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https://www.readbyqxmd.com/read/27855460/-diagnosis-and-current-therapy-of-vestibular-syndromes
#1
Michael Strupp, Thomas Brandt
Vertigo and dizziness are with an annual incidence of more than 10% and a lifetime prevalence of more than 30% among the most frequent symptoms. The keys to the diagnosis are the patient history and the bedside examination: a) for the patient history the time course, type and triggers of symptoms and accompanying symptoms, b) for the clinical examination of the vestibular system the head-impulse test (HIT), the examination for a spontaneous nystagmus, a displacement of subjective visual vertical, a positional nystagmus and the Romberg test, and c) for the differentiation between an acute peripheral and central vestibular lesion the skew deviation, central fixation nystagmus, gaze-evoked nystagmus, saccadic smooth pursuit and a normal HIT...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27814312/impact-of-artifacts-on-vor-gain-measures-by-video-oculography-in-the-acute-vestibular-syndrome
#2
Georgios Mantokoudis, Ali S Saber Tehrani, Amy Wozniak, Karin Eibenberger, Jorge C Kattah, Cynthia I Guede, David S Zee, David E Newman-Toker
OBJECTIVE: The video head impulse test (HIT) measures vestibular function (vestibulo-ocular reflex [VOR] gain - ratio of eye to head movement), and, in principle, could be used to make a distinction between central and peripheral causes of vertigo. However, VOG recordings contain artifacts, so using unfiltered device data might bias the final diagnosis, limiting application in frontline healthcare settings such as the emergency department (ED). We sought to assess whether unfiltered data (containing artifacts) from a video-oculography (VOG) device have an impact on VOR gain measures in acute vestibular syndrome (AVS)...
November 3, 2016: Journal of Vestibular Research: Equilibrium & Orientation
https://www.readbyqxmd.com/read/27789115/diazepam-and-meclizine-are-equally-effective-in-the-treatment-of-vertigo-an-emergency-department-randomized-double-blind-placebo-controlled-trial
#3
Richard D Shih, Brian Walsh, Barnet Eskin, John Allegra, Frederick W Fiesseler, Dave Salo, Michael Silverman
BACKGROUND: Vertigo is a debilitating disease that is commonly encountered in the emergency department (ED). Diazepam and meclizine are oral medications that are commonly used to alleviate symptoms. OBJECTIVES: We sought to determine whether meclizine or diazepam is superior in the treatment of patients with peripheral vertigo in the ED. METHODS: We performed a double-blind clinical trial at a suburban, teaching ED. We randomized a convenience sample of adult patients with acute peripheral vertigo (APV) to diazepam 5 mg or meclizine 25 mg orally...
October 24, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27749752/vestibular-involvement-in-patients-with-otitis-media-with-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#4
Yuka Morita, Kuniyuki Takahashi, Shuji Izumi, Yamato Kubota, Shinsuke Ohshima, Arata Horii
OBJECTIVE: Otitis media (OM) with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) is a novel concept of ear disease that is characterized by progressive mixed or sensorineural hearing loss with occasional systemic involvement. Considering the accumulating knowledge about the characteristics of and treatment for auditory dysfunction in OMAAV, the objective of this study was to investigate the vestibular function and symptoms of patients with OMAAV. STUDY DESIGN: Retrospective chart review...
September 30, 2016: Otology & Neurotology
https://www.readbyqxmd.com/read/27746761/vestibular-function-tests-for-vestibular-migraine-clinical-implication-of-video-head-impulse-and-caloric-tests
#5
Woo Seok Kang, Sang Hun Lee, Chan Joo Yang, Joong Ho Ahn, Jong Woo Chung, Hong Ju Park
Vestibular migraine (VM) is one of the most common causes of episodic vertigo. We reviewed the results of multiple vestibular function tests in a cohort of VM patients who were diagnosed with VM according to the diagnostic criteria of the Barany Society and the International Headache Society and assessed the efficacy of each for predicting the prognosis in VM patients. A retrospective chart analysis was performed on 81 VM patients at a tertiary care center from June 2014 to July 2015. Patients were assessed by the video head impulse test (vHIT), caloric test, vestibular-evoked myogenic potentials (VEMPs), and sensory organization test (SOT) at the initial visit and then evaluated for symptomatic improvement after 6 months...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27685517/hints-for-differentiating-peripheral-from-central-causes-of-vertigo
#6
Dayna Jaynstein
Dizziness and vertigo are common and difficult complaints encountered by providers. The differential diagnosis is large and varies from benign to life-threatening disorders. The true challenge becomes differentiating benign peripheral vertigo from central vertigo. The HINTS examination can help differentiate peripheral from central causes of dizziness and vertigo.
October 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/27683970/effects-of-semont-maneuver-on-benign-paroxysmal-positional-vertigo-a-meta-analysis
#7
Xiaoli Zhang, Xiaoyun Qian, Ling Lu, Jie Chen, Jing Liu, Chuanyao Lin, Xia Gao
BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common type of peripheral vertigo. This study aimed to evaluate the effects of the Semont maneuver (SM) for BPPV treatment, compared with other methods. METHODS: Studies were selected in relevant databases under pre-defined criteria up to June 2015. The Cochrane evaluation system was used to assess the quality of the studies. Effect size was indicated as a risk-ratio (RR) with corresponding 95% confidential interval (CI)...
August 12, 2016: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27676762/effect-of-a-vestibular-rehabilitation-protocol-to-improve-the-health-related-quality-of-life-and-postural-balance-in-patients-with-peripheral-vertigo
#8
Salma Jeribi, Abdelmoneem Yahia, Imen Achour, Bouthaina Hammemi, Abdelmoneem Ghorbel, Mohamed Habib Elleuch, Sameh Ghroubi
OBJECTIVE: To determine the effect of completing a vestibular rehabilitation treatment protocol on postural balance, dizziness and quality of life in patients with peripheral vertigo. MATERIAL/PATIENTS AND METHODS: A prospective study concerning patients with instability due to unilateral peripheral vestibular disorder. The patients were evaluated with a clinical examination and a test of static and dynamic balance on the Satel(®) platform in which length, mediolateral (LongX) and anterior-posterior deviations (long Y) were monitored...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27661276/the-usefulness-of-monitoring-the-neutrophil-to-lymphocyte-ratio-in-patients-with-peripheral-vertigo
#9
C Sahin, C Varim, M Uyanik, B Acar, T Acar, A Nalbant
The purpose of this study was to evaluate the usefulness of the neutrophil to lymphocyte ratio (NLR) in a differential diagnosis and follow-up of patients with peripheral vertigo. Twenty patients with benign positional paroxysmal vertigo (BPPV) and 20 patients diagnosed with vestibular neuritis (VN) were included in the study. Serum samples were analysed at the initial presentation and on the seventh day of admission retrospectively. The WBC (white blood cell) count was 10500±2100 /mm3, the neutrophil count was 4700±1100/mm3, the lymphocyte count was 5000±1200/mm3 and the NLR was 0...
July 2016: Georgian Medical News
https://www.readbyqxmd.com/read/27638073/acute-unilateral-loss-of-vestibular-function
#10
M Fetter
Sudden unilateral loss of vestibular function is the most severe condition that can occur in the vestibular system. The clinical syndrome is caused by the physiologic properties of the vestibulo-ocular reflex (VOR) arc. In the normal situation, the two peripheral vestibular end organs are connected to a functional unit in coplanar pairs of semicircular canals working in a push-pull mode. "Push-pull" mode means that, when one side is excited, the other side is inhibited, and vice versa due to two mechanisms...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27638064/vestibular-symptoms-and-history-taking
#11
A Bisdorff
History taking is an essential part in the diagnostic process of vestibular disorders. The approach to focus strongly on the quality of symptoms, like vertigo, dizziness, or unsteadiness, is not that useful as these symptoms often coexist and are all nonspecific, as each of them may arise from vestibular and nonvestibular diseases (like cardiovascular disease) and do not permit to distinguish potentially dangerous from benign causes. Instead, patients should be categorized if they have an acute, episodic, or chronic vestibular syndrome (AVS, EVS, or CVS) to narrow down the spectrum of differential diagnosis...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27638062/multisensory-integration-in-balance-control
#12
A M Bronstein
This chapter provides an introduction to the topic of multisensory integration in balance control in, both, health and disease. One of the best-studied examples is that of visuo-vestibular interaction, which is the ability of the visual system to enhance or suppress the vestibulo-ocular reflex (VOR suppression). Of clinical relevance, examination of VOR suppression is clinically useful because only central, not peripheral, lesions impair VOR suppression. Visual, somatosensory (proprioceptive), and vestibular inputs interact strongly and continuously in the control of upright balance...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27638059/anatomy-physiology-and-physics-of-the-peripheral-vestibular-system
#13
H Kingma, R van de Berg
Many medical doctors consider vertigo and dizziness as the major, almost obligatory complaints in patients with vestibular disorders. In this chapter, we will explain that vestibular disorders result in much more diverse and complex complaints. Many of these other complaints are unfortunately often misinterpreted and incorrectly classified as psychogenic. When we really understand the function of the vestibular system, it becomes quite obvious why patients with vestibular disorders complain about a loss of visual acuity, imbalance, fear of falling, cognitive and attentional problems, fatigue that persists even when the vertigo attacks and dizziness decreases or even disappears...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27631630/risk-of-peripheral-artery-occlusive-disease-in-patients-with-vertigo-tinnitus-or-sudden-deafness-a-secondary-case-control-analysis-of-a-nationwide-population-based-health-claims-database
#14
Malcolm Koo, Jin-Cherng Chen, Juen-Haur Hwang
BACKGROUND: Cochleovestibular symptoms, such as vertigo, tinnitus, and sudden deafness, are common manifestations of microvascular diseases. However, it is unclear whether these symptoms occurred preceding the diagnosis of peripheral artery occlusive disease (PAOD). Therefore, the aim of this case-control study was to investigate the risk of PAOD among patients with vertigo, tinnitus, and sudden deafness using a nationwide, population-based health claim database in Taiwan. METHODS: We identified 5,340 adult patients with PAOD diagnosed between January 1, 2006 and December 31, 2010 and 16,020 controls, frequency matched on age interval, sex, and year of index date, from the Taiwan National Health Insurance Research Database...
2016: PloS One
https://www.readbyqxmd.com/read/27595924/health-related-quality-of-life-and-disability-in-patients-with-acute-unilateral-peripheral-vestibular-disorders
#15
Maria Petri, Magdalena Chirilă, Sorana D Bolboacă, Marcel Cosgarea
INTRODUCTION: Health-related quality of life (HRQoL) is used to denote that portion of the quality of life that is influenced by the person's health. OBJECTIVES: To compare the HRQoL of individuals with vestibular disorders of peripheral origin by analyzing functional, emotional and physical disabilities before and after vestibular treatment. METHODS: A prospective, non randomized case-controlled study was conduced in the ENT Department, between January 2015 and December 2015...
August 24, 2016: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/27495105/carotid-plaque-is-a-new-risk-factor-for-peripheral-vestibular-disorder-a-retrospective-cohort-study
#16
Masaoki Wada, Taro Takeshima, Yosikazu Nakamura, Shoichiro Nagasaka, Toyomi Kamesaki, Eiji Kajii
Many chronic diseases are associated with dizziness or vertigo, as is peripheral vestibular disorder (PVD). Although carotid plaque development is linked to atherosclerosis, it is unclear whether such plaques can lead to the development of PVD. We therefore conducted this study to investigate the presence of an association between carotid plaque and new PVD events.In this retrospective study, we consecutively enrolled 393 patients ≥20 years old who had been treated for chronic diseases such as hypertension, dyslipidemia, and diabetes mellitus for ≥6 months at a primary care clinic (Oki Clinic, Japan) between November 2011 and March 2013...
August 2016: Medicine (Baltimore)
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
#17
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/27464281/-clinical-examination-of-vertigo
#18
Helge Roland Topka
Acute vertigo may originate from peripheral or central vestibular disorders. As central vestibular symptoms may indicate severe brainstem or cerebellar ischemia, rapid clinical differentiation is required. To this end, evaluation of spontaneous or gaze-evoked nystagm, head-impulse test as well identification of skew deviation are most helpful.
July 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27430449/vertigo-and-hearing-loss
#19
David E Newman-Toker, Charles C Della Santina, Ari M Blitz
Symptoms referable to disorders affecting the inner ear and vestibulocochlear nerve (eighth cranial nerve) include dizziness, vertigo, tinnitus, and hearing loss, in various combinations. Similar symptoms may occur with involvement of the central nervous system, principally the brainstem and cerebellum, to which the vestibular and auditory systems are connected. Imaging choices should be tailored to patient symptoms and the clinical context. Computed tomography (CT) should be used primarily to assess bony structures...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27416989/increased-risk-of-benign-paroxysmal-positional-vertigo-in-patients-with-anxiety-disorders-a-nationwide-population-based-retrospective-cohort-study
#20
Zi-Jun Chen, Cheng-Ho Chang, Li-Yu Hu, Ming-Shium Tu, Ti Lu, Pan-Ming Chen, Cheng-Che Shen
BACKGROUND: The objective of this study was to evaluate the risk of benign peripheral persistent vertigo (BPPV) among patients with anxiety disorders by using the Taiwan National Health Insurance Research Database (NHIRD). METHODS: We conducted a retrospective study of 15,470 participants (7735 anxiety disorder patients and 7735 control patients) selected from the NHIRD. Patients were observed for a maximum of 9 years to determine the rates of newly diagnosed BPPV...
2016: BMC Psychiatry
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