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vertigo management

L Power, W Shute, B McOwan, K Murray, D Szmulewicz
This retrospective review aims to survey the clinical characteristics and management of vestibular migraine (VM) patients seen in a tertiary hospital multi-disciplinary balance disorders clinic, and how this aligns with the evidence base in the literature. A single investigator reviewed the medical records of the patients who presented to a tertiary hospital balance disorders clinic over a four month period and identified 90 cases of VM. The mean age of patients with a diagnosis of VM was 50 years (range of 17-84) and 72 (80%) were female...
March 14, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Priyanka Bose, Andrew Wilson, Amit Mistri
INTRODUCTION Many patients who suffer a transient ischaemic attack (TIA) present to their general practitioner (GP). Early identification and treatment reduces the risk of subsequent stroke, disability and mortality. AIM To review the accuracy of TIA diagnosis in primary care, immediate management and interventions to assist GPs with the condition. METHODS This study included the search of Medline, Embase, Web of Science and Scopus databases (1995-2015). Relevant titles and abstracts were obtained using structured criteria (diagnosis, immediate management or intervention of TIAs in primary care), with full review and data extraction for eligible publications...
June 2017: Journal of Primary Health Care
Elshahat Ibrahem Ismail, Ashraf Elsayed Morgan, Mohamed Moustafa Abdeltawwab
OBJECTIVE: To check the value of home particle repositioning maneuver in the prevention of the recurrence of posterior canal benign paroxysmal positional vertigo (pc-BPPV). METHODS: In this study, patients diagnosed as unilateral posterior canal BPPV were selected following an accurate evaluation using video goggle VNG system. All patients were managed by particle repositioning maneuver (PRM). Patients were instructed to do home PRM once weekly for five years. Then, they were divided into two groups (according to choice of patient to do PRM)...
March 8, 2018: Auris, Nasus, Larynx
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...
March 2, 2018: HNO
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
Richard A Roberts
Purpose: This clinical report is presented to describe how results of vestibular function testing were considered along with other medical history to develop a management plan that was ultimately successful. Method: The patient underwent audio-vestibular assessment including comprehensive audiogram, videonystagmography, cervical vestibular evoked myogenic potential, and postural stability testing. Results: Results from initial testing were most consistent with uncompensated peripheral vestibular dysfunction affecting the right superior vestibular nerve...
March 8, 2018: American Journal of Audiology
Ashraf Elsayed Morgan, Elshahat Ibrahem Ismail, Bassem Ashraf
OBJECTIVE: This study was designed to evaluate the effectiveness of intratympanic dexamethazone (ITD) for the treatment of ipsilateral delayed endolymphatic hydrops (DEH). METHODS: Forty-one patients were diagnosed with ipsilateral DEH. Only 37 patients completed this study. Patients were randomly divided into 2 groups. Group A (n = 16) received oral medication, and group B (n = 21) received ITD once weekly for 4 consecutive weeks. RESULTS: In group A, 6 patients showed improvement in their vertigo...
February 16, 2018: ORL; Journal for Oto-rhino-laryngology and its related Specialties
Lisa Burrows
Benign paroxysmal positional vertigo (BPPV) occurs in 14.5% of patients with spinal cord injury (SCI) and may require intervention on intensive care unit (ICU). A 61-year-old man was admitted to a spinal injury ICU with a traumatic C3 complete SCI following a mountain bike accident. Ventilated but stable he complained of severe dizziness on rolling, during personal cares, which lasted for 40 s. Clinical examination was limited due to the injury and ventilation. Subjective questioning, visio-ocular control and a modified Dix-Hallpike and roll tests confirmed a right posterior canalithiasis BPPV...
February 8, 2018: BMJ Case Reports
Anna Marie Jilla, Richard A Roberts, Carole E Johnson
Audiologists are an integral part of the management of those with dizziness and vestibular disorders. However, little research has been performed on counseling approaches for patients who present with dizziness as a primary concern. Accordingly, it is important that audiology students are provided with didactic and experiential learning opportunities for the assessment, diagnosis, and management of this population. Benign paroxysmal positional vertigo is the most common vestibular disorder among adults. Doctor of Audiology students, at a minimum, should be provided with learning opportunities for counseling patients with this particular disorder...
February 2018: Seminars in Hearing
Anna-Janina Stephan, Eva Kovacs, Amanda Phillips, Jörg Schelling, Susanne Marlene Ulrich, Eva Grill
BACKGROUND: Although the management of patients presenting with vertigo and dizziness in primary care has been reported to be inefficient, little is known about the primary care providers' (PCPs) perspectives, needs, and attitudes regarding vertigo management. The objective of this study was to understand which challenges and barriers PCPs see when diagnosing and treating patients presenting with vertigo or dizziness. Specifically, we wanted to identify facilitators and barriers of successful guideline implementation in order to inform the development of targeted interventions...
February 8, 2018: Implementation Science: IS
Pedro Santos Marques, Claudia Camila Dias, Nicolas Perez-Fernandez, Jorge Spratley
OBJECTIVE: To estimate how much could intratympanic gentamicin (ITG) interfere with the vestibular-ocular reflex (VOR) parameters on instrumental head impulse test (HIT), either with scleral search coil or video head impulse test and, eventually, foresee the control of vertigo crisis in unilateral intractable Ménière's disease (MD). METHODS: A literature search was conducted in PubMed, Scopus, Web of Science and Cochrane search engines. The search terms used were "vestibular ocular reflex", "head impulse test", "gentamicin," and "Meniere's disease"...
February 2, 2018: Auris, Nasus, Larynx
Sunil Goyal, Kiran Natarajan, Amarnath Devarasetty, T Sarankumar, Neha Chauhan, Mohan Kameswaran
Background: Ear and the lateral skull base surgery is challenging and yet fascinating for a Neuro-otologist. A thorough knowledge of the complex anatomy is indispensable for the surgeon in order to provide the best possible care. Methods: The aim of the study was to highlight the present day indications for translabyrinthine approach to IAM from a Neuro-otologist perspective. Results: There were a total of 7 patients who underwent Translabyrinthine approach at our centre...
January 2018: Medical Journal, Armed Forces India
David Dornbos, H Jeffrey Kim, John A Butman, Russell R Lonser
Importance: von Hippel-Lindau (VHL) disease-associated central nervous system (CNS) lesions include hemangioblastomas and endolymphatic sac tumors (ELSTs), which are associated with significant neurological morbidity and mortality. Recent studies provide critical new biological, diagnostic, and management insights into these tumors. Observations: Biological features, natural history, clinical findings, and management strategies of VHL disease-associated CNS tumors are reviewed...
January 29, 2018: JAMA Neurology
Tetsuo Ikezono, Tomohiro Matsumura, Han Matsuda, Satomi Shikaze, Shiho Saitoh, Susumu Shindo, Setsuo Hasegawa, Seung Ha Oh, Yoshiaki Hagiwara, Yasuo Ogawa, Hiroshi Ogawa, Hiroaki Sato, Tetsuya Tono, Ryuichiro Araki, Yukihide Maeda, Shin-Ichi Usami, Yasuhiro Kase
Perilymphatic fistula is defined as an abnormal communication between the perilymph-filled space and the middle ear, or cranial spaces. The manifestations include a broad spectrum of neuro-otological symptoms such as hearing loss, vertigo/dizziness, disequilibrium, aural fullness, tinnitus, and cognitive dysfunction. By sealing the fistula, perilymphatic fistula is a surgically correctable disease. Also, appropriate recognition and treatment of perilymphatic fistula can improve a patient's condition and hence the quality of life...
2018: PloS One
A F Jahn
OBJECTIVE: A distinct subgroup of patients, presenting with apparently spontaneous onset of vertigo, is described. RESULTS: Although vestibular evaluation revealed caloric weakness, the proximate cause of vertigo was not labyrinthine dysfunction, but rather the loss of vestibular compensation for an older and previously compensated labyrinthine injury. CONCLUSION: Instead of addressing the vestibular weakness, effective management needs to focus on the condition that has caused the loss of compensation...
January 18, 2018: Journal of Laryngology and Otology
Massimo Ralli, Antonio Greco, Giancarlo Altissimi, Rosaria Turchetta, Lucia Longo, Vittorio D'Aguanno, Mario Tombolini, Giancarlo Cianfrone, Marco de Vincentiis
Vestibular schwannoma and endolymphatic hydrops are two conditions that may present with similar audio-vestibular symptoms. The association of the two in the same patient represents an unusual finding that may lead clinicians to errors and delays in diagnosis and clinical management of affected subjects. We discuss the case of a patient with an intrameatal vestibular schwannoma reporting symptoms suggestive for ipsilateral endolymphatic hydrops. The patient presented with fluctuating hearing loss, tinnitus, and acute rotatory vertigo episodes, and underwent a full audiological evaluation and imaging of the brain with contrast-enhanced Magnetic Resonance Imaging...
December 1, 2017: International Tinnitus Journal
Józef Mierzwiński, Justyna Kosowska, Justyna Tyra, Karolina Haber, Maria Drela, Dariusz Paczkowski, Paweł Burduk
BACKGROUND: Fibrous dysplasia is a slowly progressive benign fibro-osseous disorder that involves one or multiple bones with a unilateral distribution in most cases. It is a lesion of unknown etiology, uncertain pathogenesis, and diverse histopathology. Temporal bone involvement is the least frequently reported type, especially in children. We reviewed available articles regarding fibrous dysplasia with temporal bone involvement in children and added four patients aged 7 to 17 years who were diagnosed and treated in our institution from 2006 to 2017...
January 15, 2018: World Journal of Surgical Oncology
Luke Tegeler, Janice Blumer
No abstract text is available yet for this article.
January 1, 2018: Journal of the American Osteopathic Association
Katijah Khoza-Shangase
Background: The high prevalence of HIV/AIDS and the established otological manifestations of the disease have important implications for research into vestibular function in this population. Materials and Methods: The main aim of the current study was to investigate and monitor the vestibular status in a group of adult patients with AIDS receiving Highly Active Antiretroviral Therapy (HAART) and other therapies in a hospital outpatient clinic in Gauteng, South Africa...
2018: African Journal of Infectious Diseases
Steffen Rosahl, Christopher Bohr, Michael Lell, Klaus Hamm, Heinrich Iro
Vestibular schwannomas (VS) expand slowly in the internal auditory canal, in the cerebellopontine angle, inside the cochlear and the labyrinth. Larger tumors can displace and compress the brainstem. With an annual incidence of 1:100,000 vestibular schwannoma represent 6-7% of all intracranial tumors. In the cerebellopontine angle they are by far the most neoplasm with 90% of all lesions located in this region. Magnetic resonance imaging (MRI), audiometry, and vestibular diagnostics are the mainstays of the clinical workup for patients harboring tumors...
2017: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
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