral and central vestibular disorders and provides insight into evidence related to new rehabilitative interventions. Risk factors will be reviewed to create a better understanding of patient and clinical characteristics that may effect recovery among persons with vestibular disorders...
November 15, 2018: Current Opinion in Neurology
Rodney Omron
This article summarizes the systematic assessment of the dizzy patient who presents with peripheral vertigo. It demonstrates the steps and tests necessary using the Triage-Timing-Trigger-Test (Triage + TiTraTe) method to accurately diagnose the underlying most probable cause while ruling out life-threatening causes. Using video support and just-in-time infographics, it demonstrates the Dix-Hallpike, Semont, Epley, and HINTS maneuvers.
February 2019: Emergency Medicine Clinics of North America
V Colin, P Bertholon, S Roy, A Karkas
OBJECTIVE: Cochlear implantation may have a detrimental effect on vestibular function and residual hearing. Our goal was to investigate the impact of cochlear implantation on peripheral vestibular function and the symptomatology that ensues. MATERIAL AND METHODS: A prospective observational study included all adults undergoing cochlear implantation by the same operator between July 2014 and December 2015, with pre- and postoperative (4 months) neurovestibular balance examination comprising a questionnaire and clinical tests [head impulse test (HIT), head-shaking test (HST), skull vibration test (SVT)] and instrumental tests [caloric test of the lateral semicircular canal and cervical vestibular-evoked myogenic potentials (cVEMP)]...
December 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
M V Zamergrad, S P Grachev, A A Gergova
Acute vestibular disorder is a frequent cause of urgent hospitalization in elderly patients. A CNS vascular disorder is often thought to be a cause of vertigo and a patient is diagnosed with stroke or transitory ischemic attack (TIA) or vertebral-basilar insufficiency. Despite the higher risk of cerebrovascular disease in the elderly, stroke and TIA are not the only cause of acute vestibular disorder. Hyperdiagnosis of cerebrovascular diseases in patients with acute vertigo often leads to underdiagnosis of peripheral vestibular disorders that could be successfully treated if timely diagnosed...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Roland Hülse, Andreas Biesdorf, Karl Hörmann, Boris Stuck, Michael Erhart, Manfred Hülse, Angela Wenzel
BACKGROUND: Dizziness is a common complaint in medicine. Nevertheless, there is a lack of valid data concerning the age and gender distribution of dizziness disorders within a larger population. Therefore, the aim of the present study is to undertake a representative epidemiological survey that examines all age groups of an entire population and describes the age and gender distribution of the most common peripheral vestibular disorders. METHODS: A population-based epidemiological survey based on confirmed ICD-10 codes, of an entire national population was performed...
October 4, 2018: Otology & Neurotology
Q Li, C Yang, W B Liu, Z X Li, H Q Jiang
Summary A male patients at 11 years of age, was hospitalized for the right ear pain and mouth deviation for five days on August 30, 2016, accompanied by right hypophasis, right ear hearing loss, tinnitus, without otorrhea and vertigo. Patient was diagnosed as acute promyelocytic leukemia in 2008. After standardized chemotherapy, it was completely relieved and the blood and bone marrow images were almost restored to normal. Physical examination: The skin of the right external auditory canal is obviously swollen, without rupture on the surface, and the tympanic membrane cannot be seen...
August 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Renata M Knoll, Reuven Ishai, Danielle R Trakimas, Jenny X Chen, Joseph B Nadol, Steven D Rauch, Aaron K Remenschneider, David H Jung, Elliott D Kozin
Objective Vestibular symptoms such as dizziness and vertigo are common after head injury and may be due to trauma to the peripheral vestibular system. The pathophysiology of peripheral vestibular symptoms following head injury without temporal bone (TB) fracture, however, is not well understood. Herein, we investigate the histopathology of the peripheral vestibular system of patients who sustained head injury without a TB fracture. Study Design Otopathology study. Setting Otopathology laboratory. Subjects and Methods TB of subjects with a history of head injury without TB fractures were included and evaluated by light microscopy...
October 2, 2018: Otolaryngology—Head and Neck Surgery
Alia Saberi, Seyed Hashem Pourshafie, Ehsan Kazemnejad-Leili, Shadman Nemati, Sara Sutohian, Sara Sayad-Fathi
BACKGROUND: Vertigo is a common annoying complaint needing emergent treatment. There are various treatment options for this condition with different outcomes and side effects. OBJECTIVES: Assessment and comparison of the effectiveness of Ondansetron and Promethazine in the treatment of acute peripheral vertigo. MATERIALS AND METHODS: This clinical trial was conducted in an academic hospital in the north of Iran in 2017. A total of 170 eligible patients were randomly allocated to groups A: received intramuscular (IM) promethazine; and B: received intravenous (IV) Ondansetron, using quadripartite blocks...
September 14, 2018: American Journal of Otolaryngology
Ethem Şahin, İldem Deveci, Mehmet Emre Dinç, Berna Yayla Özker, Cemile Biçer, Özcan Erel
OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) is the most frequent peripheral vestibular disorder and is particularly seen among older patients suffering from vertigo. The brief vertigo attacks in and imbalance symptoms of BPPV are caused by freely floating otoconia within the semicircular canals. The aim of this prospective study was to evaluate the role of oxidative stress, using native thiol/disulfide (SH/SS) homeostasis as a novel indicator, in the etiology of BPPV. MATERIALS AND METHODS: The 62 participants in the study included 31 patients with BPPV and, as the control group, 31 healthy individuals without any cochleovestibular disorders...
August 2018: Journal of International Advanced Otology
Syeda S Ahmed, Michael Giardina, Kendra L Nicks, Han-Hung Huang
PURPOSE: This case report presents evidence-based physical therapy assessments and interventions for a patient with unilateral vestibular hypofunction (UVH). UVH is the result of peripheral vestibular dysfunction in the inner ear. CASE DESCRIPTION: The patient was a 48-year-old male with symptoms of dizziness, cephalalgia, and cervicalgia. The examination and treatment were focused on impaired cervical proprioception, which is a vital component of balance training in addition to visual, vestibular, and somatosensory re-education for patients with dizziness...
September 10, 2018: Physiotherapy Theory and Practice
Jonathan H Sin, Hira Shafeeq, Zachary D Levy
PURPOSE: The uses of nimodipine for otolaryngic indications are reviewed, and recommendations for its use in clinical practice are provided. SUMMARY: Nimodipine is currently indicated for the improvement of neurologic outcomes in adult patients with aneurysmal subarachnoid hemorrhage (aSAH). However, other oral and i.v. calcium channel blockers have not exhibited the same beneficial effects in patients with aSAH, leading clinicians to believe that nimodipine possesses unique neuroprotective effects in addition to its calcium channel-blocking and vasodilatory properties...
September 15, 2018: American Journal of Health-system Pharmacy: AJHP
Toine Mercier, Griet Deslypere, Kristiaan Nackaerts
OBJECTIVES: Ramsay Hunt syndrome (RHS) is a rare complication of varicella zoster virus (VZV) reactivation with high morbidity, requiring swift and specific treatment. METHODS: We discuss the epidemiology, diagnosis and treatment of RHS using a case report of a cancer patient who presented with disseminated VZV reactivation, including RHS. RESULTS: A 68-year old man with stage IV lung adenocarcinoma, for which he received pemetrexed maintenance chemotherapy, presented to the emergency department with a progressive skin rash despite broad spectrum antibiotics, vertigo, and diminished hearing...
September 6, 2018: Acta Clinica Belgica
A Zwergal, V Kirsch, J Gerb, J Dlugaiczyk, S Becker-Bense, M Dieterich
Vertigo and dizziness are frequent chief complaints in clinical practice. Symptoms may originate from otological, neurological, medical and psychiatric etiologies, which poses an interdisciplinary challenge. Systematic analysis of case history and clinical examination generally allow classification into peripheral-, central- or non-vestibular disorders. The most important criteria for differentiation are the timeline, quality of symptoms, modulating factors and accompanying symptoms. As concerns the clinical examination, the following tests are relevant: head impulse test, test for spontaneous nystagmus, positional nystagmus, central ocular motor signs and the Romberg test...
October 2018: Der Nervenarzt
Tanja Högg, José M A Wijnands, Elaine Kingwell, Feng Zhu, Xinya Lu, Charity Evans, John D Fisk, Ruth Ann Marrie, Yinshan Zhao, Helen Tremlett
BACKGROUND: Previous studies suggest the existence of a prodromal period in multiple sclerosis, but little is known about the phenotypic characteristics. This study aims to characterize the multiple sclerosis (MS) prodrome using data mining analytics in the healthcare setting. METHODS: We identified people with MS and matched general population controls using health administrative data in two Canadian provinces (British Columbia and Saskatchewan). Using a training dataset (66...
October 2018: Multiple Sclerosis and related Disorders
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
Maria Köping, Wafaa Shehata-Dieler, Dieter Schneider, Mario Cebulla, Daniel Oder, Jonas Müntze, Peter Nordbeck, Christoph Wanner, Rudolf Hagen, Sebastian P Schraven
BACKGROUND: Fabry Disease (FD) is an X-linked hereditary lysosomal storage disorder which leads to a multisystemic intralysosomal accumulation of globotriaosylceramid (Gb3). Besides prominent renal and cardiac organ involvement, patients commonly complain about vestibulocochlear symptoms like high-frequency hearing loss, tinnitus and vertigo. However, comprehensive data especially on vertigo remain scarce. The aim of this study was to examine the prevalence and characteristics of vertigo and hearing loss in patients with FD, depending on renal and cardiac parameters and get hints about the site and the pattern of the lesions...
August 15, 2018: Orphanet Journal of Rare Diseases
Dan Rujescu, Annette M Hartmann, Ina Giegling, Bettina Konte, Marko Herrling, Susanne Himmelein, Michael Strupp
Objective: In order to identify genetic variants associated with vestibular neuritis, a common cause of peripheral vertigo with a potential causative link to the reactivation of herpes simplex type 1 (HSV-1), we conducted a genome-wide association study. Methods: Association was assessed using approximately 8 million variants. 131 patients with vestibular neuritis and 2,609 controls of European ancestry were included. Results: Genome-wide associations with vestibular neuritis were detected in 4 regions containing protein coding genes assignable to two functional groups: virus hypothesis and insulin metabolism...
2018: Frontiers in Neurology
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