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Sample records for benign paroxysmal positional

  1. Benign Paroxysmal Positional Vertigo (BPPV)

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    ... Rated Nonprofit! Volunteer. Donate. Review. Benign Paroxysmal Positional Vertigo (BPPV) BPPV is the most common vestibular disorder. Benign ... al. Diagnosis and management of benign paroxysmal positional vertigo (BPPV). CMAJ. 2003 169(7):681-693. Nuti D, ...

  2. Benign paroxysmal positional vertigo

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    Guo Xiang-Dong

    2011-01-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a common clinical disorder characterized by brief recurrent spells of vertigo often brought about by certain head position changes as may occur with looking up, turning over in bed, or straightening up after bending over. It is important to understand BPPV not only because it may avert expensive and often unnecessary testing, but also because treatment is rapid, easy, and effective in >90% of cases. The diagnosis of BPPV can be made based on the history and examination. Patients usually report episodes of spinning evoked by certain movements, such as lying back or getting out of bed, turning in bed, looking up, or straightening after bending over. At present, the generally accepted recurrence rate of BPPV after successful treatment is 40%-50% at 5 years of average follow-up. There does appear to be a subset of individuals prone to multiple recurrences.

  3. Benign paroxysmal positional vertigo in Parkinson's disease

    NARCIS (Netherlands)

    Wensen, E. van; Leeuwen, R.B. van; Zaag-Loonen, H.J. van der; Masius-Olthof, S.; Bloem, B.R.

    2013-01-01

    BACKGROUND: Dizziness is a frequent complaint of patients with Parkinson's disease (PD), and orthostatic hypotension (OH) is often thought to be the cause. We studied whether benign paroxysmal positional vertigo (BPPV) could also be an explanation. AIM: To assess the prevalence of benign paroxysmal

  4. Benign paroxysmal positional vertigo following septorhinoplasty.

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    Koc, Eltaf Ayca Ozbal; Koc, Bulent; Eryaman, Esra; Ozluoglu, Levent N

    2013-01-01

    We present 2 cases of benign paroxysmal positional vertigo (BPPV) following septorhinoplasty. Benign paroxysmal positional vertigo following septorhinoplasty is an unusual entity. Two young women who had difficulty in breathing and nasal deformity underwent septorhinoplasty. On the second and the third postoperative days, the patients experienced vertigo that was induced by position changes. Both patients had neither preexisting ear disease nor vertigo before the surgery. All the examinations were normal. With Dix-Hallpike maneuver, which is the criterion-standard test, the characteristic nystagmus was observed. Right posterior canal BPPV was diagnosed, and they were both treated with Epley canalith repositioning maneuver. Publications related to postsurgical vertigo are available in literature, but it is still an underdiagnosed disorder. We would like to mention about this rare entity and inform the surgeons that they must keep in mind that a patient who is complaining about vertigo or dizziness after the surgery should be observed and investigated for BPPV.

  5. Benign paroxysmal positional vertigo recurrence and persistence

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    Ricardo S. Dorigueto; Mazzetti,Karen R; Gabilan,Yeda Pereira L; Ganança, Fernando Freitas [UNIFESP

    2009-01-01

    Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibular disorders. AIM: To study the recurrence and persistence of BPPV in patients treated with canalith repositioning maneuvers (CRM) during the period of one year. STUDY DESIGN: longitudinal contemporary cohort series. MATERIALS AND METHODS: One hundred patients with BPPV were followed up during 12 months after a treatment with CRM. Patients were classified according to disease evolution. Aquatic physiotherapy for ves...

  6. [Surgical treatment of benign paroxysmal positional vertigo].

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    Zaugg, Y; Grosjean, P; Maire, R

    2012-10-03

    Benign paroxysmal positional vertigo (BPPV) is a common disorder that presents to the general practitioner. This condition represents one of the most common causes of peripheral vertigo. The diagnosis is made on clinical grounds. The treatment relies on repositioning maneuvers with relief of symptoms that occur in a few weeks in the majority of the cases. Rarely, patients are incapacitated by persistent or recurrent BPPV despite multiple repositioning maneuvers. In these cases, surgical therapies are available which provide excellent results.

  7. Climatic variations and benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    Basil M.N. Saeed; Alyaa Farouk Omari

    2016-01-01

    Benign paroxysmal positional vertigo (BPPV) is probably the most common diagnosis at vertigo clinics. Seasonal cycles of several human illnesses could be attributed variously to changes in atmospheric or weather conditions. In this retrospective study, patients with BPPV from January 2010 to December 2012 were studied, and their charts were reviewed. Statistical analysis revealed a statistically significant difference in patients' numbers among different months of the year. Also there is a significant statistical correlation between the numbers of patients with climatic variations especially the temperature. The present paper discusses the possible explanations for these results which confirms the seasonal variations in BPPV, together with a review of literature to view the possible associations with other disorders that causes such sea-sonality.

  8. Benign Paroxysmal Positional Vertigo: An Integrated Perspective

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    Kourosh Parham

    2014-01-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV, the most common cause of dizziness, occurs in all age groups. It presents with vertigo on head movement, but in older patients presentation may be typical and thus accounting for a low recognition rate in the primary care setting. It may be recurrent in up to 50% of cases. BPPV is associated with displacement of fragments of utricular otoconia into the semicircular canals, most commonly the posterior semicircular canal. Otoconia are composed of otoconin and otolin forming the organic matrix on which calcium carbonate mineralizes. Otoconia may fragment with trauma, age, or changes in the physiology of endolymph (e.g., pH and calcium concentration. Presentation varied because otoconia fragments can be displaced into any of the semicircular canals on either (or both side and may be free floating (canalolithiasis or attached to the cupula (cupulolithiasis. Most cases of BPPV are idiopathic, but head trauma, otologic disorders, and systemic disease appear to be contributory in a subset. Positional maneuvers are used to diagnose and treat the majority of cases. In rare intractable cases surgical management may be considered. A strong association with osteoporosis suggests that idiopathic BPPV may have diagnostic and management implications beyond that of a purely otologic condition.

  9. Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo

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    Muhammed Dagkiran

    2015-12-01

    Full Text Available Benign paroxysmal positional vertigo is the cause of peripheral vertigo, which only takes seconds posed by certain head and body position and led to severe attacks of vertigo. Therefore, it is a disturbance that causes a continuous fear of fall and anxiety in some patients. Although benign paroxysmal positional vertigo is the most common cause of peripheral vertigo, it may cause unnecessary tests, treatment costs and the loss of labor due to the result of the delay in the diagnosis and treatment stages. Diagnosis and treatment of this disease is easy. High success rates can be achieved with appropriate repositioning maneuvers after taking a detailed medical history and accurate assessment of accompanying nystagmus. The aim of this paper was to review the updated information about benign paroxysmal positional vertigo. [Archives Medical Review Journal 2015; 24(4.000: 555-564

  10. The treatment of horizontal canal benign paroxysmal positional vertigo

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    Babac S.

    2013-01-01

    Full Text Available The aim of our study was to assess the outcome of treatment of horizontal canal benign paroxysmal positional vertigo and to analyze the influence of the different prognostic factors on treatment failure. Fifty-nine patients with horizontal canal benign paroxysmal positional vertigo were included in the study. They were divided into two groups according to the treatment protocol, randomly. The first group, after treatment with the barbecue maneuver or inverted Gufoni, depending on the nystagmus form, was instructed to sleep on the side with weaker nystagmus, and the second group did not. In the first group, 88.9% of patients were cured and 91.3% in the second one. There was no significant difference between the two groups. Migraine and the apogeotropic form of nystagmus had a significant effect on treatment outcome, while other variables had no effect.

  11. New therapeutic maneuver for anterior canal benign paroxysmal positional vertigo.

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    Yacovino, Dario A; Hain, Timothy C; Gualtieri, Francisco

    2009-11-01

    This article describes the clinical features of anterior semicircular canal benign paroxysmal positional vertigo (AC-BPPV) and a new therapeutic maneuver for its management. Our study was a retrospective review of cases from an ambulatory tertiary referral center. Thirteen patients afflicted with positional paroxysmal vertigo exhibiting brief positional down-beating nystagmus in positional tests (Dix-Hallpike and head-hanging position) were treated with a maneuver comprised of the following movements: Sequential head positioning beginning supine with head hanging 30 degrees dependent with respect to the body, then supine with head inclined 30 degrees forward, and ending sitting with head 30 degrees forward. All cases showed excellent therapeutic response to our repositioning procedure, i.e. relief of vertigo and elimination of nystagmus. The maneuver described is an option for AC-BPPV treatment.

  12. Horizontal canal benign paroxysmal positional vertigo in a fighter pilot

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    Su-Jiang Xie; Jiang-Chang Wang; Li Ding; Xi-Qing Sun

    2011-01-01

    Benign paroxysmal positional vertigo (BPPV) is the most common disorder of the peripheral vestibular system, characterized by intense, positional provoked vertigo. BPPV is thought to occur due to canalithiasis of the posterior semicircular canal. Recently, a new entity of BPPV, known as horizontal canal (HC)-BPPV, has been recognized. Although only 3 to 8% of BPPV is due to horizontal canal involvement, HC-BPPV is not rare. We present a case of a naval fighter pilot who had an incident of HC-...

  13. Horizontal canal benign paroxysmal positional vertigo in a fighter pilot

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    Su-Jiang Xie

    2011-01-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is the most common disorder of the peripheral vestibular system, characterized by intense, positional provoked vertigo. BPPV is thought to occur due to canalithiasis of the posterior semicircular canal. Recently, a new entity of BPPV, known as horizontal canal (HC-BPPV, has been recognized. Although only 3 to 8% of BPPV is due to horizontal canal involvement, HC-BPPV is not rare. We present a case of a naval fighter pilot who had an incident of HC-BPPV on the ground. The pilot aeromedical evaluation and considerations are discussed.

  14. Horizontal canal benign paroxysmal positional vertigo in a fighter pilot.

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    Xie, Su-Jiang; Wang, Jiang-Chang; Ding, Li; Sun, Xi-Qing

    2011-01-01

    Benign paroxysmal positional vertigo (BPPV) is the most common disorder of the peripheral vestibular system, characterized by intense, positional provoked vertigo. BPPV is thought to occur due to canalithiasis of the posterior semicircular canal. Recently, a new entity of BPPV, known as horizontal canal (HC)-BPPV, has been recognized. Although only 3 to 8% of BPPV is due to horizontal canal involvement, HC-BPPV is not rare. We present a case of a naval fighter pilot who had an incident of HC-BPPV on the ground. The pilot aeromedical evaluation and considerations are discussed.

  15. Benign Paroxysmal Positional Vertigo in the Acute Care Setting.

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    Fife, Terry D; von Brevern, Michael

    2015-08-01

    Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo characterized by brief episodes provoked by head movements. The first attack of BPPV usually occurs in bed or upon getting up. Because it often begins abruptly, it can be alarming and lead to emergency department evaluation. The episodes of spinning often last 10 to 20 seconds, but may occasionally last as long as 1 minute. There are several forms of BPPV. In nearly all cases, highly effective treatment can be offered to patients. This article reviews the current state of our understanding of this condition and its management.

  16. Chiropractic management of a patient with benign paroxysmal positional vertigo

    DEFF Research Database (Denmark)

    Nørregaard, Anette R; Lauridsen, Henrik H; Hartvigsen, Jan

    2009-01-01

    OBJECTIVE: This article describes and discusses the case of a patient with benign paroxysmal positional vertigo (BPPV) characterized by severe vertigo with dizziness, nausea, and nystagmus, treated without the use of spinal manipulation by a doctor of chiropractic. CLINICAL FEATURES: A 46-year......-old woman presented for care with complaints of acute vertigo and dizziness. INTERVENTION AND OUTCOME: The patient was examined and diagnosed with left posterior canalolithiasis by means of the Dix-Hallpike maneuver. She was treated successfully with the Epley maneuver once and subsequently discharged...... without further treatment. CONCLUSION: This case demonstrates the importance of correctly identifying patients with BPPV. This case also demonstrates the successful treatment of BPPV....

  17. DIAGNOSIS AND MANAGEMENT BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV

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    Putu Prida Purnamasari

    2013-05-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Benign Paroxysmal Positional Vertigo (BPPV is one of the most frequent Neurotology disorders. Benign Paroxysmal Positional Vertigo is a vestibular disorder in which 17% -20% of patients complained of vertigo. In the general population the prevalence of BPPV is between 11 to 64 per 100,000 (prevalence 2.4%. Benign Paroxysmal Positional Vertigo is a disturbance in the inner ear with positional vertigo symptoms that occur repeatedly with the typical nystagmus paroxysmal. The disorders can be caused either by canalithiasis or cupulolithiasis and could in theory be about three semicircular canals, although superior canal (anterior is very rare. The most common is the form of the posterior canal, followed by a lateral. The diagnosis of BPPV can be enforced based on history and physical examination, including some tests such as Dix-Hallpike test, caloric test, and Supine Roll test. The diagnosis of BPPV is also classified according to the types of channels. Management of BPPV include non-pharmacological, pharmacological and operations. Treatment is often used non-pharmacological includes several maneuvers such as Epley maneuver, Semount maneuver, Lempert maneuver, forced prolonged position and Brandt-Daroff exercises. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  18. Diagnosis and management of benign paroxysmal positional vertigo (BPPV).

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    Parnes, Lorne S; Agrawal, Sumit K; Atlas, Jason

    2003-09-30

    There is compelling evidence that free-floating endolymph particles in the posterior semicircular canal underlie most cases of benign paroxysmal positional vertigo (BPPV). Recent pathological findings suggest that these particles are otoconia, probably displaced from the otolithic membrane in the utricle. They typically settle in the dependent posterior canal and render it sensitive to gravity. Well over 90% of patients can be successfully treated with a simple outpatient manoeuvre that moves the particles back into the utricle. We describe the various techniques for this manoeuvre, plus treatments for uncommon variants of BPPV such as that of the lateral canal. For the rare patient whose BPPV is not responsive to these manoeuvres and has severe symptoms, posterior canal occlusion surgery is a safe and highly effective procedure.

  19. Benign paroxysmal positional vertigo in an airline pilot.

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    Sen, Ahmet; Al-Deleamy, Louai S; Kendirli, Tansel M

    2007-11-01

    Benign paroxysmal positional vertigo (BPPV) is one of the most common types of peripheral vertigo, characterized by violent whirling vertigo after a positional change. Although the condition is termed "benign," the clinical presentation can be incapacitating for pilots in certain maneuvers. We present a case of an airline transport pilot with the complaint of vertigo for 5 d. The vertigo was aggravated by head movements when looking up or rolling over, lasting for a few seconds. The patient was diagnosed with BPPV, and he was treated with physical therapy with the use of Epley maneuver. The airman applied for his First-Class medical examination after the treatment was successfully completed. The aviation medical examiner (AME) issued the airman medical certificate after contacting and receiving verbal approval from the Federal Aviation Administration's (FAA's) Aerospace Medical Certification Division (AMCD). While evaluating aviators who have had BPPV, AMEs should not issue medical certificates for any class until the condition is fully resolved. Although the AME Guide states that certification of pilots with other types of vertigo requires an FAA decision, once the patient is successfully treated and free of symptoms, approval for issuing the medical certificate can be obtained through contacting AMCD and by submitting all information and documentation pertaining to the diagnosis and treatment.

  20. Classification, diagnostic criteria and management of benign paroxysmal positional vertigo.

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    Imai, Takao; Takeda, Noriaki; Ikezono, Tetsuo; Shigeno, Kohichiro; Asai, Masatsugu; Watanabe, Yukio; Suzuki, Mamoru

    2017-02-01

    Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo and the posterior and/or lateral semicircular canals are usually affected. BPPV is characterized by brief attacks of rotatory vertigo associated with positional and/or positioning nystagmus, which are elicited by specific head positions or changes in head position relative to gravity. In patients with the posterior-canal-type of BPPV, torsional nystagmus is induced by the Dix-Hallpike maneuver. In patients with the lateral-canal-type of BPPV, horizontal geotropic or apogeotropic nystagmus is induced by the supine roll test. The pathophysiology of BPPV is canalolithiasis comprising free-floating otoconial debris within the endolymph of a semicircular canal, or cupulolithiasis comprising otoconial debris adherent to the cupula. The observation of positional and/or positioning nystagmus is essential for the diagnosis of BPPV. BPPV is treated with the canalith repositioning procedure (CRP). Through a series of head position changes, the CRP moves otoconial debris from the affected semicircular canal to the utricle. In this review, we provide the classification, diagnostic criteria, and examinations for the diagnosis, and specific and non-specific treatments of BPPV in accordance with the Japanese practical guidelines on BPPV published by the Japan Society for Equilibrium Research.

  1. Prevalence of unrecognized benign paroxysmal positional vertigo in older patients.

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    van der Zaag-Loonen, H J; van Leeuwen, R B; Bruintjes, Tj D; van Munster, B C

    2015-06-01

    Dizziness is a relatively common complaint which occurs more often with increasing age. Benign paroxysmal positional vertigo (BPPV) is an important cause which can easily be treated but is frequently not recognized by professionals. The aim of this study was to assess the prevalence of unrecognized BPPV in older patients. Patients ≥70 years of age (n = 989) indicated whether they experienced dizziness, and if so whether the symptoms were typical for BPPV. If affirmed, a diagnostic maneuver was performed. Positive patients were treated at once. All suspected patients completed quality of life questionnaires and were followed for 3 and 6 months. Positive BPPV patients were compared with negative (but suspected) patients. Almost one quarter of the patients (226 patients, 23 %) suffered from dizziness, among whom 101 were suspected of BPPV. Less than half (n = 45) underwent the diagnostic maneuver, of whom 13 (29 %) were positive for BPPV. At follow-up, one patient developed BPPV, leading to a total of 14 positive patients (overall prevalence 1.4 %). BPPV positive patients did not differ from BPPV negative patients. Among a large group of older patients, one quarter experiences dizziness, and 1.4 % has definite BPPV.

  2. Clinical evaluation of posterior canal benign paroxysmal positional vertigo

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    Titus S Ibekwe

    2012-01-01

    Full Text Available Background: Benign paroxysmal positional vertigo (BPPV is a mechanical peripheral vestibular disorder which may involve any of the three semicircular canals but principally the posterior. In as much as the literature has described theories to explain the mechanism of BPPV and also contains scholarly works that elucidate BPPV; its management remains an enigma to most clinicians. To this end, this work was aimed at outlining an evidence-based best practice for most common form of BPPV. Materials and Methods: A systematic review of the literature was conducted between 1948 and June 2011 in PubMed, Embase, Ovid, and Cochrane database through the online Library of the University of Cape Town. Seventy-nine worthy articles that addressed the study were selected on consensus of the two authors. Conclusion: There is consensus for the use of canalith repositioning procedures as the best form of treatment for posterior canal canalolithiasis. However, successful treatment is dependent on accurate identification of the implicated canal and the form of lithiasis. Furthermore, clinicians should note that there is no place for pharmacological treatment of BPPV; unless it is to facilitate repositioning.

  3. A Geriatric Perspective on Benign Paroxysmal Positional Vertigo.

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    Parham, Kourosh; Kuchel, George A

    2016-02-01

    Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in older adults. Beyond the unpleasant sensation of vertigo, BPPV also negatively affects older adults' gait and balance and increases their risk of falling. As such it has a profound effect on function, independence, and quality of life. Otoconia are the inner ear structures that help detect horizontal and vertical movements. Aging contributes to the fragmentation of otoconia, whose displacement into the semicircular, most commonly posterior canals, can produce rotatory movement sensations with head movement. BPPV is more commonly idiopathic in older adults than in younger individuals, can present atypically, and has a more-protracted course and higher risk of recurrence. Medications such as meclizine that are commonly prescribed for BPPV can be associated with significant side effects. Dix-Hallpike and Head Roll tests can generally identify the involved canal. Symptoms resolve as otoconia fragments dissolve into the endolymph, but appropriate canalith repositioning (e.g., Epley maneuver) can expedite recovery and reduce the burden of this disorder. Observations suggesting an association between idiopathic BPPV and vitamin D deficiency and osteoporosis indicate that BPPV may share risk factors with other common geriatric conditions, which highlights the importance of moving beyond purely otological considerations and addressing the needs of older adults with vertigo through a systems-based multidisciplinary approach.

  4. Gender-based comorbidity in benign paroxysmal positional vertigo.

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    Oluwaseye Ayoola Ogun

    Full Text Available It has been noted that benign paroxysmal positional vertigo (BPPV may be associated with certain disorders and medical procedures. However, most studies to date were done in Europe, and epidemiological data on the United States (US population are scarce. Gender-based information is even rarer. Furthermore, it is difficult to assess the relative prevalence of each type of association based solely on literature data, because different comorbidities were reported by various groups from different countries using different patient populations and possibly different inclusion/exclusion criteria. In this study, we surveyed and analyzed a large adult BPPV population (n = 1,360 surveyed, 227 completed, most of which were recurrent BPPV cases from Omaha, NE, US, and its vicinity, all diagnosed at Boys Town National Research Hospital (BTNRH over the past decade using established and consistent diagnostic criteria. In addition, we performed a retrospective analysis of patients' diagnostic records (n = 1,377, with 1,360 adults and 17 children. The following comorbidities were found to be significantly more prevalent in the BPPV population when compared to the age- and gender-matched general population: ear/hearing problems, head injury, thyroid problems, allergies, high cholesterol, headaches, and numbness/paralysis. There were gender differences in the comorbidities. In addition, familial predisposition was fairly common among the participants. Thus, the data confirm some previously reported comorbidities, identify new ones (hearing loss, thyroid problems, high cholesterol, and numbness/paralysis, and suggest possible predisposing and triggering factors and events for BPPV.

  5. Benign paroxysmal positional vertigo after radiologic scanning: a case series

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    Aydin Erdinc

    2008-03-01

    Full Text Available Abstract Introduction Benign paroxysmal positional vertigo (BPPV is the most common type of vertigo. It is frequently seen in elderly patients, and the course of the attack may easily mimic cerebrovascular disease. A BPPV attack after a radiologic examination has not been reported previously. We report the cases of two patients who had BPPV attacks after radiologic imaging. Case presentation The first patient with headache and tremor was admitted to the radiology department for cranial computed tomography (CT imaging. During scanning, she was asked to lie in the supine position with no other head movements for approximately 10 minutes. After the cranial CT imaging, she stood up rapidly, and suddenly experienced a vertigo attack and nausea. The second patient was admitted to the radiology department for evaluation of his renal arteries. During the renal magnetic resonance angiography, he was in the supine position for 20 minutes and asked not to move. After the examination, he stood up rapidly with the help of the technician and suddenly experienced a vertigo attack with nausea and vomiting. The results of standard laboratory analyses and their neurologic examinations were within normal limits and Dix-Hallpike tests showed rotatory nystagmus in both cases. An Epley maneuver was performed to the patients. The results of a control Dix-Hallpike tests after 1 Epley maneuver were negative in both patients. Conclusion Radiologists and clinicians must keep in mind that after radiologic imaging in which the patient is still for some time in the supine position and then helped to stand up rapidly, a BPPV attack may occur.

  6. Benign paroxysmal positional vertigo in outpatient practice: Diagnosis and treatment

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    N. V. Bestuzheva

    2014-01-01

    Full Text Available Dizziness is one of the common reasons for visits to physicians of various specialties; the data of foreign investigations show that benign paroxysmal positional vertigo (BPPV is most frequently encountered.Objective: to study the causes of dizziness, to analyze the frequency of BPPV and the efficiency of its treatment in outpatient practice.Patients and methods. The investigation enrolled 80 patients, including 55 (68.7% women and 25 (31.3% men, aged 18 to 75 years (mean age 53.8±12.8 years, who complained of dizziness and sought for medical advice in the Therapeutic-and-Diagnostic Unit, A.Ya. Kozhevnikov Clinic of Nervous System Diseases, I.M. Sechenov First Moscow State Medical University.Results. The most common causes of dizziness in outpatient practice were BPPV (46.2% and postural phobic vertigo (35%. The diagnosis of VPPV, if special positional testing (Dix-Hallpike and McClure-Pagnini tests was carried out, was shown to create no significant difficulties. The diagnosis was not established in the majority (97.5% of the patients; effective treatment was performed in one of the patients. Combined treatment, by performing the positional tests and using betaserc for 2 months, led to complete resolution of positional vertigo in most (97.3% patients.Discussion. The findings indicate the efficiency of examining patients with complaints of dizziness, by using the special otoneurological tests to detect BPPV. The purposeful questioning of patients with BPPV can suspect this disease in the majority of cases. Our investigation shows the high efficiency of rehabilitation maneuvers for BPPV, which agrees well with the data of other authors. Physicians’ poor awareness of BPPV among physicians and the high efficiency of its treatment in outpatient practice are noted.

  7. Awareness of benign paroxysmal positional vertigo in central Israel

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    Pollak Lea

    2009-04-01

    Full Text Available Abstract Background Despite its frequent occurrence and effective treatment options, benign paroxysmal positional vertigo (BPPV still remains under-estimated in the community. Methods We reviewed referral letters and medical records of 120 patients who were treated for BPPV at our Dizziness Clinic during the years 2006–2008 and searched for factors that possibly contribute to missing this entity. Results The referral diagnosis could be clustered into four groups: BPPV (25.6%, further unspecified vertigo (36.6%, dizziness (27.5% and other (10%. BPPV was recognized more frequently by ENT doctors than by other specialists. Patients referred with the correct diagnosis of BPPV were significantly younger and the duration of their symptoms shorter than in other referral groups. Patients in the distinct referral groups did not differ in the presence of autonomic symptoms or a history of another serious disease. A history typical of BPPV could be obtained in all but 11 patients, but position dependence was noted by the referring physician only in 55 patients, 31 of them correctly assigned as possible BPPV. Only in two patients was the Dix-Hallpike test performed. Thirty two patients were diagnosed with BPPV in the past, but this did not influence the recognition of the recurrence of this clinical entity. About 40% of patients had an audiogram and/or brainstem auditory evoked potentials. Electronystagmography was performed in 7.5% and brain imaging in 14% of patients before referral. Conclusion Our results show that BPPV is still an under-recognized entity. Education and the demand on specialists to learn how to treat BPPV, could improve the situation.

  8. Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo.

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    Jeong, Seong-Hae; Kim, Ji-Soo; Shin, Jong Wook; Kim, Sungbo; Lee, Hajeong; Lee, Ae Young; Kim, Jae-Moon; Jo, Hyunjin; Song, Junghan; Ghim, Yuna

    2013-03-01

    Previous studies have demonstrated an association of osteopenia/osteoporosis with idiopathic benign paroxysmal positional vertigo (BPPV). Since vitamin D takes part in the regulation of calcium and phosphorus found in the body and plays an important role in maintaining proper bone structure, decreased bone mineral density in patients with BPPV may be related to decreased serum vitamin D. We measured the serum levels of 25-hydroxyvitamin D in 100 patients (63 women and 37 men, mean age ± SD = 61.8 ± 11.6) with idiopathic BPPV and compared the data with those of 192 controls (101 women and 91 men, mean age ± SD = 60.3 ± 11.3) who had lived in the same community without dizziness or imbalance during the preceding year. The selection of the controls and acquisition of clinical information were done using the data from the Fourth Korean National Health and Nutrition Examination Survey, 2008. The serum level of 25-hydroxyvitamin D was lower in the patients with BPPV than in the controls (mean ± SD = 14.4 ± 8.4 versus 19.1 ± 6.8 ng/ml, p = 0.001). Furthermore, patients with BPPV showed a higher prevalence of decreased serum vitamin D (BPPV with the odds ratios of 3.8 (95 % confidence interval = 1.51-9.38, p = 0.004) and 23.0 (95 % confidence interval = 6.88-77.05, p BPPV and decreased serum vitamin D. Decreased serum vitamin D may be a risk factor of BPPV.

  9. Clinical analysis of benign paroxysmal positional vertigo in youth

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    Jin XU

    2012-09-01

    Full Text Available Objective To explore the clinical features of benign paroxysmal positional vertigo (BPPV in patients of 40 years old or younger. Methods The clinical features of 40 patients (age ≤40 years with BPPV admitted from August 2009 to July 2011 were retrospectively analyzed, and compared with that of 286 middle and old-aged patients (age >40 years with BPPV admitted in the same period. Results The incidence of BPPV in young patients showed a relatively higher incidence (12.3%, with the sex ratio of male to female 1:3 and a mean age of 32.1±6.2 years. The mean latent period of vertigo attack was 1.2±1.3 seconds, and 10 patients (25% showed no obvious latent period. The median duration of vertigo was 10s. The posterior semicircular canal was involved in 27 patients (67.5%. Cupulolithiasis was found in 6 patients, and all the otolithiasis was found to involve the posterior semicircular canal. The proportion of BPPV with no obvious latency was higher in the young patients than in the middle and old-aged patients (25.0% vs 11.5%, χ2=5.554, P=0.018, but no significant difference in sex ratio, the course of disease, the ratio of involved semicircular canal, the latency and the duration of vertigo attack was found between two groups (P>0.05. Conclusions The incidence of BPPV is relatively higher in youth, more common in females, and the posterior semicircular canal is commonly involved. Compared with the middle and old-aged patients with BPPV, the proportion patients with no obvious latency of vertigo attack in young patients is higher, and the incidence of cupulolithiasis involving posterior semicircular canal is higher in the youth.

  10. Benign positional vertigo

    Science.gov (United States)

    Vertigo - positional; Benign paroxysmal positional vertigo; BPPV: dizziness- positional ... Benign positional vertigo is also called benign paroxysmal positional vertigo (BPPV). It is caused by a problem in the inner ear. ...

  11. Ocular vestibular evoked myogenic potential in patients with benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Mozhgan Masoom

    2014-06-01

    Full Text Available Background and Aim: Since utricle is the main damaged organ in benign paroxysmal positional vertigo (BPPV, ocular vestibular evoked myogenic potential (oVEMP may be an appropriate method to evaluate the utricule dysfunction and the effect of disease recurrence rate on it. This study aimed to record myogenic potential in patients with benign paroxysmal positional vertigo.Methods: In a cross-sectional study, ocular myogenic potential was recorded in 25 healthy subjects and 20 patients with benign paroxysmal positional vertigo using 500 Hz-tone bursts (95 dB nHL.Results: In the affected ear, mean amplitude was lower and mean threshold was higher than those in the unaffected ear and in the normal group (p<0.05. Mean amplitude asymmetry ratio of patients was more than the healthy subjects (p0.05. Frequencies of abnormal responses in the affected ears were higher than in unaffected ears and in the normal group (p<0.05. Furthermore, the patients with recurrent vertigo showed more abnormalities than the patients with non-recurrent (p=0.030.Conclusion: In the recurrent benign paroxysmal positional vertigo, ocular vestibular evoked myogenic potential showed more damage in the utricle, suggesting this response could be used to evaluate the patients with benign paroxysmal positional vertigo.

  12. Cases requiring increased number of repositioning maneuvers in benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Mukadder Korkmaz

    Full Text Available ABSTRACT INTRODUCTION: Benign paroxysmal positional vertigo (BPPV is a clinical syndrome that is proposed to be caused by dislocated utricular debris into semicircular canals. Although the majority of patients are treated by one or two repositioning maneuvers, some of the patients need repeated maneuvers for relief. OBJECTIVE: The goal of this study was to investigate the factors associated with patients with benign paroxysmal positional vertigo who required multiple repositioning procedures for treatment. METHODS: Data were obtained from the clinical records of 153 patients diagnosed with benign paroxysmal positional vertigo. Patients were treated by repositioning maneuvers. Demographic data and the factors including age, sex, canal type, duration of symptoms, comorbidities and number of repositioning maneuvers for relief were documented for statistical analysis. RESULTS: Age, sex, canal type and the duration of symptoms had no impact on the number of maneuvers. The most common comorbidity was spine problems. Hypertension was the only comorbidity that significantly associated with increased number of maneuvers. CONCLUSION: The presence of hypertension is a risk factor for repeated maneuvers in benign paroxysmal positional vertigo treatment. Physicians should be aware of the increased probability of repeated repositioning maneuvers in these group of patients. The role of comorbidities and vascular factors need to be further clarified in the course of benign paroxysmal positional vertigo.

  13. Insights into horizontal canal benign paroxysmal positional vertigo from a human case report.

    Science.gov (United States)

    Aron, Margaret; Bance, Manohar

    2013-12-01

    For horizontal canal benign paroxysmal positional vertigo, determination of the pathologic side is difficult and based on many physiological assumptions. This article reports findings on a patient who had one dysfunctional inner ear and who presented with horizontal canal benign paroxysmal positional vertigo, giving us a relatively pure model for observing nystagmus arising in a subject in whom the affected side is known a priori. It is an interesting human model corroborating theories of nystagmus generation in this pathology and also serves to validate Ewald's second law in a living human subject.

  14. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update).

    Science.gov (United States)

    Bhattacharyya, Neil; Gubbels, Samuel P; Schwartz, Seth R; Edlow, Jonathan A; El-Kashlan, Hussam; Fife, Terry; Holmberg, Janene M; Mahoney, Kathryn; Hollingsworth, Deena B; Roberts, Richard; Seidman, Michael D; Steiner, Robert W Prasaad; Do, Betty Tsai; Voelker, Courtney C J; Waguespack, Richard W; Corrigan, Maureen D

    2017-03-01

    Objective This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV. Purpose The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. The guideline is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies to any setting in which BPPV would be identified, monitored, or managed. The target patient for the guideline is aged ≥18 years with a suspected or potential diagnosis of BPPV. The primary outcome considered in this guideline is the resolution of the symptoms associated with BPPV. Secondary outcomes considered include an increased rate of accurate diagnoses of BPPV, a more efficient return to regular activities and work, decreased use of inappropriate medications and unnecessary diagnostic tests, reduction in recurrence of BPPV, and reduction in adverse events associated with undiagnosed or untreated BPPV. Other outcomes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary return physician visits, and maximizing

  15. Persistent positional nystagmus: a case of superior semicircular canal benign paroxysmal positional vertigo?

    Science.gov (United States)

    Heidenreich, Katherine D; Kerber, Kevin A; Carender, Wendy J; Basura, Gregory J; Telian, Steven A

    2011-08-01

    Involvement of the superior semicircular canal (SSC) in benign paroxysmal positional vertigo (BPPV) is rare. SSC BPPV is distinguished from the more common posterior semicircular canal (PSC) variant by the pattern of nystagmus triggered by the Dix-Hallpike position: down-beating torsional nystagmus in SSC BPPV versus up-beating torsional nystagmus in PSC BPPV. SSC BPPV may be readily treated at the bedside, which is a key component in excluding central causes of down-beating nystagmus. We present an unusual video case report believed to represent refractory SSC BPPV based on the pattern of nystagmus and the absence of any other central signs.

  16. Physical therapy rehabilitation of benign paroxysmal positional vertigo: Evidence based case report

    OpenAIRE

    Selvam Ramachandran; Manish Goon; Priyanka Singh

    2013-01-01

    The benign paroxysmal positional vertigo results in dizziness and imbalance leading to risk of fall thus, imposing functional limitations. The repositioning-liberatory maneuvers, habituation and balance exercises are widely used as the treatment strategies of the rehabilitation program. This case report discusses the success of such rehabilitation program on two subjects based on the updated clinical evidence.

  17. [The variety of symptoms in patients with benign paroxysmal positional vertigo--revision].

    Science.gov (United States)

    Pollak, Lea

    2013-02-01

    Despite its frequent occurrence and effective treatment options, benign paroxysmal positional vertigo (BPPV) still remains underestimated in the community. Acquaintance of the physician with the various presentation symptoms assists in recognition of the entity. We report the complaints and subjective outcome in our cohort of BPPV patients and discuss the possible origin of the atypical, but common, symptoms.

  18. Physical therapy rehabilitation of benign paroxysmal positional vertigo: Evidence based case report

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    Selvam Ramachandran

    2013-01-01

    Full Text Available The benign paroxysmal positional vertigo results in dizziness and imbalance leading to risk of fall thus, imposing functional limitations. The repositioning-liberatory maneuvers, habituation and balance exercises are widely used as the treatment strategies of the rehabilitation program. This case report discusses the success of such rehabilitation program on two subjects based on the updated clinical evidence.

  19. Direction-fixed paroxysmal nystagmus lateral canal benign paroxysmal positioning vertigo (BPPV): another form of lateral canalolithiasis.

    Science.gov (United States)

    Califano, L; Vassallo, A; Melillo, M G; Mazzone, S; Salafia, F

    2013-08-01

    Benign paroxysmal positioning vertigo (BPPV) is the most frequent vertiginous syndrome. It is caused either by free-floating otoliths in the semicircular canals (canalolithiasis) or by otoconial debris adhering to a canal cupula (cupulolithiasis). The posterior canal is the most frequently involved (80%), while the lateral canal is involved less frequently (15%), and the rarest conditions are anterior canalolithiasis and apogeotropic posterior canalolithiasis (5%). The main diagnostic sign of lateral canal BPPV is paroxysmal horizontal bidirectional positioning nystagmus evoked through Pagnini-McClure's test (head roll in the yaw plane in supine position). In the geotropic variant, which is more frequent, the fast phase of the nystagmus is directed towards the lowermost ear, when the patient lies on the affected side or on the healthy side; in the apogeotropic variant, which is less frequent, the fast phase is directed always toward the uppermost ear, regardless of which side the patient lies on. Paroxysmal nystagmus is more intense on the affected side in the geotropic form, and more intense on the healthy side in the apogeotropic form. The authors describe five cases of another primitive and rare form of lateral BPPV, defined as "direction-fixed paroxysmal nystagmus lateral canal BPPV", which has previously been described by other authors as a transitory step observed during the transformation from an apogeotropic into a geotropic form. It is characterized by typical BPPV symptoms and diagnosed by the presence of a paroxysmal horizontal unidirectional positioning nystagmus, evoked through Pagnini-McClure's test, which is apogeotropic on the affected side and geotropic on the healthy side. In the reported cases, direction-fixed horizontal paroxysmal nystagmus was always transformed into a typical geotropic form. The clinical features and pathophysiology of direction-fixed nystagmus lateral canal BPPV are discussed.

  20. Benign paroxysmal positional vertigo after use of noise-canceling headphones.

    Science.gov (United States)

    Dan-Goor, Eric; Samra, Monica

    2012-01-01

    Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo. We describe a case of a woman presenting acutely with a severe episode of disabling positional vertigo. Although she had no known etiologic risk factors, this attack followed 12 hours of continuously wearing digital noise-canceling headphones. This is the first such reported association between BPPV and the use of this gadget. We also provide a short review of BPPV and speculate on the possible pathogenic mechanisms involved.

  1. Differentiation of migrainous positional vertigo (MPV) from horizontal canal benign paroxysmal positional vertigo (HC-BPPV).

    Science.gov (United States)

    Roberts, Richard A; Gans, Richard E; Kastner, Allison H

    2006-04-01

    This article presents an approach to differentiation of migrainous positional vertigo (MPV) from horizontal canal benign paroxysmal positional vertigo (HC-BPPV). Such an approach is essential because of the difference in intervention between the two disorders in question. Results from evaluation of the case study presented here revealed a persistent ageotropic positional nystagmus consistent with MPV or a cupulolithiasis variant of HC-BPPV. The patient was treated with liberatory maneuvers to remove possible otoconial debris from the horizontal canal in an attempt, in turn, to provide further diagnostic information. There was no change in symptoms following treatment for HC-BPPV. This case was diagnosed subsequently as MPV, and the patient was referred for medical intervention. Treatment has been successful for 22 months. Incorporation of HC-BPPV treatment, therefore, may provide useful information in the differential diagnosis of MPV and the cupulolithiasis variant of HC-BPPV.

  2. The Effect of Vestibular Rehabilitation in the Treatment of Elderly Patients with Benign Paroxysmal Positional Vertigo

    OpenAIRE

    N. Saki; Bayat, A; S. Nikakhlagh; F. Memari; G. Mirmomeni

    2011-01-01

    Introduction & Objective: Vertigo in the elderly is relatively common, but only a few studies are available. Vestibular rehabilitation (VR) therapy is an important therapeutic option in treating patients with significant balance deficits. The purpose of this study was to analyze the effect of vestibular rehabilitation on vertigo symptoms in elderly patients with benign paroxysmal positional vertigo (BPPV). Materials & Methods: In a cross sectional analytic design, 46 patients older than 60 ye...

  3. Diagnosis dan Tatalaksana Benign Paroxysmal Positional Vertigo (BPPV) Horizontal Berdasarkan Head Roll Test

    OpenAIRE

    Yan Edward; Yelvita Roza

    2014-01-01

    AbstrakLatar belakang: Benign Paroxysmal Positional Vertigo (BPPV) merupakan vertigo yang dicetuskan oleh perubahan posisi kepala atau badan terhadap gaya gravitasi. Diagnosis BPPV ditegakkan berdasarkan anamnesis dan manuver provokasi. Sering kali terjadi kesalahan dalam menegakkan diagnosis BPPV yang berakibat terhadap penatalaksanaan vertigo yang tidak adekuat. Tujuan: Untuk menjelaskan bagaimana diagnosis dan tatalaksana BPPV Kanalis Horizontal. Kasus: Seorang laki-laki berusia 56 tahun y...

  4. Benign Paroxysmal Positional Vertigo with Simultaneous Involvement of Multiple Semicircular Canals

    OpenAIRE

    Shim, Dae Bo; Song, Chang Eun; Jung, Eun Jung; Ko, Kyung Min; Park, Jin Woo; Song, Mee Hyun

    2014-01-01

    Background and Objectives Benign paroxysmal positional vertigo (BPPV) generally involves a single semicircular canal (single canal BPPV) but it has been reported that more than one semicircular canal on either the same or the opposite side can be involved in 6.8-20% of the cases (multiple canal BPPV). In this study, the clinical characteristics of multiple canal BPPV were analyzed and compared to those of single canal BPPV. Materials and Methods Retrospective analysis was performed on 1054 co...

  5. Association between osteoporosis and benign paroxysmal positional vertigo: a systematic review

    OpenAIRE

    Yu, Shudong; Liu, Fenye; Cheng, Zhixin; Wang, Qirong

    2014-01-01

    Background Increasing recent evidence has implicated osteoporosis as a risk factor for benign paroxysmal positional vertigo (BPPV). We conducted a systematic review to examine the association between osteoporosis and BPPV. Methods Four electronic databases (PubMed, EMBASE, Cochrane Library, and the China Network Knowledge Infrastructure) were searched to identify all papers, published in either English or Chinese, examining the association between osteoporosis (osteopenia) and BPPV. Results S...

  6. Canal switch after canalith repositioning procedure for benign paroxysmal positional vertigo.

    Science.gov (United States)

    Lin, Giant C; Basura, Gregory J; Wong, Hiu Tung; Heidenreich, Katherine D

    2012-09-01

    Canal switch is a complication following canalith repositioning procedure (CRP) for posterior canal benign paroxysmal positional vertigo (BPPV). Instead of being returned to the utricle, the loose otoconia migrate into the superior or horizontal semicircular canal. Patients remain symptomatic, and treatment can be ineffective unless the switch is recognized and additional repositioning maneuvers directed toward the appropriate semicircular canal are performed. This report provides the first videographic documentation of canal switch involving conversion of unilateral posterior semicircular canal BPPV to geotropic horizontal canalithiasis.

  7. Predictors for benign paroxysmal positional vertigo with positive Dix–Hallpike test

    Directory of Open Access Journals (Sweden)

    Noda K

    2011-12-01

    Full Text Available Kazutaka Noda, Masatomi Ikusaka, Yoshiyuki Ohira, Toshihiko Takada, Tomoko TsukamotoDepartment of General Medicine, Chiba University Hospital, Chiba, JapanObjective: Patient medical history is important for making a diagnosis of causes of dizziness, but there have been no studies on the diagnostic value of individual items in the history. This study was performed to identify and validate useful questions for suspecting a diagnosis of benign paroxysmal positional vertigo (BPPV.Methods: Construction and validation of a disease prediction model was performed at the outpatient clinic in the Department of General Medicine of Chiba University Hospital. Patients with dizziness were enrolled (145 patients for construction of the disease prediction model and 61 patients for its validation. This study targeted BPPV of the posterior semicircular canals only with a positive Dix–Hallpike test (DHT + BPPV to avoid diagnostic ambiguity. Binomial logistic regression analysis was performed to identify the items that were useful for diagnosis or exclusion of DHT + BPPV.Results: Twelve patients from the derivation set and six patients from the validation set had DHT + BPPV. Binomial logistic regression analysis selected a "duration of dizziness ≤15 seconds" and "onset when turning over in bed" as independent predictors of DHT + BPPV with an odds ratio (95% confidence interval of 4.36 (1.18–16.19 and 10.17 (2.49–41.63, respectively. Affirmative answers to both questions yielded a likelihood ratio of 6.81 (5.11–9.10 for diagnosis of DHT + BPPV, while negative answers to both had a likelihood ratio of 0.19 (0.08–0.47.Conclusion: A "duration of dizziness ≤15 seconds" and "onset when turning over in bed" were the two most important questions among various historical features of BPPV.Keywords: benign paroxysmal positional vertigo, likelihood ratio, diagnosis, screening, prediction rules

  8. Diagnosis and Treatment of Anterior-Canal Benign Paroxysmal Positional Vertigo: A Systematic Review

    Science.gov (United States)

    Kouzi, Ioanna; Spengos, Konstantinos

    2015-01-01

    Background and Purpose In contrast to the posterior- and horizontal-canal variants, data on the frequency and therapeutic management of anterior-canal benign paroxysmal positional vertigo (AC-BPPV) are sparse. To synthesize the existing body of evidence into a systematic review regarding the incidence and treatment of AC-BPPV. Methods Systematic search of medical databases employing predefined criteria, using the term "anterior canal benign paroxysmal positional vertigo." Results The electronic search retrieved 178 unique citations, 31 of which were considered eligible for further analysis. Analysis of the collected data revealed an estimated occurrence of AC-BPPV among benign paroxysmal positional vertigo patients of 3% (range 1-17.1%). No controlled therapeutic trials could be identified, and so the analysis was focused on uncontrolled case series. Treatment was categorized into three groups: Epley maneuver, Yacovino maneuver, and specific, nonstandard maneuvers described in individual articles. All three categories demonstrated success rates of over 75%, and the overall sample-size-weighted mean was 85.6%. Conclusions The present analysis demonstrated that AC-BPPV comprises about 3% of all BPPV cases. It can be treated safely using the Epley, Yacovino, and other maneuvers with rates of symptom resolution lying in the range of that reported for the other, more frequent canal variants. Multicenter controlled trials are needed in order to develop evidence-based guidelines for the treatment of AC-BPPV. PMID:26022461

  9. Effect on the disability index of adult patients with benign paroxysmal positional vertigo using vestibular rehabilitation and human movement

    OpenAIRE

    Chaverri Flores, Sofía; Chaverri Polini, Julián; Mora Campos, Andrea

    2007-01-01

    Objective: determine the effect on the disability index of adult patients with benign paroxysmal positional vertigo (BPPV) using vestibular rehabilitation therapy (VRT) and human movement. Subjects: six subjects with an average age of 49.5 ± 14.22 years who have been diagnosed with benign paroxysmal positional vertigo by an otolaryngologist. Instruments: the Dizziness Handicap Inventory and a questionnaire to determine impact on the quality of life of patients with this pathology (Ceballos an...

  10. [Treatment of the benign paroxysmal positional vertigo (BPPV) by Epley maneuver].

    Science.gov (United States)

    Pino Rivero, V; Pantoja Hernández, C G; González Palomino, A; Mora Santos, M E; Marcos García, M; Montero García, C; Blasco Huelva, A

    2007-01-01

    Benign paroxysmal positional vertigo (BPPV) is the most common of the peripheral vertigo. We report the case of a 45 years old female with that pathology suspected by the symptoms which the patient related to head changes of positions and movements. Her diagnosis was confirmed by the maneuver of Dix-Hallpike, that was positive, and the treatment consisted in a maneuver of canalicular reposition according to Epley's technique. Such maneuver was successful and actually the patient is without symptoms after more than 2 years since the first episode. Finally we have performed a bibliographic review to verify the effectiveness of that treatment.

  11. Is it important to repeat the positioning maneuver after the treatment for benign paroxysmal positional vertigo?

    Directory of Open Access Journals (Sweden)

    Alexandra Kolontai de Sousa Oliveira

    2015-04-01

    Full Text Available INTRODUCTION: Benign paroxysmal positional vertigo (BPPV is the most common cause of peripheral vestibular dysfunction.OBJECTIVE: To assess whether the performance of the Dix-Hallpike maneuver after the Epley positioning maneuver has prognostic value in the evolution of unilateral ductolithiasis of posterior semicircular canal.METHODS: A prospective cohort study in monitored patients at otoneurology ambulatory with a diagnosis of BPPV; they were submitted to the therapeutic maneuver and then to a retest in order to evaluate the treatment effectiveness; all cases were reassessed one week later and the retest prognostic value was evaluated.RESULTS: A sample of 64 patients which 47 belonging to negative retest group and 17 belonging to positive retest. Performed the maneuver in all patients, the retest presented 51.85% sensitivity, 91.89% specificity, 82.35% positive predictive value and 72.34% negative predictive value.CONCLUSION: The study shows that doing the retest after repositioning maneuver of particles in BPPV is effectual, since it has high specificity.

  12. Severe hydrocephalus complicated with benign paroxysmal positional vertigo: one case report

    Science.gov (United States)

    Chen, Jian Jun; Cheng, Wei Jin; Rao, Jie; Lu, Ye Fen; Qiu, Wei Wen

    2015-01-01

    In this study, we reported one female patient diagnosed with severe hydrocephalus who presented with benign paroxysmal positional vertigo (BPPV). She presented with progressive headache and dizziness prior to hospitalization as chief complaints. She received Diagnostic Dix-Hallpike and Roll tests to make a definite diagnosis. The patient was cured after Gufoni maneuver and did not recur after 6-month follow-up. The diagnostic procedures of this female case prompted that prior to formal treatment, patients developing severe hydrocephalus complicated with BPPV should receive provocative test for positional dizziness, performed by experienced physicians from the Department of neurology and otolaryngology. PMID:26885146

  13. Impact of postmaneuver sleep position on recurrence of benign paroxysmal positional vertigo.

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    Shufeng Li

    Full Text Available BACKGROUND: The necessity of postural restriction to patients suffering from benign paroxysmal positional vertigo is controversial. OBJECTIVE: To investigate the impact of the sleep position after the repositioning maneuver on BPPV recurrence. METHODS: 150 unilateral BPPV patients who were treated by repositioning maneuver were distributed into two groups. The patients in group A were instructed to sleep in a semi-sitting position at an angle of approximately 30 degrees and refrain from sleeping on their BPPV affected side for one week. The patients in group B were told to sleep in any preferred position. The comparison of recurrence rates according to different actual sleep positions in one week and one month was performed. RESULTS: There was a statistically significant correlation between the sleeping side and the side affected by BPPV. Without instructions on postural restriction, most patients (82.9%, 73/88 avoided sleeping on their affected side. The patients sleeping on their affected side had a higher recurrence rate (35.3% than ones sleeping in other positions in the first week after the repositioning maneuver (p<0.05, Chi-square test and Fisher's exact test. The patients sleeping randomly in following 3 weeks had a lower recurrence rate than ones sleeping in other position (p<0.05, Fisher's exact test. CONCLUSIONS: BPPV patients had a poor compliance to postural instructions. The habitual sleep side was associated with the side affected by BPPV. The patients sleeping on their affected side had a higher recurrence rate than those sleeping in other positions in first week after the repositioning maneuver.

  14. New Treatment Strategy for Apogeotropic Horizontal Canal Benign Paroxysmal Positional Vertigo

    Science.gov (United States)

    e Maia, Francisco Zuma

    2016-01-01

    The apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV) is attributed to canalithiasis of the anterior arm or cupulolithiasis. Despite some therapeutic maneuvers, I propose a new treatment strategy for apogeotropic HC-BPPV that is designed to detach both the otoconial debris from the anterior arm of the semicircular canal and the debris that is attached to the utricular side of the cupula using inertia and gravity and based on simulations with a 3D biomechanical model. PMID:27942374

  15. Application of DSA and ultrasonic blood rheography (Doppler) to benign paroxysmal positional vertigo

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    Fujita, Nobuya; Wada, Yoshiro; Suzumura, Shigeo; Matsunaga, Takashi (Nara Medical Univ., Kashihara (Japan))

    1990-03-01

    Fourteen cases of benign paroxysmal positional vertigo (BPPV) were studied with cervical circulation using DSA and Doppler. DSA study showed 7 abnormal cases out of 10 cases of BPPV. The abnormal findings included 5 cases of stenosis and 5 cases of coiling and kinking in cervical vertebral arteries. Doppler study showed that vertebral a. and also carotid a. had low volume and high laterality of cervical blood circulation in parameter of flow and velocity. These findings suggest the cervical circulation disorder was one of background factors in pathogenesis of BPPV. (author).

  16. Observation of curative effect of modified canalith reposition on 48 cases with benign paroxysmal positional vertigo

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    LAN Jun

    2012-02-01

    Full Text Available Objective To investigate the therapeutic efficacy of the canalith repositioning maneuver in benign paroxysmal positional vertigo (BPPV. Methods The modified Epley procedure, Semont maneuver and Barbecue maneuver were applied in 48 cases of BPPV. Followed for one year, the curative effects were observed. Results After treatment in modified canalith reposition, the recovery rate was 89.58% , and effective rate was 100% . Followed for one year, the recurrence rate was 6.25% . Conclusion Modified canalith reposition for BPPV has no contraindications, and no special adverse reactions. It is simple and can fastly relieve symptoms. The cost and recurrence rate are low. It is suitable for clinical application.

  17. Post-traumatic refractory multiple canal benign paroxysmal positional vertigo: a case report

    Science.gov (United States)

    Dundar, Mehmet Akif; Derin, Serhan; Aricigil, Mitat; Eryilmaz, Mehmet Akif; Arbag, Hamdi

    2016-01-01

    Benign paroxysmal positional vertigo (BPPV) is the most prevalent form of peripheral vertigo and is seen in a significant number of patients who present at neurology and ear, nose, and throat clinics. Various maneuvers may be used to determine the affected canal based on observation of specific nystagmus signs, and may also be used for treatment. Multiple canal pathology can make diagnosis and treatment more difficult. Presently described is case of BPPV with multiple canal pathology and traumatic etiology that was resistant to treatment. PMID:28275757

  18. New treatment strategy for apogeotropic horizontal canal benign paroxysmal positional vertigo

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    Francisco Zuma e Maia

    2016-11-01

    Full Text Available The apogeotropic variant of horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV is attributed to canalithiasis of the anterior arm or cupulolithiasis. Despite some therapeutic maneuvers, I propose a new treatment strategy for apogeotropic HCBPPV that is designed to detach both the otoconial debris from the anterior arm of the semicircular canal and the debris that is attached to the utricular side of the cupula using inertia and gravity and based on simulations with a 3D biomechanical model.

  19. Diagnosis dan Tatalaksana Benign Paroxysmal Positional Vertigo (BPPV Horizontal Berdasarkan Head Roll Test

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    Yan Edward

    2014-01-01

    Full Text Available AbstrakLatar belakang: Benign Paroxysmal Positional Vertigo (BPPV merupakan vertigo yang dicetuskan oleh perubahan posisi kepala atau badan terhadap gaya gravitasi. Diagnosis BPPV ditegakkan berdasarkan anamnesis dan manuver provokasi. Sering kali terjadi kesalahan dalam menegakkan diagnosis BPPV yang berakibat terhadap penatalaksanaan vertigo yang tidak adekuat. Tujuan: Untuk menjelaskan bagaimana diagnosis dan tatalaksana BPPV Kanalis Horizontal. Kasus: Seorang laki-laki berusia 56 tahun yang didiagnosis sebagai BPPV Kanalis Horizontal kiri tipe kanalolithiasis apogeotropik. Penatalaksanaan: Dilakukan barbeque maneuver terapi reposisi kanalith. Kesimpulan: Penatalaksanaan BPPV adalah berdasarkan lokasi kanal yang terlibat dengan terapi reposisi kanalith.Kata kunci: BPPV, kanalis horizontal, kanalolithiasis apogeotropik.AbstractBackground: Benign Paroxysmal Positional Vertigo (BPPV is vertigo that provoked by a position change of the head or body to the gravitation. The diagnosis of BPPV can be established by anamnesis and provocation maneuver. However, because BPPV frequently is misdiagnosed, it will implicate to an adequate therapeutic. Purposes: Explaining how to diagnose and manage a Horizontal Canal BPPV. Case : a man, 56 ages which diagnosed as a Left Horizontal Canal BPPV apogeotropic canalolithiasis type. Management: A barbeque maneuver was performed as canalith reposition treatment. Conclution: The management of BPPV is based on the involved canal with canalith repositioning treatment.Keywords: BPPV, horizontal canal, apogeotropic canalolithiasis.

  20. Therapeutic effect of Epley maneuver on patients with posterior semicircular canal in benign paroxysmal positional vertigo

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    Gholamali Dashti-Khadivaki

    2010-06-01

    Full Text Available Background: Benign paroxysmal positional vertigo (BPPV is characterized by brief attacks of vertigo, nausea and/or positional nystagmus during head movements. Epley maneuver is one of the therapeutic processes for these patients and had various results in different studies. The objective of this study was to determine the efficacy of this procedure on treatment of patients with BPPV.Material and Methods: This study was performed from January 2008 till September 2009 in otolaryngology clinic of Khatam teaching hospital in Zahedan. The study was conducted among 67 patients (38 female, 29 male with p-BPPV between the ages of 27 and 68 years old. Epley maneuver with restriction was performed for treatment after diagnosis of BPPV and one week later, results evaluated using the Dix-Hallpike test.Result: 92.5% of patients had positive response to this type of treatment. Conclusions: The study revealed good efficacy of Epley maneuver on patients with BPPV

  1. Apogeotropic Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo: Some Clinical and Therapeutic Considerations

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    Vannucchi, Paolo; Pecci, Rudi; Giannoni, Beatrice; Di Giustino, Fabio; Santimone, Rossana; Mengucci, Arianna

    2015-01-01

    We lately reported the cases of patients complaining positional vertigo whose nystagmic pattern was that of a peripheral torsional vertical positional down beating nystagmus originating from a lithiasis of the non-ampullary arm of the posterior semicircular canal (PSC). We considered this particular pathological picture the apogeotropic variant of PSC benign paroxysmal positional vertigo (BPPV). Since the description of the pilot cases we observed more than 150 patients showing the same clinical sign and course of symptoms. In this paper we describe, in detail, both nystagmus of apogeotropic PSC BPPV (A-PSC BPPV) and symptoms reported by patients trying to give a reasonable explanation for these clinical features. Moreover we developed two specific physical therapies directed to cure A-PSC BPPV. Preliminary results of these techniques are related. PMID:26557364

  2. Apogeotropic posterior semicircular canal benign paroxysmal positional vertigo: some clinical and therapeutic considerations

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    Paolo Vannucchi

    2015-03-01

    Full Text Available We lately reported the cases of patients complaining positional vertigo whose nystagmic pattern was that of a peripheral torsional vertical positional down beating nystagmus originating from a lithiasis of the non-ampullary arm of the posterior semicircular canal (PSC. We considered this particular pathological picture the apogeotropic variant of PSC benign paroxysmal positional vertigo (BPPV. Since the description of the pilot cases we observed more than 150 patients showing the same clinical sign and course of symptoms. In this paper we describe, in detail, both nystagmus of apogeotropic PSC BPPV (A-PSC BPPV and symptoms reported by patients trying to give a reasonable explanation for these clinical features. Moreover we developed two specific physical therapies directed to cure A-PSC BPPV. Preliminary results of these techniques are related.

  3. Efficacy of Epley maneuver in treatment of benign paroxysmal positional vertigo of the posterior semicircular canal

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    Babac Snežana

    2012-01-01

    Full Text Available Background/Aim. Benign paroxysmal positional vertigo is one of the most frequent peripheral vestibular system disorders. The aim of this study was to examine the efficacy of the Epley maneuver in treating benign paroxysmal positional vertigo of the posterior semicircular canal (p- BPPV and to discover possible causes of failure. Methods. This prospective study included 75 patients. In all the cases medical history showed and the positioning Dix-Hallpike test confirmed the diagnosis of p-BPPV. We also performed clinical ENT examination, searching for spontaneous nystagmus, vestibulospinal tests, caloric test, and audiometry. All the patients were treated by the modified Epley canalith repositioning maneuver. The patients were followed up at the intervals of seven and, fourteen days, and one, tree, and six months and one year. The maneuver was repeated if vertigo and nystagmus on control positioning test persisted. The transition from positive into negative Dix Hallpike test after one or two Epley maneuver was considered as success in treatment. Results. After the initial Epley maneuver the recovery rate was 90.7%, and after the second 96%. In three (4% patients with secondary p-BPPV, symptoms did not cease even after the second repositioning maneuver. The etiology of p-BPPV had a significant effect on the maneuver’s success rate (p < 0.01, whereas duration of symptoms, age and gender had no effect (p > 0.05. After a successful treatment 11 (14.66% patients had recurrent attack of BPPV during the first year. Conclusion. The Epley maneuver is very successful repositioning procedure in treating p- BPPV. The patients with idiopathic form p-BPPV showed higher success rate with Epley maneuver than those with secondary p-BPPV.

  4. Complications in implant surgery by Summer's technique: benign paroxysmal positional vertigo (BPPV).

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    Galli, M; Petracca, T; Minozzi, F; Gallottini, L

    2004-09-01

    The aim of this study is to show the correlation between implant surgery using an osteotomic technique and benign paroxysmal positional vertigo (BPPV). The case of a 55-year-old patient submitted to oral implant surgery in the 2.3 area is described. The ridge was thin in this particular location and therefore the maxillary expansion technique according to Summer was preferred. After removing the sutures, the patient suffered from vertigo and was in a confusional state. The patient was therefore placed in the Tredelenburg's position and a few minutes later he felt better. However, the symptomatology that seemed disappeared was present again the following day. A careful check-up showed the presence of BPPV, treated as described in this paper.

  5. Treatment of Horizontal Canal Benign Paroxysmal Positional Vertigo: A New Rehabilitation Technique

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    D. Testa

    2012-01-01

    Full Text Available The aim of this study was to evaluate the effectiveness of a new technical variant applied to the Gufoni's manoeuvre, in the treatment of horizontal canal benign paroxysmal positional vertigo (HSC-BPPV. 87 patients with BPPV of HSC (55 women and 32 men, aged between 21 and 80 years, were randomized either to modified Gufoni's manoeuvre or to the Gufoni's manoeuvre. 93% of patients treated with modified Gufoni's manoeuvre was cured after the first treatment session, of which only 2% had a conversion into PSC-BPPV, while the Gufoni's manoeuvre led to a symptoms resolution in 88% of cases, of which 16% had a conversion into PSC-BPPV. Therefore, the modified Gufoni's manoeuvre shows the same effectiveness in the resolution of symptoms of Gufoni's manoeuvre, but it appears more effective than the latter to reduce the percentage of conversion of the HSC-BPPV into PSC-BPPV (χ2=6.13, P=0.047.

  6. Efficacy of Applying Postural Restrictions after Epley Maneuver in Patients with Benign Paroxysmal Positional Vertigo

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    Gholamali Dashti-Khavidaki

    2014-01-01

    Full Text Available Background: The purpose of this study was to determine the efficacy of applying postural restrictions after Epley maneuver on therapeutic success in patients with BPPV (Benign Paroxysmal Positional Vertigo. Materials and Methods: This randomized controlled clinical trial study was conducted in among 118 patients with BPPV at Khatam-al-Anbia hospital in Zahedan. First group treated with postural restrictions and the second with no restrictions. After one week the presence of BPPV examined and data were analyzed. Results: In first group 84.7% did not show symptoms of vertigo, as well as 45 patients in second group. Results did not show any significant difference between two groups. Conclusion: This study showed that instructions had no significant effect on the patients’ treatment outcomes.

  7. Management of benign paroxysmal positional vertigo with the canalith repositioning maneuver in the emergency department setting.

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    Burmeister, David B; Sacco, Regina; Rupp, Valerie

    2010-10-01

    Vertigo is a common clinical manifestation in the emergency department (ED). It is important for physicians to determine if the peripheral cause of vertigo is benign paroxysmal positional vertigo (BPPV), a disorder accounting for 20% of all vertigo cases. However, the Dix-Hallpike test--the standard for BPPV diagnosis--is not common in the ED setting. If no central origin of the vertigo is determined, patients in the ED are typically treated with benzodiazepine, antihistamine, or anticholinergic agents. Studies have shown that these pharmaceutical treatment options may not be the best for patients with BPPV. The authors describe a case of a 38-year-old woman who presented to the ED with complaints of severe, sudden-onset vertigo. The patient's BPPV was diagnosed by means of a Dix-Hallpike test and the patient was acutely treated in the ED with physical therapy using the canalith repositioning maneuver.

  8. Enlarged vestibular aqueduct (EVA) related with recurrent benign paroxysmal positional vertigo (BPPV).

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    Manzari, Leonardo

    2008-01-01

    The vestibular aqueduct is a bony canal related to the bony labyrinth of the inner ear and represents the non-sensory components of the endolymph-filled, closed, membranous labyrinth. The association of congenital sensorineural hearing loss with a large or enlarged vestibular aqueduct is well known as the large vestibular aqueduct syndrome (LVAS). The enlarged VA (EVA) comprises abnormalities not only in the structure of the inner ear, but also in the physiology of the auditory and vestibular systems. The clinical picture of this clinical entity is variable [Yetiser S, Kertment M, Ozkaptan Y. Vestibular disturbance in patients with Large Vestibular Aqueduct Syndrome (LVAS). Acta Otolaryngol (StochK) 1999;119: 641-646]. Signs and symptoms of the auditory impairment are more commonly described in the literature: hearing loss ranges from mild to profound, arising from fluctuating to stepwise progressive or sudden. Vestibular disturbances, ranging from mild imbalance to episodic vertigo, are rarely described in the literature. Benign paroxysmal positional vertigo (BPPV) is a labyrinthine disorder with a typical behavior: intense crises of rotational vertigo induced by postural changes of the head, with short duration and usually good responsiveness to rehabilitative maneuvers. These maneuvers are effective in about 80% of patients with BPPV. BPPV often recurs. About 1/3 of patients have a recurrence in the first year after treatment, and by five years, about half of all patients have a recurrence. Vestibular aqueduct has been demonstrated by conventional tomography and computed tomography (CT), however, CT scans cannot show the membranous labyrinth itself. On MR images it is not the vestibular aqueduct that is visualized but its contents, the endolymphatic duct and sac, and can show the abnormalities of the fluid spaces related to the membranous labyrinth. It is proposed that recurrent benign paroxysmal positional vertigo (BPPV) is related with volumetric abnormalities

  9. Visual Suppression is Impaired in Spinocerebellar Ataxia Type 6 but Preserved in Benign Paroxysmal Positional Vertigo

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    Masahiko Kishi

    2012-10-01

    Full Text Available Positional vertigo is a common neurologic emergency and mostly the etiology is peripheral. However, central diseases may mimic peripheral positional vertigo at their initial presentation. We here describe the results of a visual suppression test in six patients with spinocerebellar ataxia type 6 (SCA6, a central positional vertigo, and nine patients with benign paroxysmal positional vertigo (BPPV, the major peripheral positional vertigo. As a result, the visual suppression value of both diseases differed significantly; e.g., 22.5% in SCA6 and 64.3% in BPPV (p < 0.001. There was a positive correlation between the visual suppression value and disease duration, cerebellar atrophy, and CAG repeat length of SCA6 but they were not statistically significant. In conclusion, the present study showed for the first time that visual suppression is impaired in SCA6, a central positional vertigo, but preserved in BPPV, the major peripheral positional vertigo, by directly comparing both groups. The abnormality in the SCA6 group presumably reflects dysfunction in the central visual fixation pathway at the cerebellar flocculus and nodulus. This simple test might aid differential diagnosis of peripheral and central positional vertigo at the earlier stage of disease.disease.

  10. Spontaneous nystagmus in benign paroxysmal positional vertigo: is it a new sign?

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    Fahimeh Hajiabolhassan

    2013-12-01

    Full Text Available Benign Paroxysmal Positional Vertigo (BPPV is a condition that indicates a benign inner ear disorder. It is generally believed that BPPV is due to the dislodged otoconial particles from otolith organs and unusual collection of them within any of semicircular canals or even in all three semicircular canals. Although the typical features of nystagmus in BPPV have been well-studied, very few studies (just four articles have highlighted the presence of spontaneous nystagmus in BPPV recently. During the past 10 years, 2850 patients have been examined at the audiology unit of our department, and 254 patients have received diagnoses of BPPV but recently 2 patients presented with BPPV and spontaneous nystagmus, a new symptom that has been never observed in our clinical records. We herein describe this rare symptom in 2 case of BPPV. A 50-year-old woman with BPPV who showed an 18 degree spontaneous nystagmus treated with Epley maneuver and a 53-year-old man with 3 degree spontaneous nystagmus.

  11. Benign paroxysmal positional vertigo: a study of two manoeuvres with and without betahistine.

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    Cavaliere, M; Mottola, G; Iemma, M

    2005-04-01

    Efficacy of the liberatory manoeuvre and of gradual otolitis dispersion technique, with or without associated drug therapy, have been compared. Included in this prospective study were 103 patients with benign paroxysmal positional vertigo seen in the Outpatient Department. Patients were classified into 4 groups according to treatment: Liberatory Manoeuvre according to methods described by Semont et al., with and without betahistine, Gradual Otolitis Dispersion Technique according to Brandt and Daroff, with and without betahistine. Evaluation was performed at baseline and at 3, 7, 14, 30, 60 and 90 days after start of treatment. Response to treatment was evaluated using criteria of Epley. At day 14, liberatory manoeuvre-betahistine and Brandt and Daroff-betahistine groups did significantly better than liberatory manoeuvre and Brandt and Daroff groups (p betahistine group; 96.30% (p > 0.05) in Brandt and Daroff-betahistine group; these results were significantly better (p or =60 years), response to treatment was similar. In conclusion, both liberatory manoeuvre and Brandt and Daroff, when associated with betahistine, were significantly more effective than manoeuvres alone (p betahistine group, in the initial phase, was greater that in Brandt and Daroff-betahistine group, albeit, differences were not significant (p > 0.05). Age-related effects of manoeuvres were compared in 71 patients or =60 years, showing a similar improvement rate at the end of the investigation in both groups. In our opinion, liberatory manoeuvre and Brandt and Daroff associated with betahistamine produces faster recovery compared to liberatory manoeuvre and Brandt and Daroff alone. Nevertheless, 3 months after onset of treatment, all patients showed complete recovery due to spontaneous evolution of paroxysmal positional vertigo, in other words, treatment does not appear to influence the final improvement rate and its role should be accepted as a significant reduction in persistence of symptoms.

  12. Epley's Maneuver in Benign Paroxysmal Positional Vertigo: Series of Cases Reports

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    Marchiori, Luciana Lozza de Moraes

    2011-04-01

    Full Text Available Introduction: Benign paroxysmal positional vertigo (BPPV is probably the most common cause of vertigo in women. Objective: To report the result of Epley's maneuver when treating BPPV patients. Method: Study of a series of 9-month-long cases of five female individuals aged between 46 and 64 with BPPV, who were submitted to Epley's maneuver at a scholar clinics, having the positive Dix-Hallpike maneuver at the first consultation as an inclusion criterion, and evaluations were repeated in a six and nine-month term. Results: Only one Epley's maneuver, as the only therapeutic procedure, was enough to eliminate nystagmus and positional vertigo in 4 patients, who did not show a positive Dix-Hallpike maneuver in the two reevaluations performed. Only one patient showed BPPV in the first reevaluation of the study term, and nystagmus reoccurred in the second evaluation only. Conclusion: Epley's repositioning maneuver proved to be a simple and effective BPPV treatment method for this study's patients at length.

  13. Quantitative analysis of benign paroxysmal positional vertigo fatigue under canalithiasis conditions.

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    Boselli, F; Kleiser, L; Bockisch, C J; Hegemann, S C A; Obrist, D

    2014-06-03

    In our daily life, small flows in the semicircular canals (SCCs) of the inner ear displace a sensory structure called the cupula which mediates the transduction of head angular velocities to afferent signals. We consider a dysfunction of the SCCs known as canalithiasis. Under this condition, small debris particles disturb the flow in the SCCs and can cause benign paroxysmal positional vertigo (BPPV), arguably the most common form of vertigo in humans. The diagnosis of BPPV is mainly based on the analysis of typical eye movements (positional nystagmus) following provocative head maneuvers that are known to lead to vertigo in BPPV patients. These eye movements are triggered by the vestibulo-ocular reflex, and their velocity provides an indirect measurement of the cupula displacement. An attenuation of the vertigo and the nystagmus is often observed when the provocative maneuver is repeated. This attenuation is known as BPPV fatigue. It was not quantitatively described so far, and the mechanisms causing it remain unknown. We quantify fatigue by eye velocity measurements and propose a fluid dynamic interpretation of our results based on a computational model for the fluid-particle dynamics of a SCC with canalithiasis. Our model suggests that the particles may not go back to their initial position after a first head maneuver such that a second head maneuver leads to different particle trajectories causing smaller cupula displacements.

  14. Natural history of horizontal canal benign paroxysmal positional vertigo is truly short.

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    Shim, Dae Bo; Ko, Kyung Min; Lee, Joon Hee; Park, Hong Ju; Song, Mee Hyun

    2015-01-01

    The objective of the study is to characterize the natural course of positional vertigo and nystagmus in patients with horizontal canal benign paroxysmal positional vertigo (h-BPPV) and to analyze the difference in the natural course between the two variants of h-BPPV. We conducted a prospective study in 106 patients with geotropic type h-BPPV [h-BPPV (Geo)] (n = 43) and apogeotropic type h-BPPV [h-BPPV (Apo)] (n = 63) who agreed and signed the written informed consent of no treatment. All patients were asked to answer a detailed interview about the onset time of positional vertigo and to visit the hospital every 1-3 days. At every visit, they were interviewed about cessation time of positional vertigo and positional nystagmus was assessed. The mean period ± SD between the onset and remission of vertigo in the h-BPPV (Geo) was 6.7 ± 6.3 days, whereas that in the h-BPPV (Apo) was 3.7 ± 4.1 days. In addition, the mean period ± SD from the initial diagnosis to the disappearance of positional nystagmus in the h-BPPV (Geo) was 4.7 ± 3.9 days, whereas that in the h-BPPV (Apo) was 4.4 ± 5.0 days. Although the duration until natural remission of positional nystagmus did not differ between the two variants of h-BPPV, the remission of vertigo occurred faster in h-BPPV (Apo) than h-BPPV (Geo) (p BPPV is much shorter than that indicated in previous reports. The positional vertigo disappeared faster in the h-BPPV (Apo) compared to the h-BPPV (Geo) unlike the positional nystagmus.

  15. The risk factors of acute attack of benign paroxysmal positional vertigo

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    Rabiei Sohrab

    2010-04-01

    Full Text Available ntroduction: Many people suffer from vertigo. Its origin in 85% of cases is otological while in 15% is central etiology. Benign paroxysmal positional vertigo (BPPV is the most common cause of the true vertigo. In this research we evaluated the risk factors of acute attack of BPPV. Materials and Methods: This study was performed on 322 patients, presenting with BPPV. Diagnosis was confirmed by history and Dix-Hallpike manoeuvre. The underling risk factors documented carefully. Data analyzed by SPSS and K.square test. Results: Number of 321 patients (including 201 females and 120 males with BPPV included in our study. Their average age was 41. They showed symptoms for 1 month to 15 years (mean 8 months. Emotional stress was positive in 34% and trauma was the only risk factor in 8.12% patients. Ear surgery and prolonged journey were respectively the main risk factors in 7.2 and 12.8% of patients. Conclusion: The confirmed risk factors of acute attack of BPPV were as trauma, major surgery and ear surgery especially stapedotomy, vestibular  neuronitis and prolonged bedrestriction. Meniere was not considered as risk factor. In our study the psychological conflict was the major risk factor for BPPV. Other new risk factors which introduced for first time included; sleep disorder, fatigue, professional sport, starving and prolonged journey.

  16. Horizontal canal benign paroxysmal positional vertigo: diagnosis and treatment of 37 patients

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    Eliana Teixeira Maranhão

    2015-06-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV, the most frequent cause of vertigo is associated with high morbidity in the elderly population. The most common form is linked to debris in the posterior semicircular canal. However, there has been an increasing number of reported BPPV cases involving the horizontal canals. The purpose of this article is to highlight the clinical features, diagnosis, and treatment in 37 patients with horizontal canal BPPV; twenty-six with geotropic nystagmus, and eleven with the apogeotropic form. Treatment consisted of the Gufoni manoeuver in eighteen patients (48.6%, the barbecue 360° maneuver in twelve patients (32.4%, both manoeuvers in four patients (10.8%, both manoeuvers plus head shaking in one patient (2.7%, and the Gufoni maneuver plus head shaking in two patients. Cupulolithiasis patients were asked to sleep in a forced prolonged position. We obtained a complete resolution of vertigo and nystagmus in 30 patients (81.0% on the initial visit.

  17. Benign Paroxysmal Positional Vertigo of Lateral Semicircular Canal: A Systematic Review and Meta-Analysis

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    Aly M. Nagy El-Makhzangy

    2015-01-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is the most common cause of vertigo of peripheral origin. The lateral semicircular canal (LSCC follows the posterior semicircular canal (PSCC as the site of pathology in the majority of patients. Therapy, aiming at relocating particles causing aberrant LSCC stimulation has been applied by forced prolonged positioning, barbecue, and particle repositioning maneuvers. Results of the different techniques are variable. This systematic review/meta-analysis aimed to find out which therapy technique yields higher cure rates. MedLine database provided at National Library of Medicine was searched for randomized controlled trials comparing results of different therapeutic techniques for patients with LSCC BPPV. For studies included in qualitative analysis/synthesis, the following were collected independently by the author: number of participants, count of patients with geotropic and apogeotropic LSCC in each treatment group, and resolution of vertigo/nystagmus assessed by symptomatic improvement and negative supine roll test 1–24 hours following intervention considering the type of LSCC BPPV (geotropic/apogeotropic. Level Ia evidence (systematic review of RCTs shows superiority of Gufoni maneuver over sham for both geotropic and apogeotropic LSCC BPPV. Comparisons between different therapeutic maneuvers for LSCC BPPV based on results of published RCTs could not be set.

  18. Hyperinsulinemia and hyperglycemia: risk factors for recurrence of benign paroxysmal positional vertigo

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    Guilherme Webster

    2015-08-01

    Full Text Available INTRODUCTION: Changes in carbohydrate metabolism may lead to recurrence of benign paroxysmal positional vertigo.OBJECTIVE: To evaluate the influence of the disturbance of carbohydrate metabolism in the recurrence of idiopathic BPPV.METHODS: A longitudinal prospective study of a cohort, with 41 months follow-up. We analyzed the results of 72 glucose-insulin curves in patients with recurrence of BPPV. The curves were classified into intolerance, hyperinsulinemia, hyperglycemia and normal.RESULTS: The RR for hyperinsulinism was 4.66 and p = 0.0015. Existing hyperglycemia showed an RR = 2.47, with p = 0.0123. Glucose intolerance had a RR of 0.63, with p = 0.096. When the examination was within normal limits, the result was RR = 0.2225 and p = 0.030.DISCUSSION: Metabolic changes can cause dizziness and vertigo and are very common in people who have cochleovestibular disorders. However, few studies discuss the relationship between idiopathic BPPV and alterations in carbohydrate metabolism. In the present study, we found that both hyperglycemia and hyperinsulinemia are risk factors for the recurrence of BPPV, whereas a normal test was considered a protective factor; all these were statistically significant. Glucose intolerance that was already present was not statistically significant in the group evaluated.CONCLUSION: Hyperinsulinemia and hyperglycemia are risk factors for the recurrence of idiopathic BPPV and a normal exam is considered a protective factor.

  19. Evaluation of vertebrobasilar artery changes in patients with benign paroxysmal positional vertigo.

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    Zhang, Daopei; Zhang, Shuling; Zhang, Hongtao; Xu, Yuming; Fu, Shengqi; Yu, Meng; Ji, Peng

    2013-09-11

    The aim of this study was to investigate vertebrobasilar artery (VBA) lesions in elderly patients with benign paroxysmal positional vertigo (BPPV) by magnetic resonance angiography. VBA lesions in patients older than 65 years of age with BPPV were prospectively investigated by magnetic resonance angiography. Vascular risk factors, blood vessel changes, and vertigo severity were recorded. Age-matched individuals without BPPV were included in the control group. Of 126 patients screened for this study, 104 were included. Relevant comorbidities included diabetes (12 patients), hypertension (23 patients), and dyslipidemia (20 patients). Findings included left or right vertebral artery (VA) stenosis or occlusion (22 patients, 21.2%), VA tortuosity (25 patients, 24.0%), VA dominance (20 patients, 19.2%), basilar artery (BA) stenosis or occlusion (nine patients, 8.6%), and BA tortuosity (12 patients, 11.5%). These abnormal vessels differed between BPPV patients and the control group (all PVertigo did not differ between the abnormal VA and abnormal BA groups (P>0.05), but did differ between the normal group and the abnormal VA or BA group (PVertigo severity correlated with VA stenosis or occlusion, VA dominance, and unilateral or bilateral VA tortuosity. VBA tortuosity and VA dominance were common in BPPV patients and may contribute toward BPPV.

  20. Benign paroxysmal positional vertigo simultaneously affecting several canals: a 46-patient series.

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    Soto-Varela, Andrés; Rossi-Izquierdo, Marcos; Santos-Pérez, Sofía

    2013-03-01

    Although it is uncommon for benign paroxysmal positional vertigo (BPPV) to affect more than one canal simultaneously, it is not exceptional. We attempt to determine whether these patients present differences relative to "single-canal" cases. A prospective study was done in patients with BPPV, divided into three groups: single-canal BPPV, multi-canal BPPV in one ear and multi-canal BPPV in both ears. Diagnosis was by Dix and Hallpike, supine roll and cephalic hyperextension tests. Treatment was according to the affected canals, by Semont, Epley, Lempert and Yacovino manoeuvres. Aetiology, sex, age, response to treatment, recurrence and final status in each of the three groups was evaluated. Five hundred and eighty-three patients were diagnosed with BPPV: 537 single-canal (92 %) and 46 multi-canal (8 %); of the latter, 36 bilateral and 10 unilateral cases. Basic differences between groups were: greater percentage of idiopathic cases in single-canal (p BPPV was more common in unilateral multi-canal (p = 0.006, Chi-square). No differences between groups in response to treatment, recurrence and final status were detected. There are aetiological differences between patients with single-canal BPPV, unilateral multi-canal BPPV and bilateral multi-canal BPPV. Response to therapeutic manoeuvres, however, shows that over 90 % of the patients in all the groups are cured.

  1. Influence of supplemental vitamin D on intensity of benign paroxysmal positional vertigo: A longitudinal clinical study

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    Sheikhzadeh, Mahboobeh; Lotfi, Yones; Mousavi, Abdollah; Heidari, Behzad; Monadi, Mohsen; Bakhshi, Enayatollah

    2016-01-01

    Background: Benign paroxysmal positional vertigo (BPPV) is linked to vitamin D deficiency. This clinical trial aimed to determine the influence of vitamin D supplementation on intensity of BPPV. Methods: The study population was selected consecutively and the diagnosis of BPPV was made by history and clinical examination and exclusion of other conditions. Intensity of BPVV was assessed based on VAS score (0-10). Serum 25-hydroxyvitamin D (25-OHD) was measured using ELISA method and levels BPPV decreased significantly as compared with control (P=0.001 for both groups) but at endpoint, the intensity of BPPV aggravated and regressed to the baseline value in vitamin D deficient non-treated group (P=0.001) whereas, in vitamin D treated group, improvement of BPPV remained stable and unchanged over the study period. Conclusion: This study indicates that correction of vitamin D deficiency in BPPV provides additional benefit to rehabilitation therapy (Epley maneuver) regarding duration of improvement. These findings suggest serum 25-OHD measurement in recurrent BPPV. PMID:27386060

  2. Image-based computer-assisted diagnosis system for benign paroxysmal positional vertigo

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    Kohigashi, Satoru; Nakamae, Koji; Fujioka, Hiromu

    2005-04-01

    We develop the image based computer assisted diagnosis system for benign paroxysmal positional vertigo (BPPV) that consists of the balance control system simulator, the 3D eye movement simulator, and the extraction method of nystagmus response directly from an eye movement image sequence. In the system, the causes and conditions of BPPV are estimated by searching the database for record matching with the nystagmus response for the observed eye image sequence of the patient with BPPV. The database includes the nystagmus responses for simulated eye movement sequences. The eye movement velocity is obtained by using the balance control system simulator that allows us to simulate BPPV under various conditions such as canalithiasis, cupulolithiasis, number of otoconia, otoconium size, and so on. Then the eye movement image sequence is displayed on the CRT by the 3D eye movement simulator. The nystagmus responses are extracted from the image sequence by the proposed method and are stored in the database. In order to enhance the diagnosis accuracy, the nystagmus response for a newly simulated sequence is matched with that for the observed sequence. From the matched simulation conditions, the causes and conditions of BPPV are estimated. We apply our image based computer assisted diagnosis system to two real eye movement image sequences for patients with BPPV to show its validity.

  3. Impaired mental rotation in benign paroxysmal positional vertigo and acute vestibular neuritis.

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    Matteo eCandidi

    2013-11-01

    Full Text Available Vestibular processing is fundamental to our sense of orientation in space which is a core aspect of the representation of the self. Vestibular information is processed in a large subcortical-cortical neural network. Tasks requiring mental rotations of human bodies in space are known to activate neural regions within this network suggesting that vestibular processing is involved in the control of mental rotation. We studied whether mental rotation is impaired in patients suffering from two different forms of unilateral vestibular disorders (Vestibular Neuritis – VN- and Benign Paroxysmal positional Vertigo – BPPV with respect to healthy matched controls (C. We used two mental rotation tasks in which participants were required to: i mentally rotate their own body in space (egocentric rotation thus using vestibular processing to a large extent and ii mentally rotate human figures (allocentric rotation thus using own body representations to a smaller degree. Reaction times and accuracy of responses showed that VN and BPPV patients were impaired in both tasks with respect to C. Significantly, the pattern of results was similar in the three groups suggesting that patients were actually performing the mental rotation without using a different strategy from the control individuals. These results show that dysfunctional vestibular inflow impairs mental rotation of both own body and human figures suggesting that unilateral acute disorders of the peripheral vestibular input massively affect the cerebral processes underlying mental rotations.

  4. Variables Affecting Canalith Repositioning Maneuver (CRM Trend for Treating Patients with Benign Paroxysmal Positional Vertigo (BPPV

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    E. Entezari

    2006-07-01

    Full Text Available Background: The purpose of this study was to identify variables affecting outcome in patients with benign paroxysmal positional vertigo (BPPV treated with canalith repositioning maneuver (CRM. Methods: This interventional study was conducted on 58 patients (14 males, 44 females, mean age 48.12+13.22 referred to the Vertigo Rehabilitation Clinic of the Rehabilitation School of Tehran University of Medical Sciences from 2002 to 2004. All patients were treated with CRM. According to the treatment efficacy the patients were allocated in three groups: completely treated, partially treated, and not treated. The effect of factors including age, sex, etiology, duration of BPPV, unilateral or bilateral disease, number of maneuvers, and number of sessions on outcome in patients was evaluated. Results: Forty-nine patients (84.5% were completely cured. Age, sex, etiology, and duration did not significantly affect the treatment outcome. Unilateral BPPV can be treated significantly better than bilateral BPPV. Forty-seven patients who were completely treated needed 1 session and thirty-seven of them required 2 maneuvers. Conclusion: CRM is significantly effective for BPPV treatment. Treating unilateral BPPV is expected to be easier. As most of the patients will be cured by 1 or 2 maneuvers or in 1 session, patients who required more sessions or more maneuvers may not be completely treated.

  5. Benign Paroxysmal Positional Vertigo Following Sinus Floor Elevation in Patient with Antecedents of Vertigo.

    Science.gov (United States)

    Akcay, Huseyin; Ulu, Murat; Kelebek, Seyfi; Aladag, Ibrahim

    2016-07-01

    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. Upon further questioning after the procedure she gave an account of two times vertigo history within the last 9 years. Despite nootropic drug medication and canalith repositioning procedure applied by a specialist at operation night, the condition did not improve. Patient did not totally recover and was admitted again after 1 month. After repeated maneuvers, nine dosage intravenous serous fluid and piracetam administration the patient recovered. Duration of these procedures took 10 days and the patient was successfully treated with no recurrence of dizziness. Prevention and management of OSFE related BPPV are reviewed especially in patients having prior vertigo history in this report.

  6. Physical Activity in the Prevention of Benign Paroxysmal Positional Vertigo: Probable Association

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    Bazoni, Jéssica Aparecida

    2014-08-01

    Full Text Available Introduction Physical inactivity is an important risk factor for many age-related diseases and symptoms such as dizziness and vertigo. Objective The aim of the study was to investigate the possible association between benign paroxysmal positional vertigo (BPPV and regular physical activity in elderly subjects. Methods This cross-sectional study included 491 elderly individuals who lived independently. Physical exercise was assessed through a questionnaire and BPPV by history and the Dix-Hallpike maneuver. Results The present study indicates no significant association between BPPV with lack of physical activity in men and in the total population. We have confirmed associations between BPPV with lack of physical activity in women (p = 0.01. Women with a sedentary lifestyle who do not practice physical activity are 2.62 more likely to have BPPV than those with regular physical activity. Conclusion These results highlight the importance of identifying risk factors for BPPV that can be modified through specific interventions. Regular physical activity is a lifestyle with potential to decrease the risk of vertigo in women.

  7. Quick repositioning maneuver for horizontal semicircular canal benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    Jinrang Li; Pengfei Guo; Shiyu Tian; Keliang Li; Hao Zhang

    2015-01-01

    Objective:To investigate the efficacy of quick repositioning maneuver for horizontal semicircular canal benign paroxysmal positional vertigo (H-BPPV). Methods:Clinical data of 67 patients with H-BPPV who underwent quick repositioning maneuver in our hospital from July 2009 to November 2014 were retrospectively analyzed. The maneuver involved rotating the patient in the axial plane for 180? from the involved side towards contralateral side as quickly as possible. Results:Complete symptom resolution was achieved in 61 patients (91.0%) at one week and in 64 patients (95.5%) at 3 months post-treatment. During the repositioning maneuver process, there were no obvious untoward responses except transient nausea with or without vomiting in a few patients. Conclusion:The results indicate that the quick repositioning maneuver is an easy and effective alternative treatment in the management of H-BPPV. Copyright © 2015 The Authors. Production & hosting by Elsevier (Singapore) Pte Ltd On behalf of PLA General Hospital Department of Otolaryngology Head and Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  8. [Evaluation of the treatment of benign paroxysmal positional vertigo with the DHI-S questionnaire].

    Science.gov (United States)

    López-Escámez, J A; Gómez Fiñana, M; Fernández, A; Sánchez Canet, I; Palma, M J; Rodríguez, J

    2001-01-01

    Benign paroxysmal positional vertigo (BPPV) is a recurrent chronic disease and its handicap is usually underestimated. The aim of this study is to determine the impact of the treatment by Epley maneuver on short-term BPPV-related quality of life. Forty-two individuals with BPPV were included: 39 with posterior canal affected, 2 with the lateral canal and one with the anterior canal. Diagnosis was established if a consistent clinical history was found and Dix-Hallpike test (DHT) in cases with canal posterior involvement. Subjects with positive DHT were treated by a single Epley maneuver and were recommended to avoid supine for the next 48 hours. The BPPV relapses were investigated at 7th and 30th day post-treatment. BPPV-associated quality of life was evaluated by the Dizzness Handicap Inventory Short-form (DHI-S) at days 1st and 30th post-treatment. Total and partial scores for emotional, physical and functional subscales were compared by Wilcoxon test for paired samples. Dix-Hallpike test was found positive in el 59% individuals (23/39), and 41% cases did not required any treatment. Among 23 patients treated with Epley maneuver, DHT was found negative in 90% at 30th day follow-up. Mean and standard deviation of the total scores obtained in the DHI-S at the first day were 19.22 +/- 9.66 in the DHT positive-patients and 19.79 +/- 10.14 in the whole group (DHT positive or negative). These scores significantly decreased to 10.84 +/- 10.99 at 30 days post-treatment (p = 0.002 and p = 0.001, respectively). In conclusion, the DHI-S is a specific health questionnaire able to assess BPPV-related health and the effectiveness of treatment.

  9. Delayed diagnosis and treatment of benign paroxysmal positional vertigo associated with current practice.

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    Wang, Hui; Yu, Dongzhen; Song, Ningying; Su, Kaiming; Yin, Shankai

    2014-02-01

    The purposes of this study were to demonstrate the current status of benign paroxysmal positional vertigo (BPPV) management and the advantages of repositioning maneuvers as well as to facilitate the accurate and efficient diagnosis and management of BPPV. Of 131 participants with severe dizziness/vertigo who were examined and treated, 31 (23.7%) fulfilled the diagnostic criteria for BPPV. All patients in the study had a diagnosis of BPPV confirmed by their history, typical subjective symptom reports, and characteristic positional nystagmus during the Dix-Hallpike test and/or roll test. All participants were comprehensively interviewed regarding their medical history, characteristics of the first attack of vertigo, associated symptoms, previous financial costs, and number of hospital visits. The average duration from the appearance of the first symptoms until a final diagnostic positional maneuver was >70 months. On average, patients visited hospitals more than eight times before the final diagnosis due to initial visits to inappropriate departments, including neurology, emergency, orthopaedic surgery, and Traditional Chinese Medicine, with a corresponding average financial cost of more than 5,000 RMB. The canalith repositioning procedure (CRP) was effective in 80.65% of patients after the first repositioning maneuver. Our data demonstrated that despite the significant prevalence of BPPV, delays in diagnosis and treatment frequently occur, which have both cost and quality-of-life impacts on both patients and their caregivers. The CRP is very effective for patients with BPPV. It is important for patients to pay more attention to the impact of BPPV on their lives and recognize its nature to ensure compliant follow-up in otolaryngology.

  10. Residual dizziness after successful repositioning maneuvers for idiopathic benign paroxysmal positional vertigo in the elderly.

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    Teggi, Roberto; Giordano, Leone; Bondi, Stefano; Fabiano, Beatrice; Bussi, Mario

    2011-04-01

    Even after successful repositioning maneuvers for benign paroxysmal positional vertigo (BPPV), some patients report dizziness lasting for a certain period afterwards. We studied the prevalence and clinical factors associated with residual dizziness in a sample of elderly patients. Sixty outpatients over 65 years of age, affected by idiopathic BPPV were recruited; the exclusion criterion was a history of previous episodes of vertigo, including positional. The patients were asked to describe their self-perceived anxiety for vertigo on a Visual Analogue Scale (VAS) and successively treated with appropriate maneuvers till resolution of nystagmus. Data concerning the demographic and clinical features of BPPV were collected. Patients were followed until complete resolution of subjective dizziness and imbalance without positional nystagmus. Data about residual dizziness were collected from the second day from resolution of BPPV. Clinical and demographic factors related to residual dizziness were analyzed. Twenty-two subjects (37%) reported residual dizziness. In these subjects, the mean duration of residual dizziness was 13.4 ± 7.5 days. No association was observed between residual dizziness and gender, involved canal and the number of repositioning maneuvers before resolution. On the other hand, age older than 72 years, symptom duration greater than 9 days and VAS scale for anxiety greater than 10/100 were associated with an increased risk of residual dizziness. The odds ratio were respectively 6.5 (age-residual dizziness, Confidence Interval 95%), 6.5 (duration of vertigo-residual dizziness, Confidence Interval 95%) and 15.5 (anxiety levels-residual dizziness, Confidence Interval 95%). Longer symptom duration before diagnosis was associated with higher anxiety levels. The results underline the necessity for an early and correct diagnosis of BPPV, especially in the elderly.

  11. Benign positional vertigo - aftercare

    Science.gov (United States)

    Vertigo - positional - aftercare; Benign paroxysmal positional vertigo - aftercare; BPPV - aftercare; Dizziness - positional vertigo ... Your health care provider may have treated your vertigo with the Epley maneuver . These are head movements ...

  12. Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver

    OpenAIRE

    Silva, Camila Nicácio da; Ribeiro, Karyna Myrelly O. B. de Figueiredo; Freitas, Raysa Vanessa de Medeiros; Ferreira, Lidiane Maria de Britho Macedo; Guerra, Ricardo Oliveira

    2016-01-01

    Introduction Benign Paroxysmal Positional Vertigo (BPPV) is one of themost common and treatable causes of peripheral vestibular vertigo in adults. Its incidence increases with age, eventually leading to disability and a decreased quality of life. Objective The research aims to assess short-term effects of Otolith Repositioning Maneuver (ORM) on dizziness symptoms, quality of life, and postural balance in elderly people with Benign Paroxysmal Positional Vertigo. Methods A quasi-experiment...

  13. The Clinical Utility of Vestibular Evoked Myogenic Potentials in Patients of Benign Paroxysmal Positional Vertigo

    Science.gov (United States)

    Sreenivasan, Anuprasad; Parida, Pradiptata Kumar; Alexander, Arun; Saxena, Sunil Kumar; Suria, Gopalakrishnan

    2015-01-01

    Context Vestibular Evoked Myogenic Potentials (VEMP) is an emerging tool to diagnose Benign Paroxysmal Positional Vertigo (BPPV). The clinical utility of VEMP has been reported only in small accord in Indian literature. Aim To study the latency and amplitude of VEMP in patients with BPPV and compare it with that of normal subjects. Settings and Design The study included two groups. Group one (control group) were 18 normal subjects. Group two (test group) were 15 subjects with unilateral BPPV. Materials and Methods Those subjects who fulfilled the selection criteria based on case history and audiological assessment were taken for the VEMP recording. The VEMP response consist of positive and negative successive waves (pI-nI), with latency values in adults about 13 and 23 milliseconds respectively. Statistical Analysis Data was analysed using Statistical Package for Social Sciences (SPSS) version 12 (Chicago, IL, USA). Unpaired t-test was employed to measure the statistical difference between control group and test group. Results The difference in n23 and the peak to peak amplitude between the ipsilateral and contralateral ears of the test group were statistically significant, whereas such a difference in the p13 latency turned out to be statistically insignificant. It should be noted that, out of 15 patients in the test group, five patients showed only artifact tracer recordings in both the ears which is considered as no response. The heterogeneity of the results extended from absence of VEMP to prolongation of both p13, n23; prolongation of p13 alone; and even side to side variations. Conclusion Absent response from the ipsilateral ear, prolonged latency of n23 and decreased peak to peak amplitude (p13, n23), indicates the disease pathology. However, large sample size is required to draw further conclusions and to consolidate the usage of VEMP in the diagnosis of BPPV. PMID:26266140

  14. Diagnosis of Single- or Multiple-Canal Benign Paroxysmal Positional Vertigo according to the Type of Nystagmus

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    Dimitris G. Balatsouras

    2011-01-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a common peripheral vestibular disorder encountered in primary care and specialist otolaryngology and neurology clinics. It is associated with a characteristic paroxysmal positional nystagmus, which can be elicited with specific diagnostic positional maneuvers, such as the Dix-Hallpike test and the supine roll test. Current clinical research focused on diagnosing and treating various types of BPPV, according to the semicircular canal involved and according to the implicated pathogenetic mechanism. Cases of multiple-canal BPPV have been specifically investigated because until recently these were resistant to treatment with standard canalith repositioning procedures. Probably, the most significant factor in diagnosis of the type of BPPV is observation of the provoked nystagmus, during the diagnostic positional maneuvers. We describe in detail the various types of nystagmus, according to the canals involved, which are the keypoint to accurate diagnosis.

  15. The Effect of Vestibular Rehabilitation in the Treatment of Elderly Patients with Benign Paroxysmal Positional Vertigo

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    N. Saki

    2011-04-01

    Full Text Available Introduction & Objective: Vertigo in the elderly is relatively common, but only a few studies are available. Vestibular rehabilitation (VR therapy is an important therapeutic option in treating patients with significant balance deficits. The purpose of this study was to analyze the effect of vestibular rehabilitation on vertigo symptoms in elderly patients with benign paroxysmal positional vertigo (BPPV. Materials & Methods: In a cross sectional analytic design, 46 patients older than 60 years (aged 61 to 72 years with BPPV who referred to the ENT center of Imam Khomeini Hospital, Ahwaz, were studied. After an otologic evaluation, videonystagmography and dizziness handicap inventory (DHI evaluations were performed for each case. Then, vestibular rehabilitation (VR therapy was carried out by means of Epley maneuver. Efficacy of a VRT was tested by comparing pre-treatment with post-treatment VNG and DHI assessments. The data were analyzed by SPSS 16 software. Results: The average age of the patients was 67.28 ± 4.5 years. VR caused normal Hallpike findings in 31 (67.4 % and noticeable reduction in nystagmus amplitudes in 9 patients. We found a significant correlation between nystagmus amplitudes and DHI scores (r=0.77. The mean DHI scores decreased from 53.26±16.12 points to 15.36±9.23 points (p<0.001 at the end of the treatment course. Conclusion: Our investigation revealed that VR plays an important role in reducing vertigo in at-risk elderly patients. Lack of appropriate treatment in this population may cause a serious balance problem (such as bone fracture and long-term handicap that may interfere with their daily activities. (Sci J Hamadan Univ Med Sci 2011;18(1:33-36

  16. Vestibular evoked myogenic potentials and digital vectoelectronystagmography's study in patients with benign paroxysmal positional vertigo

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    Lira-Batista, Marta Maria da Silva

    2013-04-01

    Full Text Available Introduction: Benign Paroxysmal Positional Vertigo (BPPV is a very common vestibular disorder characterized by brief but intense attacks of rotatory vertigo triggered by simple rapid movement of the head. The integrity of the vestibular pathways can be assessed using tests such as digital vectoelectronystagmography (VENG and vestibular evoked myogenic potentials (VEMP. Aim: This study aimed to determine the VEMP findings with respect to latency, amplitude, and waveform peak to peak and the results of the oculomotor and vestibular components of VENG in patients with BPPV. Method: Although this otoneurological condition is quite common, little is known of the associated VEMP and VENG changes, making it important to research and describe these results. Results: We examined the records of 4438 patients and selected 35 charts after applying the inclusion and exclusion criteria. Of these, 26 patients were women and 9 men. The average age at diagnosis was 52.7 years, and the most prevalent physiological cause, accounting for 97.3% of cases, was ductolithiasis. There was a statistically significant association between normal hearing and mild contralateral sensorineural hearing loss. The results of the oculomotor tests were within the normal reference ranges for all subjects. Patients with BPPV exhibited symmetrical function of the semicircular canals in their synergistic pairs (p < 0.001. The caloric test showed statistically normal responses from the lateral canals. The waveforms of all patients were adequate, but the VEMP results for the data-crossing maneuver with positive positioning showed a trend toward a relationship for the left ear Lp13. There was also a trend towards an association between normal reflexes in the caloric test and the inter-peak VEMP of the left ear. It can be concluded that although there are some differences between the average levels of the VENG and VEMP results, these differences were not statistically significant

  17. Benign Paroxysmal Positional Vertigo after Dental Procedures: A Population-Based Case-Control Study

    Science.gov (United States)

    Lin, Yueh-Wen; Sung, Pi-Yu; Chuang, Hsun-Yang; Liao, Wen-Ling

    2016-01-01

    Background Benign paroxysmal positional vertigo (BPPV), the most common type of vertigo in the general population, is thought to be caused by dislodgement of otoliths from otolithic organs into the semicircular canals. In most cases, however, the cause behind the otolith dislodgement is unknown. Dental procedures, one of the most common medical treatments, are considered to be a possible cause of BPPV, although this has yet to be proven. This study is the first nationwide population-based case-control study conducted to investigate the correlation between BPPV and dental manipulation. Methods Patients diagnosed with BPPV between January 1, 2007 and December 31, 2012 were recruited from the National Health Insurance Research Database in Taiwan. We further identified those who had undergone dental procedures within 1 month and within 3 months before the first diagnosis date of BPPV. We also identified the comorbidities of the patients with BPPV, including head trauma, osteoporosis, migraine, hypertension, diabetes, hyperlipidemia and stroke. These variables were then compared to those in age- and gender-matched controls. Results In total, 768 patients with BPPV and 1536 age- and gender-matched controls were recruited. In the BPPV group, 9.2% of the patients had undergone dental procedures within 1 month before the diagnosis of BPPV. In contrast, only 5.5% of the controls had undergone dental treatment within 1 month before the date at which they were identified (P = 0.001). After adjustments for demographic factors and comorbidities, recent exposure to dental procedures was positively associated with BPPV (adjusted odds ratio 1.77; 95% confidence interval 1.27–2.47). This association was still significant if we expanded the time period from 1 month to 3 months (adjusted odds ratio 1.77; 95% confidence interval 1.39–2.26). Conclusions Our results demonstrated a correlation between dental procedures and BPPV. The specialists who treat patients with BPPV should

  18. Benign Paroxysmal Positional Vertigo after Dental Procedures: A Population-Based Case-Control Study.

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    Tzu-Pu Chang

    Full Text Available Benign paroxysmal positional vertigo (BPPV, the most common type of vertigo in the general population, is thought to be caused by dislodgement of otoliths from otolithic organs into the semicircular canals. In most cases, however, the cause behind the otolith dislodgement is unknown. Dental procedures, one of the most common medical treatments, are considered to be a possible cause of BPPV, although this has yet to be proven. This study is the first nationwide population-based case-control study conducted to investigate the correlation between BPPV and dental manipulation.Patients diagnosed with BPPV between January 1, 2007 and December 31, 2012 were recruited from the National Health Insurance Research Database in Taiwan. We further identified those who had undergone dental procedures within 1 month and within 3 months before the first diagnosis date of BPPV. We also identified the comorbidities of the patients with BPPV, including head trauma, osteoporosis, migraine, hypertension, diabetes, hyperlipidemia and stroke. These variables were then compared to those in age- and gender-matched controls.In total, 768 patients with BPPV and 1536 age- and gender-matched controls were recruited. In the BPPV group, 9.2% of the patients had undergone dental procedures within 1 month before the diagnosis of BPPV. In contrast, only 5.5% of the controls had undergone dental treatment within 1 month before the date at which they were identified (P = 0.001. After adjustments for demographic factors and comorbidities, recent exposure to dental procedures was positively associated with BPPV (adjusted odds ratio 1.77; 95% confidence interval 1.27-2.47. This association was still significant if we expanded the time period from 1 month to 3 months (adjusted odds ratio 1.77; 95% confidence interval 1.39-2.26.Our results demonstrated a correlation between dental procedures and BPPV. The specialists who treat patients with BPPV should consider dental procedures to be a

  19. Bilateral posterior semi-circular canal obliteration surgery for refractory benign paroxysmal positional vertigo (BPPV) in three patients.

    Science.gov (United States)

    Das, Sudip; Rea, Peter A

    2016-02-15

    Benign paroxysmal positional vertigo (BPPV) is a common cause of peripheral vestibular disorder(1) characterised by a short lasting rotatory vertigo triggered by movement of the head. Unilateral posterior canal plugging has become an accepted, if uncommonly used, method of treating intractable cases. However there is very limited experience of bilateral posterior canal plugging. When the current series of cases began, there were no cases reported in the literature. Two small series have since been reported from America and Australia.(2,3) This is the first published UK series to our knowledge. This article is protected by copyright. All rights reserved.

  20. Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo Presenting with Torsional Downbeating Nystagmus: An Apogeotropic Variant

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    Paolo Vannucchi

    2012-01-01

    Full Text Available The aim of this study is to verify the hypothesis that free-floating particles could sometimes localize into the distal portion of the non ampullary arm of the posterior semicircular canal (PSC so that assuming the Dix-Hallpike’s positions, the clot could move towards the ampulla eliciting a inhibitory torsional-down beating paroxysmal positional nystagmus (PPNy, instead of typical excitatory torsional-up beating PPNy. Among 45 patients with vestibular signs suggesting anterior semicircular canal paroxysmal positional vertigo (PPV, collected from February 2003 to August 2006, we detected a group of 6 subjects whose clinical findings showed a singular behaviour during follow-up. At the first check-up, all patients were submitted to different types of physical manoeuvres for ASC canalolithiasis. Patients were controlled during the same session and after one week. When we found that nystagmus was qualitatively changed we adopted the appropriate physical therapies for that sign. At a next check-up, after having performed some physical therapies, all patients had a typical PSC PPNy of the opposite side, with respect to that of the ASC initially diagnosed. Basing on these observations we conclude that PSC PPV, similarly to lateral semicircular canal PPV, could manifests in a apogeotropic variant.

  1. Positive to Negative” Dix-Hallpike test and Benign Paroxysmal Positional Vertigo recurrence in elderly undergoing Canalith Repositioning Maneuver and Vestibular Rehabilitation

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    Ribeiro, Karyna M. O. B. de Figueiredo

    2016-02-01

    Full Text Available 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. Methods In this randomized controlled trial, 7 older adults (median age: 69 years, range 65–78 underwent Canalith Repositioning Maneuver and Vestibular Rehabilitation for thirteen weeks. Seven older adults (median age: 73 years, range 65–76 in the control group received only Canalith Repositioning Maneuver. The participants were assessed at baseline (T0, one (T1, five (T5, nine (T9, and thirteen weeks (T13. We assessed the differences between the groups by Mann-Whitney and Fisher exact tests, and used the Friedman and Wilcoxon tests to determine the intragroup differences. Results No significant differences were found between groups for the positive to negative Dix-Hallpike test, recurrence, and number of maneuvers to achieve a negative test. The number of maneuvers to achieve negative Dix-Hallpike test was lower in intragroup comparisons in the experimental group. Conclusion The findings suggest that additional Vestibular Rehabilitation did not influence the positive to negative Dix-Hallpike test, recurrence, or number of maneuvers to achieve a negative test in elderly patients with chronic Benign Paroxysmal Positional Vertigo.

  2. The effect of serum vitamin D normalization in preventing recurrences of benign paroxysmal positional vertigo: A case-control study

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    Sheikhzadeh, Mahboobeh; Lotfi, Yones; Mousavi, Abdollah; Heidari, Behzad; Bakhshi, Enyatollah

    2016-01-01

    Background: Benign paroxysmal positional vertigo (BPPV) is a condition with recurrent attacks in a significant proportion of patients. The present case- control study was conducted to assess the influence of serum vitamin D normalization on recurrent attacks of vitamin D deficient patients. Methods: Diagnosis of BPPV was made based on history and clinical examination and exclusion of other conditions. Serum 25-hydroxy vitamin D (25-OHD) was measured using ELISA method and a levels of BPPV in the treatment group decreased significantly compared with the control group (14.8% vs 96.3% OR= 0.18, P=0.001). Conclusion: The findings of this study indicate that the normalization of serum vitamin D significantly reduces BPPV recurrences. PMID:27757201

  3. Benign paroxysmal torticollis in infancy

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    Dimitrijević Lidija

    2006-01-01

    Full Text Available Background. Benign paroxysmal torticollis (BPT is an episodic functional disorder of unknown etiology, characterized by the periods of torticollic posturing of the head, that occurs in the early months of life in healthy children. Case report. We reported two patients with BPT. In the first patient the symptoms were observed at the age of day 20, and disappeared at the age of 3 years. There were 10 episodes, of which 2 were followed by vomiting, pallor, irritability and the abnormal trunk posture. In the second patient, a 12-month-old girl, BPT started from day 15. She had 4 episodes followed by vomiting in the first year. Both girls had the normal psychomotor development. All diagnostical tests were normal. Conclusion. The recognition of BPT, as well as its clinical course may help to avoid not only unnecessary tests and the treatment, but also the anxiety of the parents.

  4. Single Treatment Approaches to Benign paroxysmal Positional Vertigo, Is It Enough?

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    Ahmed Abdel-Bassit* , Mohammed Elsaid

    2005-06-01

    Full Text Available Bening paroxysmal positional vertigo (B.P.P.V is one of the most common vestibular disorders.During the last years, it has been attributed to cupulolithiasis or canalithiasis of the posterior semicircular canal.This randomized study was done to determine the effectiveness of two different physical therapy approaches and to determine if a single treatment approaches is enough.In this prospective study 80 patients received either a single treatment based on the hypothesis that the vertigo and nystagmus of (B.P.P.V are due to debris adhering to the cupula of posterior semicircular canal (cupulolithiasis, Semont maneuver, or a single treatment based on the hypothesis that the debris is free floating in the long arm of the posterior semicircular canal (canalithiasis, Epley maneuver.Treatment outcome was classified as asymptomatic, improved and no change. Analysis of the results of this study revealed that at the end of the first session , out of 80 patients, 60(75% were asymptomatic ; 14(18% improved ;6(7% showed no change. Follow­up showed that 8 patients developed recurrence. After a second session to 22 patients (8 recurrences, 10 improved, 4 had no change ,17 became asymptomatic.This means that at the end of the seconed session ,69 (86% of 80 patients became asymptomatic ; 9(11% of 80 patients improved ; 2(3% of 80 patients showed no change. In conclusion , this study shows that 1 The success rate of Semont's maneuver was up to 80%, so it is much better than Epley maneuver 70% after the first session. 2Recurrent cases are best treated with second session.

  5. 良性阵发性位置性眩晕发病率及发病机制新进展%Advances in research on morbidity and mechanism of benign paroxysmal positional vertigo

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    时美娟; 孟晴; 吕哲; 路虹

    2016-01-01

    Benign paroxysmal positional vertigo is becoming increasingly familiar with clinicians. Advanced in stud-ies on the morbidity and mechanism of benign paroxysmal positional vertigo will be reviewed in this paper.%良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)作为周围性眩晕发病率最高的病种已为越来越多的临床医生所熟悉,本文将BPPV的发病率及发病机制最新研究进展予以综述。

  6. Investigating the role of Sirt1-modulated oxidative stress in relation to benign paroxysmal positional vertigo and Parkinson's disease.

    Science.gov (United States)

    Tsai, Kun-Ling; Cheng, Yuan-Yang; Leu, Hsin-Bang; Lee, Yi-Yen; Chen, Tzeng-Ji; Liu, Ding-Hao; Kao, Chung-Lan

    2015-09-01

    Benign paroxysmal positional vertigo (BPPV) is one of the most frequently encountered primary complaints in dizziness clinics. The incidence of BPPV has been proven to increase with age. The relationship between BPPV and another neurodegenerative disease, Parkinson's disease (PD), has not been previously discussed. This study aimed to investigate the relationship of BPPV and PD with oxidative stress. A total of 30,811 subjects participated in our cohort study. The study cohort comprised 5057 BPPV patients and a comparison cohort of 25,754 nonBPPV patients. SIRT1 axis gene expression was investigated in BPPV patient blood samples and a PD cell model of 6-hydroxydopamine (6-OHDA)-treated PC-12 cells to elucidate the potential in vitro and in vivo mechanisms of degeneration in PD and BPPV. Our data suggest that BPPV patients with histories of head injuries show a significantly higher hazard to develop subsequent PD (hazard ratio, 3.942; confidence interval, 1.523-10.205, p = 0.005). We also observed that oxidative status is increased in blood samples from patients with BPPV. Our in vitro study suggests that SIRT1 function is inhibited by oxidative stress, which thereby promotes 6-hydroxydopamine-induced cell death. We conclude that BPPV is independently associated with an increased risk of PD. This finding may be attributed to oxidative stress-mediated inhibition of SIRT1 expression levels.

  7. Effect of Repositioning Maneuver Type and Postmaneuver Restrictions on Vertigo and Dizziness in Benign Positional Paroxysmal Vertigo

    Directory of Open Access Journals (Sweden)

    Michel Toupet

    2012-01-01

    Full Text Available Introduction. To compare the efficiency of Epley (Ep and Sémont-Toupet (ST repositioning maneuvers and to evaluate postmaneuver restriction effect on short-term vertigo and dizziness after repositioning maneuvers by an analog visual scale (VAS in benign positional paroxysmal vertigo (BPPV. Material and Methods. 226 consecutive adult patients with posterior canal BPPV were included. Patients were randomized into 2 different maneuver sequence groups (n=113: 2 ST then 1 Ep or 2 Ep then 1 ST. Each group of sequence was randomized into 2 subgroups: with or without postmaneuver restrictions. Vertigo and dizziness were assessed from days 0 to 5 by VAS. Results. There was no difference between vertigo scores between Ep and ST groups. Dizziness scores were higher in Ep group during the first 3 days but became similar to those of ST group at days 4 and 5. ST maneuvers induced liberatory signs more frequently than Ep (58% versus 42% resp., P<0.01, Fisher's test. After repositioning maneuvers, VAS scores decreased similarly in patients with and without liberatory signs. Postmaneuver restrictions did not influence VAS scores. Conclusion. Even if ST showed a higher rate of liberatory signs than Ep in this series, VAS scores were not influenced by these signs.

  8. Curing a 96-year-old patient afflicted with benign paroxysmal positional vertigo on a motorized turntable

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    Bockisch CJ

    2014-04-01

    Full Text Available Christopher J Bockisch,1–3 Dominik Straumann,1,4 Konrad P Weber1,2 1Department of Neurology, University Hospital Zurich, 2Department of Ophthalmology, University Hospital Zurich, 3Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 4Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland Background: Dizziness in the elderly is a serious health concern due to the increased morbidity caused by falling. The most common cause of dizziness in the elderly, benign paroxysmal positional vertigo (BPPV, is frequently undiagnosed, and bedside treatment of these patients can be difficult due to neck and back stiffness, which makes repeated and accurate repositioning maneuvers difficult. Case presentation: After a fall, a 96-year-old woman was referred by a resident neurologist for intractable BPPV. The patient was placed on a motorized turntable and repositioned to remove the calcite particles from the affected posterior semicircular canal. Video monitoring of the eyes allowed confirmation of the diagnosis, as well as an immediate evaluation of the effectiveness of the maneuver. Conclusion: Every patient with dizziness or imbalance, even in the absence of typical complaints of BPPV, should be tested with provocation maneuvers, because the clinical picture of BPPV is not always typical. Even if elderly patients with dizziness are very frail, the completion of provocation maneuvers is imperative, since the therapeutic maneuvers are extremely effective. A motorized turntable is very helpful to perform the repositioning accurately and safely. Keywords: vestibulo ocular reflex, nystagmus, vertigo

  9. Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver

    Directory of Open Access Journals (Sweden)

    Silva, Camila Nicácio da

    2015-10-01

    Full Text Available Introduction Benign Paroxysmal Positional Vertigo (BPPV is one of the most common and treatable causes of peripheral vestibular vertigo in adults. Its incidence increases with age, eventually leading to disability and a decreased quality of life. Objective The research aims to assess short-term effects of Otolith Repositioning Maneuver (ORM on dizziness symptoms, quality of life, and postural balance in elderly people with Benign Paroxysmal Positional Vertigo. Methods A quasi-experimental study, which evaluated 14 elderly people that underwent the Otolith Repositioning Maneuver and reevaluation after one week. The authors performed statistical analysis by descriptive analysis of central tendency and dispersion; for pre- and post-treatment conditions, the authors used the Wilcoxon test. Results All aspects of the Dizziness Handicap Inventory (physical, functional, emotional, and total scores as well as the Visual Analogue Scale (VAS decreased after therapy (p < 0.05 and p = 0.001, respectively. However, more than half of the elderly participants did not achieve negative Dix-Hallpike. Regarding static and dynamic balance, there were significant differences in some parameters of the modified Clinical Test of Sensory Interaction and Balance, Limits of Stability and gait assessment measured by the Dizziness Gait Index (p < 0.05. Conclusion Results reveal clinical and functional benefits in elderly people with Benign Paroxysmal Positional Vertigo submitted to Otolith Repositioning Maneuver. However, most of the participants did not overcome Benign Paroxysmal Positional Vertigo and not all aspects of postural balance improved. Therefore, a longer follow-up period and a multidisciplinary team are required to establish comprehensive care for elderly patients with dizziness complaints.

  10. Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver

    Science.gov (United States)

    Silva, Camila Nicácio da; Ribeiro, Karyna Myrelly O. B. de Figueiredo; Freitas, Raysa Vanessa de Medeiros; Ferreira, Lidiane Maria de Britho Macedo; Guerra, Ricardo Oliveira

    2015-01-01

    Introduction Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common and treatable causes of peripheral vestibular vertigo in adults. Its incidence increases with age, eventually leading to disability and a decreased quality of life. Objective The research aims to assess short-term effects of Otolith Repositioning Maneuver (ORM) on dizziness symptoms, quality of life, and postural balance in elderly people with Benign Paroxysmal Positional Vertigo. Methods A quasi-experimental study, which evaluated 14 elderly people that underwent the Otolith Repositioning Maneuver and reevaluation after one week. The authors performed statistical analysis by descriptive analysis of central tendency and dispersion; for pre- and post-treatment conditions, the authors used the Wilcoxon test. Results All aspects of the Dizziness Handicap Inventory (physical, functional, emotional, and total scores) as well as the Visual Analogue Scale (VAS) decreased after therapy (p Vertigo submitted to Otolith Repositioning Maneuver. However, most of the participants did not overcome Benign Paroxysmal Positional Vertigo and not all aspects of postural balance improved. Therefore, a longer follow-up period and a multidisciplinary team are required to establish comprehensive care for elderly patients with dizziness complaints. PMID:26722348

  11. Comparison Between the Effectiveness of Physical Maneauer and Medicinal Therapy in the Treatment of Benign Paroxysmal Positional Vertigo

    Directory of Open Access Journals (Sweden)

    M. Mali

    2007-01-01

    Full Text Available Abstract Background and purpose: Benign paroxysmal positional vertigo (BPPV is the most common cause of vertigo. Its pathophysiology is described by canalolithiasis theory. A safe and simple treatment has been proposed in recent years (canalith repositioning maneuver. This study has been performed to compare the effectiveness of physical maneuver and medical therapy in the treatment of BPPV.Materials and Methods: The study was a clinical trial. Patients with BPPV (Being diagnosed based on positive Dix – Hallpike test and history were randomized into 2 groups on first visit. They were matched for sex, age and cause of BPPV. 23 patients received Epley maneuver and 22 patients received Betahistine. Patients were evaluated at first week and first month after the beginning of the treatment.Results: After one week, 58.3 % of patients in drug group and 94.1 % of patients in maneuver group had negative Hallpike test. After 1 week, all patients were asked about the resolution of symptoms. After 1 week, 39.77% of patients in drug group and 81.52 % of patients in maneuver group improved. This difference between the 2 groups was statistically significant (2 = -4/338; p< 0/001. After 1 month, 56. 83 % of patients in drug group and 86.98 % of patients in maneuver group improved (z =- 3/ 305; p<0/01. The difference of subjective improvement was statistically significant between 1 week and 1 month follow up in drug group (z = -2/85 ; p<0.01, this difference however was not statistically significant in maneuver group (z= -1.5 ; NS.Conclusion: In short term the Epley maneuver is much more effective than medical therapy to control symptoms of BPPV and is the best treatment for this disease.

  12. Does benign paroxysmal positional vertigo explain age and gender variation in patients with vertigo by mechanical assistance maneuvers?

    Science.gov (United States)

    Wang, Jing; Chi, Fang-Lu; Jia, Xian-Hao; Tian, Liang; Richard-Vitton, Th

    2014-11-01

    Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular diseases. The aim of this study was to explore the prevalence of BPPV in vertigo patients and the characteristics of BPPV in diagnosis and repositioning using mechanical assistance maneuvers and to analyze and summarize the reasons showing these characteristics. Seven hundred and twenty-six patients with vertigo were enrolled in this study. All patients were inspected by TRV armchair (SYNAPSYS, model TRV, France). BPPV patients were identified by the examination results. The characteristics and results using TRV armchair in diagnosis and treatment of BPPV were compared and analyzed. Of 726 vertigo patients, 209 BPPV patients were diagnosed, including 58 men and 151 women, aged from 16 to 87 (mean 52.90 ± 11.93) years. There were significant differences in the proportion of BPPV in male and female vertigo patients (P = 0.0233), but no differences among all age groups (P = 0.3201). Of 209 BPPV patients, 208 cases were repositioned by TRV armchair and no one appeared to have otolithic debris relocated into another canal in the repositioning procedures. 202 cases (97.12 %) were successful and six cases (2.87 %) were effective. None of them failed. This study suggests that BPPV is one of the most common diseases in the young vertigo patients, just like that in the old ones. Female of the species has predilection for BPPV and the site of predilection is the right posterior semicircular canals (PC-BPPV). The results of repositioning are perfect using mechanical assistance maneuvers.

  13. Significance of the 'bow and lean test' for the diagnosis of benign horizontal semicircular canal paroxysmal positional vertigo

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    Ying CHEN

    2012-10-01

    Full Text Available Objective To observe and assess the positive rate and accuracy of 'bow and lean test' in the horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV. Methods Ninety-two HSC-BPPV patients who were diagnosed by head roll test (HRT were enrolled, and then further tested with 'bow and lean test' (BLT between Oct 1, 2010 and Sep 30, 2011. They were treated by Barbecue maneuver or Brandt-Daroff exercise on the basis of HRT and BLT tests. The positive rate of BLT test was analyzed, and its accuracy for diagnosis and success rate for treatment of HSC-BPPV were compared between HRT and BLT. Results Among the 92 patients, 83(90.2% of them showed BLT nystagmus. Fifty-seven of 83 (68.7% patients showed both bowing nystagmus and leaning nystagmus, and 18(21.7% and 8(9.6% respectively showed bowing nystagmus alone or leaning nystagmus alone. Among 92 patients, 74(80.4% of them the affected side could be determined by HRT with 69 BLT positive and 5 BLT negative. Among the 69 BLT-positive patients, 60 patients showed the same result of HRT, and successful result was achieved by manipulation. 9 patients showed different result between BLT and HRT, in whom manipulation failed according to the result of HRT, but succeeded when manipulation was performed according to BLT. In 18 patients(19.6% it was not able to determine the affected side by HRT, but in 14 patients manipulation was successful when BLT result was applied. In 4 patients BLT failed to evoke nystagmus, but after practicing Brandt-Daroff exercise, vertigo and HRT nystagmus disappeared 3 days later. Among the 92 patients, 65(70.7% were cured according to HRT, while 83(90.2% got successful result according to BLT(P < 0.05. Conclusion The positive rate and accuracy for HSC-BPPV by BLT are high. It is a useful method for determining the affected side in HSC-BPPV, and to provide the basis for selecting effective manipulation treatment.

  14. Horizontal semicircular canal benign paroxysmal positional vertigo%水平半规管良性阵发性位置性眩晕

    Institute of Scientific and Technical Information of China (English)

    洪渊; 焉双梅; 吴子明; 杨旭

    2016-01-01

    Benign paroxysmal position vertigo (BPPV) is a paroxysmal short episode of vertigo caused by head posi-tion changes accompanied by characteristic nystagmus, and the most common vestibular disorder. Posterior semicircular ca-nal BPPV (-BPPV) is the most common type of BPPV. Dix-Hallpike test has been recommended as a"gold diagnostic stan-dard"for PSC-BPPV and Epley maneuver is the most effective method for treating PSC-BPPV. Horizontal Semicircular Ca-nal BPPV (HSC-BPPV) is second common only to the PSC-BPPV, although its actual incidence may have been underestimat-ed. However, Diagnosis and treatment of HSC-BPPV are not the same as PSC-BPPV. History, research, epidemiology, classi-fication, etiology, pathogenesis, diagnosis and treatment developments relevant to HSC-BPPV are reviewed in this article.%良性阵发性位置性眩晕(Benign Paroxysm Positional Vertigo,BPPV)是一种阵发性、由头位变动引起的伴有特征性眼震的短暂发作性眩晕,是最常见的前庭疾病。后半规管BPPV(Benign Paroxysmal Positional Vertigo of Posterior Semicircular Canal,PSC-BPPV)是最常见的BPPV类型,临床上推荐Dix-Hallpike试验作为诊断PSC-BPPV的“金标准”,Epley法是目前治疗PSC-BPPV最有效的复位方法。水平半规管BPPV(Benign Paroxysmal Positional Vertigo of Horizontal Semicircular Canal,HSC-BPPV)发病机制复杂,是仅次于PSC-BPPV的常见BPPV亚型,其实际发病率可能被低估。临床实践中,HSC-BPPV其诊断与复位治疗方法与PSC-BPPV均不相同。本文即围绕HSC-BPPV研究的发展史及流行病学、分类、病因、发病机制、诊断及治疗复位方法的相关进展做一综述。

  15. [CROATIAN GUIDELINES FOR DIAGNOSIS AND MANAGEMENT OF BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV)].

    Science.gov (United States)

    Maslovara, Sinisa; Butković-Soldo, Silva; Drvis, Petar; Roje-Bedeković, Marina; Trotić, Robert; Branica, Srećko; Habek, Mario; Cvjetko, Tereza; Vesligaj, Tihana; Adamec, Ivan; Gabelić, Tereza; Jurić, Stjepan; Vceva, Andrijana; Vranjes, Zeljko; Sarić, Ingrid; Cejić, Olivera; Zivić, Tihomir

    2015-01-01

    BPPV is generally the most common cause of vertigo, caused by a pinch-off of tiny calcium carbonate crystals (called the otoconia or the otoliths) from the macula utriculi, most frequently due to the degenerative processes or a trauma, whereby the crystals, under the action of gravity in certain head positions coinciding with its direction, arrive to some of the semicircular canals, usually the posterior one, due to the existent anatomical circumstances and relationships, thus creating an inadequate stimulus of the cupular senses while floating through the endolymph and provoking symptoms of a strong and short-term dizziness. Two main clinical forms can be distinguished: canalolythiasis, with an accommodation of otolithic debris in the semicircular canal, and cupulolythiasis, with their location immediately next to the cupular sense. The diagnosis is established by a positive positioning test, Dix-Hallpike for the posterior and the supine roll for the lateral canal. Although one can expect a spontaneous recovery subsequent to few weeks or months, various methods of otolith repositioning to a less sensitive place lead to a prompt improvement while reducing or withdrawing the symptoms completely. These guidelines are intended for all who treat the BPPV in their work, with an intention to assist in the diagnosis and application of an appropriate therapeutic method.

  16. Benign Paroxysmal Positional Vertigo (BPPV): History, Pathophysiology, Office Treatment and Future Directions

    OpenAIRE

    Jeremy Hornibrook

    2011-01-01

    BPPV is the most common cause of vertigo. It most often occurs spontaneously in the 50 to 70 year age group. In younger individuals it is the commonest cause of vertigo following head injury. There is a wide spectrum of severity from inconsistent positional vertigo to continuous vertigo provoked by any head movement. It is likely to be a cause of falls and other morbidity in the elderly. Misdiagnosis can result in unnecessary tests. The cardinal features and a diagnostic test were clarified i...

  17. Benign Paroxysmal Positional Vertigo (BPPV): History, Pathophysiology, Office Treatment and Future Directions.

    Science.gov (United States)

    Hornibrook, Jeremy

    2011-01-01

    BPPV is the most common cause of vertigo. It most often occurs spontaneously in the 50 to 70 year age group. In younger individuals it is the commonest cause of vertigo following head injury. There is a wide spectrum of severity from inconsistent positional vertigo to continuous vertigo provoked by any head movement. It is likely to be a cause of falls and other morbidity in the elderly. Misdiagnosis can result in unnecessary tests. The cardinal features and a diagnostic test were clarified in 1952 by Dix and Hallpike. Subsequently, it has been established that the symptoms are attributable to detached otoconia in any of the semicircular canals. BPPV symptoms can resolve spontaneously but can last for days, weeks, months, and years. Unusual patterns of nystagmus and nonrepsonse to treatment may suggest central pathology. Diagnostic strategies and the simplest "office" treatment techniques are described. Future directions for research are discussed.

  18. Effectiveness of canalith repositioning manoeuvers (CRM) in patients with benign paroxysmal positional vertigo (BPPV).

    Science.gov (United States)

    Tevzadze, N; Shakarishvili, R

    2007-01-01

    BPPV is the most common disorder of the vestibular system affected up to 21% of vertigo patients, characterised by short-lasting episodes of vertigo in association with rapid changes in head position. We have detected, treated and followed up 204 patients with BPPV during two years. 204 patients (163 women 41men) were enrolled in this study, at the time of evolution the duration of symptoms varied from several days to several months. We evaluated idiophatic forms of BPPV in 126 cases and secondary types BPPV in 78 cases. All patients with typical history of BPPV underwent neurological examination, including Dix-Hallpike (to detect posterior and anterior canal BPPV) and Roll Test (to detect horizontal canal BPPV). We treat patients with CRM and followed up them in 48 hours and 7 days, one month, 6 month and one year after initial management. Posterior semicircular canal was involved in 170 patients, remain 34 patients suffered from canalolithiasis of horisontal (31 patients) and anterior (3 patients) semicircular canal. After a single treatment session the symptoms disappeared completely in 139 patients, in 40 patients after twice, 16 patients after 3 times and 9 patients after 4 times maneuver sessions. No effectiveness was found in 5 patients; during follow-up 7 successfully treated patients experienced a recurrence between 1 and 6 months, in two cases after one year; they were retreated and all achieved a positive result. It is concluded that diagnosis of BPPV is simple and save, do not need expensive neuroradiological tests; CRM provides effective and long term control of symptoms in patients with BPPV.

  19. Unintentional conversion of benign paroxysmal positional vertigo caused by repositioning procedures for canalithiasis: transitional BPPV.

    Science.gov (United States)

    Babic, Borivoj B; Jesic, Snezana D; Milovanovic, Jovica D; Arsovic, Nenad A

    2014-05-01

    (transitional Hc cupulolithiasis) or by the subsequent controlling positional test (transitional Hc canalithiasis and common crux reentry); underlying mechanisms are discussed.

  20. Quedas em idosos com Vertigem Posicional Paroxística Benigna Elderly falls associated with benign paroxysmal positional vertigo

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    Fernando Freitas Ganança

    2010-02-01

    Full Text Available Vertigem Posicional Paroxística Benigna (VPPB pode causar quedas, principalmente em pacientes idosos. OBJETIVO: Verificar se o número de quedas em idosos com VPPB diminui após a realização de manobras de reposicionamento de partículas (MRP. MATERIAL E MÉTODO: Estudo retrospectivo em que foram incluídos idosos com VPPB que tenham apresentado queda no último ano. Todos os pacientes submeteram-se à MRP de acordo com o canal semicircular (CSC acometido. Após a abolição da vertigem e do nistagmo de posicionamento, os pacientes foram acompanhados ao longo de 12 meses e investigados em relação ao número de quedas neste período. Para comparar o número de quedas antes e após as MRP utilizou-se avaliação estatística por meio do teste de Wilcoxon. RESULTADOS: Foram incluídos 121 pacientes. Cento e um pacientes apresentaram acometimento do CSC posterior, 16 do lateral e quatro do anterior. Verificou-se redução do número de quedas após as MRP, com diferença estatisticamente significante na amostra geral (pBenign Paroxysmal Positional Vertigo (BPPV can cause falls, especially in the elderly. AIM: to study whether or not elderly patients with BPPV have a reduction on their falls after the particle repositioning maneuver (PRM. MATERIALS AND METHODS: retrospective study including elderly with BPPV who had fall(s during the last year. All patients were submitted to the PRM according to the affected semicircular canal (SCC. After the abolition of positioning vertigo and nystagmus, the patients were submitted to a 12 month follow-up and were investigated about the number of fall(s. Wilcoxon's test was performed to compare the number of fall(s before and after 12 months of the PRM. RESULTS: One hundred and twenty one patients were included in the study. One hundred and one patients presented involvement of the posterior SCC, 16 of the lateral and four of the anterior. We noticed a reduction on the number of falls, with statistically

  1. Vertiginous Symptoms and Objective Measures of Postural Balance in Elderly People with Benign Paroxysmal Positional Vertigo Submitted to the Epley Maneuver.

    Science.gov (United States)

    Silva, Camila Nicácio da; Ribeiro, Karyna Myrelly O B de Figueiredo; Freitas, Raysa Vanessa de Medeiros; Ferreira, Lidiane Maria de Britho Macedo; Guerra, Ricardo Oliveira

    2016-01-01

    Introduction Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common and treatable causes of peripheral vestibular vertigo in adults. Its incidence increases with age, eventually leading to disability and a decreased quality of life. Objective The research aims to assess short-term effects of Otolith Repositioning Maneuver (ORM) on dizziness symptoms, quality of life, and postural balance in elderly people with Benign Paroxysmal Positional Vertigo. Methods A quasi-experimental study, which evaluated 14 elderly people that underwent the Otolith Repositioning Maneuver and reevaluation after one week. The authors performed statistical analysis by descriptive analysis of central tendency and dispersion; for pre- and post-treatment conditions, the authors used the Wilcoxon test. Results All aspects of the Dizziness Handicap Inventory (physical, functional, emotional, and total scores) as well as the Visual Analogue Scale (VAS) decreased after therapy (p balance, there were significant differences in some parameters of the modified Clinical Test of Sensory Interaction and Balance, Limits of Stability and gait assessment measured by the Dizziness Gait Index (p postural balance improved. Therefore, a longer follow-up period and a multidisciplinary team are required to establish comprehensive care for elderly patients with dizziness complaints.

  2. First-referral presentations of patients with benign paroxysmal positional vertigo who were negative on positional testing and who lacked nystagmus.

    Science.gov (United States)

    Tan, Jun; Yu, Dongzhen; Feng, Yanmei; Song, Qiang; You, Jin; Shi, Haibo; Yin, Shankai

    2015-11-01

    The aim of the present study was to explore the demographic, clinical, and pathogenetic features; and treatment outcomes of patients with benign paroxysmal positional vertigo (BPPV) who were negative upon positional testing at their first referral. A total of 133 patients presented with histories of BPPV but were negative, in our hands, upon positional testing. Patients were told to cease taking vestibular suppressant medication (if any) and were to return for re-examination when positional vertigo symptoms recurred. If BPPV was diagnosed, the appropriate repositioning maneuver was applied and patients were re-examined weekly until the characteristic nystagmus and vertigo disappeared. Follow-up was performed 1 week, 4 weeks, 3 months, 6 months, and 1 year after diagnosis. The 133 patients were compared with a group of 250 patients with typical BPPV. Sixty-five of the 133 patients (termed the n-BPPV group) were subsequently identified with typical BPPV. Such diagnoses were made within 10 days of the first referral in 37 (56.9%) cases. Patients of the n-BPPV group had a longer duration of the last episode of vertigo than did others (39.7 ± 38.4 vs. 26.1 ± 36.7 days, p BPPV and typical BPPV patients responded similarly to treatment and exhibited similar recurrence rates. BPPV patients who were negative upon positional testing at first referral were quite common, accounting for 26% of all typical BPPV patients. No significant difference in either treatment outcome or recurrence rate was evident between n-BPPV and typical BPPV positions. Positional vertigo and nystagmus are not always present as BPPV progresses.

  3. COMPARISON OF EPLEY’S MANOEUVRE WITH AND WITH OUT BETA HISTIDINE THERAPY IN RELIEVING VERTIGO IN BENIGN PAROXYSMAL POSITIONAL VERTIGO ( P - BPPV PATIENTS

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    Sheetal

    2015-08-01

    Full Text Available INTRODUCTION: Benign paroxysmal positioning vertigo (BPPV is a disorder characterized by brief attacks of vertigo, with associated nystagmus, precipitated by certain changes in head position with respect to gravity. 1 It is the most common cause of the syndrome of provoked vertigo Our study is to determine the role of the manoeuvres in BPPV and to study the efficacy of the manoeuvres in BPPV . AIM AND OBJECTIVE : The role and efficacy of Epley’s canalith repositioning manoeuvre in the treatment of posterior canal BPPV . METHODOLOGY: this interventional study of 60 patients between age 30 - 70 years were selected randomly based on symptoms of positional vertigo and positive Dix - Hallpike’s positional test. P atients were divided into two study groups’ first group comprising 30 patients who underwent epley’s manoeuvre alone whereas second group comprising of 30 patients underwent epley’s manoeuvre with betahistidine therapy. The outcome of study was assessed at the end of 4 weeks and 3 months respectively subjectively with Visual Analog Scale (VAS and Dizziness Handic ap Inventory Survey (DHI and objectively by Dix - Hallpike’s positional test. RESULTS: There is no significant difference between the two scores of the subjects with Beta histidine and without B e t a histidine because p - value is 0.794 . This shows that Epley’s manoeuvre the best treatment modality for the subjects in relieving vertigo in benign paroxysmal positional vertigo which is noninvasive and inexpensive CONCLUSION: there was no difference in subjective and objective parameters between the two study groups.

  4. Use of TissuePatchDural™ in the closure of an iatrogenic fistula following posterior semicircular canal occlusion surgery for intractable benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Jaswinder Singh Sandhu

    2010-10-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a common disorder caused by the dislocation of otoconia most commonly into the posterior canal. The primary symptoms are brief episodes of head-position related vertigo which may be accompanied by nausea and disequilibrium. BPPV is usually managed conservatively with excellent results, however in a small number of cases the symptoms can become persistent and incapacitating. The most common treatment in such cases involves the surgical occlusion of the canal. This procedure carries a small risk of post operative perilymph leakage via an iatrogenic fistula.In this paper we outline a case of a patient who developed a perilymph leak following occlusion surgery for intractable BPPV. We describe a novel surgical method that was used to close the fistula using a synthetic polymer based patch (TissuePatchDural™, which has not been applied in the field of otology previously.

  5. 良性阵发性位置性眩晕的Epley手法治疗%Epley Treatment for Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    刘兴健; 吴子明; 张素珍; 王秋菊

    2011-01-01

    Objective Epley is one of the main method in the treatment of benign paroxysmal positional vertigo . This study was to observe the clinical efficacy of epley for Posterior semicircular canal benign paroxysmal positional vertigo. Methods Diagnosis of BPPV referenced the Chinese Medical Association published guidelines for Head and Neck Surgery Branch( 2007 ). By Dix - Hallpike test, the latency of nystagmus was about 3 ~ 15s, and the duration of nystagmus was less than 1 min. Results 402 patients with BPPV got Epley treatment, of whom,376 people used one time getting well, 17 people used twice getting well, only 9 people failed to respond to medical treatment. Conclusion This Epley is quite feasible. What's more, safety and reliability are very stabilized, recovering fast. It has already become a significant approach in the diagnosis and treatment center in BPPV in our hospital.%目的 Epley法是良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的主要治疗方法之一,本文观察这一耳石复位法对后半规管BPPV的临床疗效.方法 BPPV的诊断参照2007年中华医学会鼻咽喉头颈外科分会发表的指南.通过Dix-Hallpike试验,患者头为一侧偏向悬位时,出现向下耳扭转及上跳性眼震,眼震潜伏期3~15s,眼震的持续时间小于1min. 结果后半规管BPPV明确诊断后,此402例伴耳科症状后的BPPV患者经Epley耳石手法复位,其376例患者1次治愈,17例患者经2次治愈,9例患者治疗无效.结论 这种Epley耳石复位手法可行性强,安全性,可靠性稳定,恢复速度快,已成为笔者医院耳鼻咽喉-头颈外科眩晕诊疗中心在治疗良性阵发性位置性眩晕的重要方法.

  6. Increased Risk of Ischemic Stroke in Patients with Benign Paroxysmal Positional Vertigo: A 9-Year Follow-up Nationwide Population Study in Taiwan

    Directory of Open Access Journals (Sweden)

    Chung-Lan eKao

    2014-06-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a common form of vertigo and is characterized by episodic dizziness related to changes in head position relative to gravity. Benign paroxysmal positional vertigo symptoms can be similar to those of central nervous system vascular diseases. The association between BPPV and ischemic stroke has not yet been investigated. The study cohort consisted of patients who were diagnosed with BPPV at least twice in the previous year as an outpatient or for whom BPPV was the primary diagnosis as an inpatient (n = 4104. An age- and gender-matched sample that excluded patients with a diagnosis of any form of vertigo was selected as the comparison cohort (n = 8397. All cases were followed up from January 1, 2000, to December 31, 2008. The demographic characteristics, medical comorbidities and use of medications in both groups were investigated using chi-square tests. A stratified analysis of stroke risk factors was performed to determine the hazard ratios of BPPV. During the 9-year follow-up period, 185 of the 4104 (4.5% subjects with BPPV and 240 of the 8379 (2.9% subjects without BPPV developed ischemic strokes. The crude hazard ratio of BPPV for developing ischemic strokes was 1.708. After adjusting for stroke risk factors, the risk of developing ischemic strokes in BPPV subjects was 1.415-fold higher than the risk among those without BPPV (confidence interval: 1.162-1.732, p = 0.001. After a subgroup analysis stratified according to stroke risk factors, BPPV remained independently associated with a higher risk of developing future ischemic stroke. We conclude that BPPV is independently associated with a risk of subsequent ischemic stroke. More aggressive control of modifiable risk factors for ischemic strokes should be conducted in patients with BPPV.

  7. Concurrent posterior semicircular canal benign paroxysmal positional vertigo in patients with ipsilateral sudden sensorineural hearing loss: is it caused by otolith particles?

    Science.gov (United States)

    Kim, Chang-Hee; Shin, Jung Eun; Park, Hong Ju; Koo, Ja-Won; Lee, Jun Ho

    2014-04-01

    The etiology of benign paroxysmal positional vertigo (BPPV) is still elusive even though detached otolith particles from the utricular macula are generally thought to be responsible for the pathogenesis of BPPV. Sudden sensorineural hearing loss (SSNHL), of which the etiology is also idiopathic in most cases, may accompany concurrent BPPV. This uncommon condition of concurrent BPPV with SSNHL has been assumptively explained as selective damage of the cochlea and the utricle due to viral neurolabyrinthitis. Recently, radiological evidences that inner ear hemorrhage is observed in patients with SSNHL accompanied by severe vertigo have been reported. The basic hypothesis for this study is that blood debris in the endolymphatic fluid due to inner ear hemorrhage is one of the causes of concurrent posterior semicircular canal (PSCC) BPPV in patient with ipsilateral SSNHL. In this report, we will outline the clinical findings of 4 patients with PSCC BPPV with SSNHL, and present an experimental results using whole blood in artificial endolymph to evaluate the hypothesis.

  8. Advances in benign paroxysm positional vertigo%良性阵发性位置性眩晕诊治研究进展

    Institute of Scientific and Technical Information of China (English)

    何萍; 徐先荣

    2015-01-01

    良性阵发性位置性眩晕(benign paroxysm positional vertigo,BPPV)是最常见的前庭疾病,其发病率越来越高,占眩晕病人的30%.本文系统地回顾了有关BPPV的相关文献,阐明了BPPV的历史进程、病理基础、诊断方法及分型,详细描述了BPPV的不同治疗方法和最新进展.根据飞行人员BPPV的特点,总结BPPV的航空医学鉴定原则.

  9. Performance of DHI score as a predictor of benign paroxysmal positional vertigo in geriatric patients with dizziness/vertigo: a cross-sectional study.

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    Amrish Saxena

    Full Text Available BACKGROUND: Dizziness/vertigo is one of the most common complaint and handicapping condition among patients aged 65 years and older (Geriatric patients. This study was conducted to assess the impact of dizziness/vertigo on the quality of life in the geriatric patients attending a geriatric outpatient clinic. SETTINGS AND DESIGN: A cross-sectional study was performed in a geriatric outpatient clinic of a rural teaching tertiary care hospital in central India. MATERIALS AND METHODS: In all consecutive geriatric patients with dizziness/vertigo attending geriatric outpatient clinic, DHI questionnaire was applied to assess the impact of dizziness/vertigo and dizziness associated handicap in the three areas of a patients' life: physical, functional and emotional domain. Later, each patient was evaluated and underwent Dix-Hallpike maneuver by the physician who was blind of the DHI scoring of the patient. STATISTICAL ANALYSIS USED: We compared means and proportions of variables across two categories of benign paroxysmal positional vertigo (BPPV and non-BPPV. For these comparisons we used Student's t-test to test for continuous variables, chi-square test for categorical variables and Fisher's exact test in the case of small cell sizes (expected value<5. RESULTS: The magnitude of dizziness/vertigo was 3%. Of the 88 dizziness/vertigo patients, 19 (22% and 69(78% cases, respectively, were attributed to BPPV and non-BPPV group. The association of DHI score ≥50 with the BPPV was found to be statistically significant with x(2 value = 58.2 at P<0.01. CONCLUSION: DHI Score is a useful tool for the prediction of benign paroxysmal positional vertigo. Correct diagnosis of BPPV is 16 times greater if the DHI Score is greater than or equal to 50. The physical, functional and emotional investigation of dizziness, through the DHI, has demonstrated to be a valuable and useful instrument in the clinical routine.

  10. Analysis 75 Misdiagnosed Cases of Benign Paroxysmal Positional Vertigo%良性发作性位置性眩晕75例误诊分析

    Institute of Scientific and Technical Information of China (English)

    李庭毅; 彭淑华; 胡松; 王丽; 盛飞; 王小平; 李文辉

    2015-01-01

    Objective To explore the clinical features and misdiagnosis cause of benign paroxysmal positional vertigo (BPPV) to propose methods to prevent misdiagnosis. Methods The clinical data of 75 cases were analyzed respectively. Results Among 75 misdiagnosed cases, 41 cases were misdiagnosed as cervical spondylosis, 17 as posterior circulation is-chemia, 6 as Meniere Disease, 7 as somatoform disorders, and 4 misdiagnosed as arteriosclerosis. Misdiagnosis time was from 8 d-6 years. The main clinical manifestations of BPPV were transient vertigo and nystagmus when the heads of the patients changed positions. Roll and Dix-hallpike tests showed that 59 cases were diagnosed as canalis semicircular is posterior, 12 as BPPV of horizontal semicircular canal and 4 as BPPV of mixed patterns. The cure rate of one-week treatment of Epley and Barbecue rolling repositioning was 100% and the cure rate of three months was 93. 3% . Conclusion The curative effect of manipulative reduction is noticeable for BPPV. Clinician must strengthen awareness of the disease in order to improve diagno-sis and treatment of BPPV.%目的:探讨良性发作性位置性眩晕(benign paroxysmal positional vertigo, BPPV)的临床特征和误诊原因,提出防范误诊措施。方法回顾分析 BPPV 误诊75例的临床资料。结果75例主要临床表现为改变头位时出现短暂性眩晕、呕吐及眼震。误诊为颈椎病41例,后循环缺血17例,躯体形式障碍 7例,梅尼埃病6例,动脉硬化4例,误诊时间8 d ~6年。经 Roll 试验及 Dix-hallpike 试验诊断为后半规管 BPPV 59例,水平半规管 BPPV 12例,混合型BPPV 4例;予 Epley 复位法及 Barbecue 翻滚法复位治疗1周治愈率达100%,3个月治愈率达93.3% 。结论 BPPV临床表现缺乏特异性,易误诊,手法复位对 BPPV 效果显著。临床医生应加强对本病的认识,提高诊断水平及处理能力。

  11. Diagnosis and treatment of 49 patients with benign paroxysmal positional vertigo%49例良性阵发性位置性眩晕诊疗体会

    Institute of Scientific and Technical Information of China (English)

    肖辉良; 黄合银; 张伟华; 岳耀光

    2010-01-01

    目的 探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的诊疗方法.方法 对2007年9月-2009年10月期间诊断的49例BPPV采用管石手法复位治疗,其中后半规管性BPPV采用Epley颗粒复位法,无效者改用Semont法,前半规管性BPPV采用反向Epley法,水平半规管性BPPV采用Barbecue翻滚法.结果 PC-BPPV 33例(67.3%),HC-BPPV12例(24.5%),AC-BPPV 2例(4.1%),混合型2例(4.1%);治疗随访时间4~8个月,痊愈44例(89.8%);改善3例(6.1%).复发2例(4.1%)再次治疗有效.结论 通过不同变位试验可对BPPV进行诊断并明确区分耳石所沉积的半规管,以便采用正确的复位法达到有效的治疗目的 ,对同时发生多个半规管及伴发突聋的患者应避免漏诊.%Objective To explore the diagnosis and treatment of benign paroxysmal positional vertigo (BPPV). Methods Fority-nine patients with BPPV were diagnosised between September 2007 and October 2009. After the type and the effect side were determined, appropriate repositioning maneuvers were selected, posterior canal (PC) BPPV treatmented with Epley's canalith respositioning maneuver or Semont liberatory maneuver, horizonial canal (HC) BPPV with Barbecue maneuver and anterior canal (AC) involve- ment with reverse Epley's maneuver. Results Of 49 patients, 33 cases (67.3%) was in PC involvement, 12 cases (24.5%) in HC involvement, 2 cases (4.1 %) in AC involvement and 2 cases (4.1 %) in the mixed type. After follow -up of 4 to 8 months, the total cure rate was 89.8%, the improvement rate was 6.1 % and recurrence rate was 6.1 %. Conclusions Different types of BPPV incoulding variant canals can be diagnosised according to the nystagmic characteristics of the appropriate provoking maneuvers, and it is necessary to apply the appropriate repositioning maneuvers. Missed diagnosis should be avoided for multi canal involvement and accompany with sudden deafness.

  12. Is There a Possible Association between Dietary Habits and Benign Paroxysmal Positional Vertigo in the Elderly? The Importance of Diet and Counseling

    Science.gov (United States)

    Schultz, Adriane Rocha; Neves-Souza, Rejane Dias; Costa, Viviane de Souza Pinho; Meneses-Barriviera, Caroline Luiz; Franco, Pricila Perini Rigotti; Marchiori, Luciana Lozza de Moraes

    2015-01-01

    Introduction Poor diet habits and inadequate intake of nutrients are a concern in the elderly. Nutritional education with guidance may improve the results of the treatment of vertigo. Objective Evaluate the presence of benign paroxysmal positional vertigo (BPPV) associated with feeding habits. Methods Cross-sectional study with elderly people living independently. We evaluated nutritional habits through the method of dietary 24-hour recall and manipulation of Dix-Hallpike. Results Based on a sample of 487 individuals, 117 had BPPV. Among the 117 elderly patients with BPPV, 37 (31.62%) had inadequate feeding. From those 370 individuals without BPPV, 97 (26.21%) had inappropriate feeding. No significant association between nutritional habits and BPPV in the total population was observed (p = 0.3064). However, there was significant relation between BPPV and inadequate carbohydrate intake (p = 0.0419) and insufficient fiber intake (p = 0.03), and the diet of these subjects was rich in polyunsaturated fatty acids (p = 0.0084). Conclusion These data correlate with the dyslipidemia and hypertriglyceridemia status, making it extremely important to reduce the intake of fats and carbohydrates and increase the fiber intake to stabilize triglycerides and thus minimize harmful effects on the inner ear. Food readjustment is suggested in patients with BPPV, along with the work of a multidisciplinary team to improve the quality of the elderly. PMID:26491473

  13. Evaluation of quality of life pre- and post-vestibular rehabilitation in patients with benign paroxysmal positional vertigo associated with Meniere's disease

    Directory of Open Access Journals (Sweden)

    Azzi, Viviane Jacintha Bolfe

    2012-01-01

    Full Text Available Introduction: Vertigo is a symptom that impacts the patients' quality of life and may force them to cease performing activities of daily living. Here, we discuss benign paroxysmal positional vertigo (BPPV and Meniere's disease (MD, which show exacerbated symptoms when they appear in association. Vestibular rehabilitation (VR is an effective treatment in reducing vertigo, especially in conjunction with other therapies. Aim: To evaluate the quality of life of patients with BPPV and MD before and after VR. Method: We conducted a descriptive observational qualitative and quantitative case study with 12 patients aged 35 to 86 years. All patients diagnosed with BPPV and MD received treatment in the ENT clinic. The Brazilian DHI questionnaire, which assesses the quality of life with a focus on physical, emotional, and functional aspects, was used for data collection, and was completed by patients before the first session and after the fifth session of VR. Data were tested using the Shapiro-Wilk normality test, followed by Wilcoxon, Friedman, and Spearman correlation tests (p < 0.05. Results: There were significant improvements in scores for all aspects, with median changes ranging from 12 to 0 in the physical, 6 to 1 in the emotional, and 11 to 1 in the functional aspect. There were no correlations between the scores and sample characteristics. Conclusion: VR was an effective method for the treatment of patients with BPPV and MD; it improves quality of life and shows the maximal influence on physical aspect scores, regardless of age or gender.

  14. The effects of abnormality of cVEMP and oVEMP on rehabilitation outcomes in patients with idiopathic benign paroxysmal positional vertigo.

    Science.gov (United States)

    Hoseinabadi, Reza; Pourbakht, Akram; Yazdani, Nasrin; Kouhi, Ali; Kamali, Mohammad

    2016-03-01

    The presence of utricular and saccular dysfunction impairs quality of life (QoL) in patients. The aims of the present study were to examine the effect of repositioning maneuvers on QoL of patients with idiopathic benign paroxysmal positional vertigo (BPPV) and to describe the effect of cervical vestibular-evoked myogenic potential (cVEMP) or ocular VEMP (oVEMP) abnormalities on patient recovery after rehabilitation. Thirty idiopathic BPPV patients with/without otolith dysfunctions (n = 15, each group) were included in this clinical trial study. Otolith dysfunction was determined using oVEMP and cVEMP abnormalities. EcochG and caloric tests were performed to rule out other causes of secondary BPPV. The QoL in groups of patients with idiopathic BPPV was assessed using a Persian version of the dizziness handicap inventory (DHI-P) before and after treatment with Epley's maneuver. Pre-treatment results showed significant handicaps in both groups. DHI-P scores were higher in BPPV patients with otolith dysfunction (total, functional, emotional, physical score: 34.13, 11.20, 7.06, 15.86, respectively) than those in patients without otolith dysfunction (total, functional, emotional, physical score: 25.46, 7.86, 6.13, 11.46, respectively, P BPPV patients with cVEMP or oVEMP abnormalities, QoL is more compromised in comparison with that in BPPV patients without these dysfunctions. Otolith dysfunction enhances the negative effects of BPPV on QoL.

  15. 良性阵发性位置性眩晕研究现状%Present research situation of benign paroxysmal positional ver-tigo

    Institute of Scientific and Technical Information of China (English)

    杨强

    2016-01-01

    良性阵发性位置性眩晕是一种具有自限性的周围性前庭性疾病,近年来受到诸多学科特别是耳鼻喉科医师的认识,相关临床研究使良性阵发性位置性眩晕患者能够得到及时的治疗,效果颇令人满意。但应注意近年来耳石复位泛化问题,掌握正确的诊断和治疗方法具有重要临床意义。%Benign paroxysmal positional vertigo (BPPV ) is a self‐limited periph‐eral vestibular disease and is know n by many otolaryngology doctors in recent years ,related clinical resear‐ches make the BPP patients get timely treatment ,and effect is quite satisfactory .But attention should be paid to otolith reposition generalization in recent ,it has an important clinical significance to master correct diagnosis and treatment method .

  16. Risk factors of primary benign paroxysmal positional vertigo%原发性良性阵发性位置性眩晕的危险因素

    Institute of Scientific and Technical Information of China (English)

    赵仁亮; 刘涛; 孙慧; 贾庆霞

    2016-01-01

    良性阵发性位置性眩晕(BPPV)是眩晕最常见的类型,分为原发性和继发性,头部外伤、手术和内耳疾病为公认的继发因素,但原发性BPPV的病因和发病机制尚不明.最近研究发现原发性BPPV与多种因素相关,本文就这些危险因素进行综述.%Benign paroxysmal positional vertigo (BPPV) is the most common kind of vertigo,which can be divided into idiopathic and secondary types.Head trauma,surgery,and inner ear diseases may induce the secondary BPPV,but the etiology and pathogenesis of idiopathic BPPV is still unknown.Recent studies indicate that multiple factors are associated with idiopathic BPPV;in this article we will review the risk factors of idiopathic BPPV.

  17. 良性阵发性位置性眩晕的诊断治疗%Diagnosis and treament of benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    张素珍; 吴子明; 赵承军

    2003-01-01

    目的探讨良性阵发位置性眩晕(benign paroxysmal positional vertigo,BPPV)的诊断标准及治疗方法.方法:追溯复习1999.12至2002.11两年间37例BPPV的诊断与治疗.诊断依据典型发病史及体位试验,在排除其他疾病的基础上诊断本病.采用综合治疗,包括血管扩张剂、体位治疗及前庭功能锻炼.结果:10名(27%)患者经治疗后眩晕未再复发;17名(46%)症状减轻、发病次数减少;10例(27%)仍有间歇性发作,经药物治疗持续几小时后好转.结论:虽国内外对BPPV的诊治尚无统一标准,根据临床公认的耳石症理论确诊后,采用药物、体位治疗加前庭功能锻炼是有效的治疗方法.

  18. Is There a Possible Association between Dietary Habits and Benign Paroxysmal Positional Vertigo in the Elderly? The Importance of Diet and Counseling

    Directory of Open Access Journals (Sweden)

    Schultz, Adriane Rocha

    2015-05-01

    Full Text Available Introduction Poor diet habits and inadequate intake of nutrients are a concern in the elderly. Nutritional education with guidance may improve the results of the treatment of vertigo. Objective Evaluate the presence of benign paroxysmal positional vertigo (BPPV associated with feeding habits. Methods Cross-sectional study with elderly people living independently. We evaluated nutritional habits through the method of dietary 24-hour recall and manipulation of Dix-Hallpike. Results Based on a sample of 487 individuals, 117 had BPPV. Among the 117 elderly patients with BPPV, 37 (31.62% had inadequate feeding. From those 370 individuals without BPPV, 97 (26.21% had inappropriate feeding. No significant association between nutritional habits and BPPV in the total population was observed (p = 0.3064. However, there was significant relation between BPPV and inadequate carbohydrate intake (p = 0.0419 and insufficient fiber intake (p = 0.03, and the diet of these subjects was rich in polyunsaturated fatty acids (p = 0.0084. Conclusion These data correlate with the dyslipidemia and hypertriglyceridemia status, making it extremely important to reduce the intake of fats and carbohydrates and increase the fiber intake to stabilize triglycerides and thus minimize harmful effects on the inner ear. Food readjustment is suggested in patients with BPPV, along with the work of a multidisciplinary team to improve the quality of the elderly.

  19. Particle Repositioning Maneuver Treatment in Benign Paroxysmal Positional Vertigo%良性阵发性位置性眩晕43例管石复位法治疗分析

    Institute of Scientific and Technical Information of China (English)

    白忠; 钮燕; 吕超; 吴海莺; 马燕

    2011-01-01

    Objective To evaluate the clinical effect of particle repositioning maneuver on benign paroxysmal positional vertigo (BPPV). Method Totally 43 cases of BPPV were treated by means of different particle repositioning maneuveres according to the affected canal. Results One week after the last treatment for 43 patients of BPPV, 32 cases were cured; 9 cases had effects. The totally effective rate was 95.3% (41/43). Conclusion Particle repositioning maneuver is a safe, easy, cheap and effective treatment method for benign paroxysmal positional vertigo.%目的 探讨管石复位法治疗良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床效果.方法 确诊为BPPV的43例患者,判定半规管病变侧别和类型后,应用管石复位法治疗.结果 最后一次治疗后1周进行疗效评估,43例BPPV的患者,治愈32例(74.4%),有效9例(20.9%),总有效率95.3%.结论 管石复位法治疗良性阵发性位置件眩晕,具有操作安全、简单、疗效确切、费用低廉等特点.

  20. 老年良性阵发性位置性眩晕诊断与治疗%Diagnosis and treatment of benign paroxysmal positional vertigo in the elderly

    Institute of Scientific and Technical Information of China (English)

    徐晶; 王建明

    2016-01-01

    Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disease, which has high incidence especially in older patients. This article systematically reviews relevant literatures in the ifeld of BPPV at home and abroad, and summarizes etiology, pathogenesis and clinical features of BPPV in elderly patients, concomitantly describes the diagnosis and treatments of elderly patients with BPPV. Our objective is to improve the level of earlier diagnosis and therapeutic intervention for patients with Benign paroxysmal positional vertigo.%良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)是常见的外周性前庭疾病,尤其在老年人群中具有较高发病率。本文系统地回顾了国内外在BPPV领域的相关文献,并总结分析老年BPPV患者的病因、发病机制及临床特点,详细描述了老年BPPV患者诊断与治疗情况,以期提高临床对老年BPPV的认识及诊治水平。

  1. 良性阵发性位置性眩晕126例误诊分析%Misdiagnosis Analysis of 126 Patients with Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    邵永良; 李晓明; 李建红; 周永清; 吴彦桥; 李震; 尚建华

    2011-01-01

    目的 探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的误诊原因,提出防范误诊措施,以提高诊治水平.方法 回顾性分析我院2008年1月~2011年1月首诊误诊为其他疾病的126例BPPV临床资料.结果 本组特发性BPPV 84例,继发性BPPV 42例,早期误诊为后循环缺血54例,颈性眩晕32例,突发性耳聋6例,前庭神经元炎5例,梅尼埃病、耳带状疱疹各3例,其他药物或治疗不良反应23例.126例均经详细询问病史及Dix-Hallpike变位试验和(或)滚转试验检查,并行耳石手法复位治疗.本组眩晕症状均缓解,首次复位治愈率72.2% (91/126),观察随访3~24个月,总治愈率94.4% (119/126),复发率5.6%.结论 良性阵发性位置性眩晕为常见周围性眩晕,在眩晕患者诊治过程中,应注重病史采集和变位试验检查,以降低BPPV的误诊率.%Objective To explore the misdiagnosis causes of benign paroxysmal positional vertigo(BPPV) and to improve diagnosis and treatment. Methods The clinical data of 126 patients not diagnosed as having BPPV at first during January 2008 to January 2011 in our hospital were retrospectively analyzed. Results 84 patients with BPPV were spontaneous, 42 were secondum. 54 patients were misdiagnosed as having ischemia of retral circulation, 32 as having cervical vertigo, 6 as having deafness, 5 as having vestibular neuronitis, 3 as having meniere disease, 3 as having herpes zoster auricularis, and 23 as having adverse reaction of treatment. The 126 patients were inquired of disease history, and underwent Dix-Hallpike positioning test and (or) roll test and manipulative reduction. The symptoms were alleviated and initial success rate was 72.2%. During 3-24 month follow-ups, total success rate was 94.4% (119/126), and recurrence rate was 5.6%.Conclusion BPPV is a common disease of vestibular vertigo. Therefore, we should pay attention to history taking and positioning nystagmus examination before diagnosis

  2. New treatment strategy for cupulolithiasis associated with benign paroxysmal positional vertigo of the lateral canal: the head-tilt hopping exercise.

    Science.gov (United States)

    Yamanaka, Toshiaki; Sawai, Yachiyo; Murai, Takayuki; Okamoto, Hideyuki; Fujita, Nobuya; Hosoi, Hiroshi

    2014-12-01

    This study was performed to determine whether a novel treatment was effective against cupulolithiasis associated with benign paroxysmal positional vertigo (BPPV) of the lateral semicircular canal, which is characterized by apogeotropic direction-changing nystagmus. We herein describe our head-tilt hopping (HtH) exercise, which is designed to release otoconial debris strongly adhered to the cupula. The subjects were trained to hop while tilting their heads laterally. They completed 3 to 5 exercise sessions per day over a 4-week period. Each session ended with a 20-hop trial. The HtH exercises were performed by 27 patients with intractable lateral canal BPPV who exhibited positional vertigo and persistent nystagmus beating toward the uppermost ear for more than 4 weeks, despite performing therapeutic head shaking in the horizontal plane maneuver. All the patients were subjected to the supine roll test before and immediately after the first trial as well as after 1 and 4 weeks of the program to evaluate the effect of the treatment on their apogeotropic nystagmus. Nystagmus of 9 (33.3 %) patients disappeared immediately after the first training session. After 1 and 4 weeks of the training, the number of patients that had experienced either of these improvements had increased to 15 (55.6 %) and 19 (70.4 %) subjects, respectively. These results suggest that HtH exercises aimed at releasing otoconial debris from the cupula are feasible as a new therapy for cupulolithiasis associated with intractable lateral canal BPPV. However, further studies for comparison with control are required to confirm these preliminary results.

  3. Validation of 5-item and 2-item questionnaires in Chinese version of Dizziness Handicap Inventory for screening objective benign paroxysmal positional vertigo.

    Science.gov (United States)

    Chen, Wei; Shu, Liang; Wang, Qian; Pan, Hui; Wu, Jing; Fang, Jie; Sun, Xu-Hong; Zhai, Yu; Dong, You-Rong; Liu, Jian-Ren

    2016-08-01

    As possible candidate screening instruments for benign paroxysmal positional vertigo (BPPV), studies to validate the Dizziness Handicap Inventory (DHI) sub-scale (5-item and 2-item) and total scores are rare in China. From May 2014 to December 2014, 108(55 with and 53 without BPPV) patients complaining of episodic vertigo in the past week from a vertigo outpatient clinic were enrolled for DHI evaluation, as well as demographic and other clinical data. Objective BPPV was subsequently determined by positional evoking maneuvers under the record of optical Frenzel glasses. Cronbach's coefficient α was used to evaluate the reliability of psychometric scales. The validity of DHI total, 5-item and 2-item questionnaires to screen for BPPV was assessed by receiver operating characteristic (ROC) curves. It revealed that the DHI 5-item questionnaire had good internal consistency (Cronbach's coefficient α = 0.72). Area under the curve of total DHI, 5-item and 2-item scores for discriminating BPPV from those without was 0.678 (95 % CI 0.578-0.778), 0.873(95 % CI 0.807-0.940) and 0.895(95 % CI 0.836-0.953), respectively. It revealed 74.5 % sensitivity and 88.7 % specificity in separating BPPV and those without, with a cutoff value of 12 in the 5-item questionnaire. The corresponding rate of sensitivity and specificity was 78.2 and 88.7 %, respectively, with a cutoff value of 6 in 2-item questionnaire. The present study indicated that both 5-item and 2-item questionnaires in the Chinese version of DHI may be more valid than DHI total score for screening objective BPPV and merit further application in clinical practice in China.

  4. 耳石症患者复位治疗成功后头晕观察%Residual dizziness after repositional maneuvers for benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    王利一; 高波; 黄魏宁

    2014-01-01

    Objective To investigate the residual dizziness after repositional maneuvers for benign paroxysmal position-al vertigo.Methods 418 patients were divided into two groups: the elderly group and the control group.The inci-dence rate and durations of dizziness were evaluated.Results 62 patients(45.3%) reported residual dizziness in elder-ly group and 76 patients(27%) in control group(P<0.01), the mean durations of the residual dizziness was 14.6 ± 4.4 days in elderly group and 8.9 ±4.7 days in control group(P<0.01).There was no correlation between residual dizziness and sex in elderly group.Conclusion After the repositional maneuvers for benign paroxysmal positional ver-tigo, the incidence rate of residual dizziness and the duration in the elderly are higher and longer than the younger.%目的:观察后半规管耳石症( BPPV)患者经手法复位成功后,其头晕发生率及持续时间。方法2009~2011年门诊确诊单侧后半规管BPPV手法复位成功患者418例,分成老年组(≥60岁)137例、青年组(<60岁)281例,分别观察两组头晕发生率及持续时间。结果老年组头晕发生率45.3%(62/137),青年组27%(76/281),两组间差异有统计学意义(P<0.01);头晕平均持续时间老年组(14.6±4.4)d,青年组(8.9±4.7)d,两组间差异有统计学意义(P<0.01);老年组中女性头晕发生率43.3%(39/90),男性48.9%(23/47),两组间差异无统计学意义(P>0.05);老年组中女性头晕平均持续时间(15.7±5.3)d,男性(14.7±4.6)d,两组间差异无统计学意义(P>0.05)。结论老年BPPV患者复位治疗成功后头晕发生率明显高于青年组,头晕持续时间明显长于青年组;老年组头晕发生率及持续时间与性别无关。

  5. Efficacy of cervical and ocular vestibular-evoked myogenic potentials in evaluation of benign paroxysmal positional vertigo of posterior semicircular canal.

    Science.gov (United States)

    Singh, Niraj Kumar; Apeksha, Kumari

    2016-09-01

    Benign paroxysmal positional vertigo (BPPV) constitutes a major proportion of the population with peripheral vestibulopathies. Although the freely floating otoconia within the semicircular canals is responsible for the symptoms of BPPV, the source of the otoconia debris is mainly believed to be the otolith organs. Therefore, the pathology in either or both the otolith organs appears a logical proposition. Cervical and ocular vestibular-evoked myogenic potentials (cVEMP and oVEMP), being the tests for functional integrity of the otolith organs, appear promising for investigating otolith involvement in BPPV. While recent evidences are suggestive of equivocal findings for cVEMP, there are only a few studies on oVEMP. Additionally, both these potentials have never been explored in the same set of individuals with BPPV. Therefore, the present study aimed to evaluate the functional integrity of the otolith organs through cVEMP and oVEMP in individuals with posterior canal BPPV. Thirty-one individuals with unilateral posterior canal BPPV and 31 age- and gender-matched healthy controls underwent 500 Hz tone-burst-evoked cVEMP and oVEMP. The results demonstrated no significant group difference on any of the cVEMP parameters (p > 0.05). A similar trend was noticed for the latency-related parameters of oVEMP. However, the peak-to-peak amplitude was significantly smaller in the affected ears of individuals with BPPV than their unaffected ears and the ears of healthy controls (p BPPV group showed significantly higher inter-aural amplitude difference ratio than the healthy controls (p BPPV, and therefore, oVEMP appears to be better suited to clinical investigation than cVEMP in individuals with posterior canal BPPV.

  6. Posturografia do Balance Rehabilitation Unit (BRU TM na vertigem posicional paroxística benigna Balance Rehabilitation Unit (BRU TM posturography in benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Silvia Roberta Gesteira Monteiro

    2012-06-01

    Full Text Available A posturografia tem sido utilizada na avaliação de pacientes com vestibulopatias. OBJETIVO: Avaliar o equilíbrio corporal à posturografia do Balance Rehabilitation Unit (BRU TM em pacientes com vertigem posicional paroxística benigna (VPPB. Desenho de Estudo: Caso controle prospectivo. MATERIAL E MÉTODO: Estudo transversal controlado em 45 pacientes com VPPB e por um grupo controle homogêneo constituído de 45 indivíduos hígidos. Os pacientes foram submetidos à avaliação otoneurológica, incluindo a posturografia do Balance Rehabilitation Unit (BRU TM. RESULTADOS: A média dos valores da área de elipse e da velocidade de oscilação no grupo experimental foi significantemente maior (p Posturography has been used in the evaluation of patients with vestibular disorders. AIM: To evaluate balance control with the Balance Rehabilitation Unit (BRU TM posturography in patients with Benign Paroxysmal Positional Vertigo. Study design: Prospective case-control. MATERIALS AND METHODS: A cross-sectional controlled study was carried out in 45 patients with BPPV, and a homogeneous control group consisting of 45 healthy individuals. Patients were submitted to a balance function evaluation by means of the Balance Rehabilitation Unit (BRU TM posturography. RESULTS: The mean values of the ellipse area and the sway velocity in a firm surface and saccadic stimulation (p = 0.060. CONCLUSION: The Balance Rehabilitation Unit (BRU TM posturography enables to identify postural control abnormalities in patients with BPPV.

  7. Treatment strategy in acute benign paroxysmal positional vertigo%良性阵发性位置性眩晕的急性期处理策略

    Institute of Scientific and Technical Information of China (English)

    陈希杭; 张榕; 陈曦

    2015-01-01

    目的 探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)急性期临床特点、处理策略.方法 回顾性分析福建医科大学附属第一医院耳鼻咽喉头颈外科2010年10月~2014年10月期间诊断为急性期BPPV患者46例,予口服抗眩晕治疗,分析急性期处理策略、手法复位的相关风险及并发症.结果 46例急性期BPPV患者予口服抗眩晕治疗,1周后复诊时症状消失痊愈18例,症状改善有效27例,无效者1例;对仍有眩晕的28例予手法复位,眼震、症状均消失.另外报道1例急性期BPPV在手法复位过程中,出现腰椎骨折,予对应处理;1例在耳石复位后出现耳石嵌顿现象并短暂性脑缺血发作.结论 BPPV因发病病程长短、自愈性、急性期BPPV手法复位可能存在的风险,应充分评估患者全身情况;对骨质疏松、围绝经期患者,复位过程中应充分告知手法复位风险并采取相应预防性措施,避免副损伤.

  8. 管石复位法治疗良性阵发性位置性眩晕%Canalith repositioning procedures in treating benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    王锡温; 张庆泉; 王强

    2010-01-01

    目的 探讨管石复位法治疗良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的效果与方法.方法 回顾分析了2006年4月至2010年3月间我院治疗的BPPV患者96例,其中男性34例,女性62例,年龄43~70岁(平均55.5岁),后半规管BPPV 78例,水平半规管BPPV 16例,同时合并同侧后、水平半规管BPPV 2例,分别采用Epley管石复位法、Barbecue翻滚疗法及Brandt-Daroff习服疗法治疗.结果 后半规管BPPV 78例,经用Epley管石复位法治疗1~3次眩晕消失;水平半规管BPPV 16例,14例采用Barbecue翻滚疗法治疗1~2次眩晕消失,2例复位4次仍有眩晕,考虑嵴顶结石症,改用Brandt-Daroff习服疗法治疗半月眩晕消失;2例同时合并同侧后、水平半规管BPPV患者各复位2次眩晕消失.结论 管石复位法治疗BPPV安全有效,可疑嵴顶结石症患者,改用Brandt-Daroff习服疗法治疗效果良好.

  9. Effect of treatment with betahistine dihydrochloride on the postural stability in patients with different duration of benign paroxysmal positional vertigo.

    Science.gov (United States)

    Stambolieva, Katerina; Angov, Georgi

    2010-01-01

    The effect of betahistine dihydrochloride on the postural stability after repositioning Epley's maneuver (EM) in patients with BPPV was evaluated by static posturography in open and closed eyes conditions. Ninety patients were divided into four groups by duration (less and above 60 days of BPPV) and by treatment (with and without treatment with betahistine). The investigation was made one hour after the positive Dix-Hallpike test, 10 and 20 days after the treatment with EM. "Sway velocity" (SV) was calculated to evaluate postural stability. The results show dependence between efficacy of treatment with betahistine applied after EM and duration of BPPV. Betahistine normalized postural stability of patients with duration of BPPV less than 60 days after 10 days of treatment and had less effect on patients with duration of BPPV above 60 days. We assume that after removing the otoconia betahistine plays an important role for improving blood flow in the inner ear. The short presence of otoconia didn't damage sensory receptor, and restoring the normal function of motion-sensitive hairs cells and stabilizing the posture was observed.

  10. Therapeutical Effects of Automatic Benign Paroxysmal Positional Vertigo Diagnosis and Therapy System on Benign Paroxysmal Positional Vertigo%良性阵发性位置性眩晕诊疗系统对良性阵发性位置性眩晕诊疗效果的临床研究

    Institute of Scientific and Technical Information of China (English)

    单希征; 马丽涛; 彭新; 李娜

    2013-01-01

      目的观察良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)诊疗系统对BPPV的诊疗效果。方法选取2010年6月至2012年12月就诊于武警总医院耳鼻咽喉头颈外科中美眩晕病研究所门诊和病房BPPV患者120例,随机分为BPPV诊疗系统组和手法复位组各60例,比较两种治疗方法对BPPV的诊疗效果。结果 BPPV组间诊断符合率为100%(Kappa检验值1.000)。BPPV诊疗系统组的次日有效率为96.7%,1周有效率为100%,而BPPV手法组次日有效率为88.3%,1周有效率为91.7%,两组组间比较差异无显著性(P=0.057)。结论 BPPV诊疗系统对BPPV诊断准确,治疗效果好,有助于实现对BPPV高效标准化的诊断和治疗。%Objective To evaluate the diagnostic and therapeutical effects of automatic benign paroxysmal positional vertigo(BPPV) diagnosis and therapy system on BPPV. Methods Automatic BPPV diagnosis and therapy system consists of the hardware, software and work station. One hundred and twenty patients who were admitted to Sino-US Technical Cooperation Institute of Vertigo, General Hospital of Chinese People's Armed Police Forces from June 2010 to December 2012 were randomly divided into two groups for repositioning treatment procedures using automatic BPPV diagnosis and therapy system and classic maneuver. Results In the diagnosis, the results were consistent between both groups(Kappa=1.0000). In treatment, the efficacy rate was 96.7%in the equipment group and 88.3%in the maneuver group on the second day, and was 100%in the equipment group and 91.7%in the maneuver group one week later. No statistically significant differences were demonstrated between both groups when analyzed with chi-square(χ2) test. Conclusion The automatic BPPV diagnosis and therapy system on BPPV treating can be reliable(100%total effective rate), and also be automatic and standard for BPPV diagnosis and therapy.

  11. Clinical features of benign paroxysmal positional vertigo Vertigem posicional paroxística benigna: caracterização clínica

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    Mariana Azevedo Caldas

    2009-08-01

    Full Text Available Benign paroxysmal positioning vertigo (BPPV is considered as the most common vestibular disease. AIM: to evaluate the age, gender, type and site of the lesion, association with other vestibular diseases, progression, and recurrence in these patients. MATERIAL AND METHOD: A retrospective series study. Data from medical reports of BPPV patients examined in series during the past six years were analyzed. RESULTS: prevalences of BPPV were: at age 41-60 years (42.2 %; in females (62.8 %, wit nystagmus and positioning vertigo (81.3%; affecting the posterior canal (87%, unilateral (91.8 %, the right labyrinth (60.2% - pA vertigem posicional paroxística benigna (VPPB é considerada a mais comum das vestibulopatias. OBJETIVO: Avaliar pacientes com VPPB quanto à idade, gênero, tipo e localização da lesão, associação com outras vestibulopatias, dados evolutivos e recorrência. MATERIAL E MÉTODO: Estudo de séries retrospectivo. Foram analisados os prontuários de 1271 pacientes consecutivos examinados nos últimos seis anos com VPPB. RESULTADOS: A VPPB apresentou prevalência de faixa etária entre 41 e 60 anos (42,2%, gênero feminino (62,8%, presença de nistagmo e vertigem de posicionamento (81,3%, comprometimento do canal posterior (87,0%; p<0,001, unilateral (91,8%, do labirinto direito (60,2%; p<0,001, por ductolitíase (97,5%, forma idiopática (74,8%, associação com a doença de Ménière em relação a outras afecções (55,4%; p<0,001, cura ou melhora por meio de manobra de reposicionamento de partículas (77,9%; e pela possibilidade de recorrência (21,8%, em um ano de acompanhamento. CONCLUSÃO: A VPPB é caracterizada pela prevalência de faixa etária entre 41 e 60 anos, gênero feminino, presença de nistagmo e vertigem de posicionamento, comprometimento do canal posterior unilateral do labirinto direito por ductolitíase, forma idiopática, associação com a doença de Ménière em relação a outras afecções, cura ou melhora

  12. Manobras de reposicionamento no tratamento da vertigem paroxística posicional benigna Treatment of benign paroxysmal positional vertigo with repositioning manevers

    Directory of Open Access Journals (Sweden)

    Roberto A. Maia

    2001-09-01

    Full Text Available Introdução: Vertigem paroxística posicional benigna (VPPB é uma das mais freqüentes patologias do sistema vestibular. Caracteriza-se clinicamente pela presença de episódios recorrentes de tonturas rotatórias, tipicamente desencadeados por determinados movimentos cefálicos, realizados pelo paciente. A confirmação diagnóstica é obtida exclusivamente pela manobra de Dix-Hallpike. Nessa manobra, observa-se sistematicamente o desencadeamento de nistagmo. Forma de estudo: Prospectivo clínico não randomizado. Material e método: No total, sete pacientes com diagnóstico clínico de VPPB são submetidos a tratamento pela manobra de reposicionamento de Epley. Resultado: Desses sete pacientes avaliados, cinco apresentaram ótima recuperação; dois, com resultado bom; e um, com mau resultado; para este último caso, outras formas de tratamento são apresentadas. Conclusão: O exame otoneurológico, realizado em todos os pacientes, demonstrou ser de interessante valor prognóstico quanto ao resultado do tratamento proposto. A manobra de reposicionamento de Epley demonstrou ser um método de tratamento da VPPB simples, e eficaz na grande maioria dos pacientes aqui relatados.Introduction: Benign Paroxysmal Positional Vertigo (BPPV is among the most common vestibular disorders. It is characterized by recurrent episodes of vertigo induced by changes in head position. The condition is readly diagnosed by performing the Dix-Hallpike maneuver. Nystagmus is always present by this way. Study design: Prospective results clinical not randomized. Material and method: A total of seven patients diagnosed with BPPV received the repositioning maneuver of Epley. Five out of seven patients had excellent recovery, two patients had good results and one had a bad result. For this last one different treatments are discussed. Conclusion: We performed otoneurological examination in all patients; this test seems to be an intersting prognosis method for seeking the

  13. Active head rotation in benign positional paroxysmal vertigo Da rotação cefálica ativa na vertigem posicional paroxística benigna

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    Fernando Freitas Ganança

    2009-08-01

    Full Text Available Benign Positional Paroxysmal Vertigo (BPPV is one of the most common vestibular diseases and the active head rotation test one of the most modern methods of vestibular function assessment. AIM: this study aims to verify if the active head rotation test may reveal signs of horizontal and/or vertical vestibulo-ocular reflex dysfunction in vertigo patients suspected for BPPV. STUDY DESIGN: retrospective series study. MATERIALS AND METHOD: Neurotological evaluation including computerized electronystagmography and active head rotation on the horizontal and vertical axes were conducted in 100 patients suspected for BPPV patients. Results: Isolated or associated abnormalities of the horizontal and/or vertical vestibulo-ocular reflex gain, phase and symmetry were indicative of vestibular involvement and found in 77.0% of the BPPV patients. CONCLUSION: the active head rotation test revealed horizontal and/or vertical vestibulo-ocular reflex dysfunctions in a relevant number of BPPV patients.A vertigem posicional paroxística benigna (VPPB corresponde a uma das vestibulopatias mais comuns e a rotação cefálica ativa um dos métodos mais modernos de avaliação da função vestibular. OBJETIVO: O objetivo desta pesquisa foi verificar se a prova de rotação cefálica ativa pode revelar sinais de disfunção do reflexo vestíbulo-ocular horizontal e/ou vertical em pacientes vertiginosos com hipótese diagnóstica de VPPB. DESENHO DO ESTUDO: Estudo de série retrospectivo. MATERIAL E MÉTODO: Uma avaliação otoneurológica incluindo a eletronistagmografia computadorizada e a prova de rotação cefálica ativa, no plano horizontal e vertical foi conduzida em 100 pacientes com hipótese diagnóstica de VPPB. Resultados: Alterações isoladas ou associadas de ganho, fase e assimetria do reflexo vestíbulo-ocular horizontal e/ou vertical, foram os achados indicativos de comprometimento vestibular em 77,0% dos casos de VPPB. CONCLUSÃO: A prova de rota

  14. 红外视频采集仪记录BPPV患者眼震的结果分析%Analysis of Video- Nystagmography in Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    高波; 宋海涛; 龚霞; 周金梅; 黄魏宁

    2006-01-01

    目的 探讨用红外视频眼动采集仪(CHARTR VNG)观察记录良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的眼震特点.方法 用红外视频采集仪详细记录78例BPPV患者在Dix-Hallpike试验及滚转试验中的眼震变化.结果 40例(51.28%)为一侧后半规管病变;13例(16.67%)为一侧水平半规管病变;6例(7.7%)为一侧上半规管病变;19例(24.36%)出现多发位置性眼震,其中6例为双侧后半规管病变,2例双侧上半规管病变,3例为双侧水平半规管病变,8例患者在不同头位下出现眼震,提示混合半规管病变.结论 红外视频眼动采集仪可以更直观地观察眼动变化,对诊断BPPV受累半规管提供可靠依据,特别是对非典型位置性的眼震,能更好的提示良性阵发性位置性眩晕患者非典型位置性的眼震发生率,包括水平半规管、上半规管病变和多个半规管联合病变.患者的治疗可以根据不同的受累半规管采取不同方法.

  15. Benign paroxysmal positional vertigo recurrence and persistence Recorrência e persistência da vertigem posicional paroxística benigna

    Directory of Open Access Journals (Sweden)

    Ricardo S Dorigueto

    2009-08-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is one of the most common vestibular disorders. AIM: To study the recurrence and persistence of BPPV in patients treated with canalith repositioning maneuvers (CRM during the period of one year. STUDY DESIGN: longitudinal contemporary cohort series. MATERIALS AND METHODS: One hundred patients with BPPV were followed up during 12 months after a treatment with CRM. Patients were classified according to disease evolution. Aquatic physiotherapy for vestibular rehabilitation (APVR protocol was applied in cases of persistent BPPV. RESULTS: After CRM, 96% of the patients were free from BPPV's typical nystagmus and dizziness. During the follow up period of 1 year, 26 patients returned with typical BPPV nystagmus and vertigo. Nystagmus and vertigo were persistent in 4% of the patients. Persistent BPPV presented improvement when submitted to APVR. Conclusion: During the period of one year, BPPV was not recurrent in 70% of the patients, recurrent in 26% and persistent in 4%.A vertigem posicional paroxística benigna (VPPB é das vestibulopatias mais comuns. OBJETIVO: Verificar a recorrência e a persistência da VPPB no período de um ano em pacientes que foram tratados com manobras de reposicionamento de estatocônios (MRE. FORMA DE ESTUDO: coorte contemporânea longitudinal. MATERIAL E MÉTODO: Cem pacientes com VPPB foram acompanhados durante 12 meses após o tratamento com MRE. Os pacientes foram classificados de acordo com a evolução da doença no período de um ano. O protocolo de fisioterapia aquática para reabilitação vestibular (FARV foi aplicado nos pacientes com VPPB persistente. RESULTADOS: Após as MRE, 96% dos pacientes aboliram o nistagmo e a vertigem de posicionamento. Destes pacientes, 26 apresentaram recorrência da VPPB, no período de um ano. Em 4% dos pacientes, a VPPB foi persistente. Os pacientes com VPPB persistente apresentaram melhora clínica após a realização da FARV. CONCLUS

  16. Características audiológicas de idosos com Vertigem Posicional Paroxística Benigna Audiologic features of elderly with Benign Paroxysmal Positional Vertigo

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    Nathali Singaretti Moreno

    2009-04-01

    Full Text Available A Vertigem Posicional Paroxística Benigna (VPPB é uma das causas mais comuns de tontura, sendo a desordem vestibular mais comum em idosos vertiginosos. Seu quadro clínico característico é tontura ao movimentar a cabeça, com ausência de alterações auditivas. OBJETIVO: Este trabalho tem como objetivo verificar as características audiológicas de idosos com VPPB de canal posterior. MATERIAL E MÉTODO: Foi realizada uma análise retrospectiva de exames de audiometria tonal limiar de 37 idosos com VPPB de canal posterior e de 37 idosos sem nenhuma queixa de tontura e/ou vertigem, sendo observadas as características audiológicas dos dois grupos estudados. RESULTADOS: Ambos os grupos apresentaram altos índices de perda auditiva, sendo observada, predominantemente, perda auditiva do tipo neurossensorial descendente, não havendo diferença estatisticamente significante entre os grupos. CONCLUSÃO: Diante desses dados, podemos concluir que a VPPB de canal posterior não tem influência sobre as características da perda auditiva em idosos, porém, devido à degeneração espontânea do sistema vestíbulo-coclear, tal população tem prevalência de perda auditiva.Benign Paroxysmal Positional Vertigo (BPPV is one of the most common causes of dizziness; it constitutes the most common vestibular disorder in the elderly with vertigo. Its characteristic clinical aspect is dizziness at head movement, with not hearing alteration. AIM: This paper aims at studying the audiologic characteristics of elderly with BPPV of the posterior semicircular canal. MATERIALS AND METHODS: We carried out a retrospective analysis of threshold tonal audiometry exams of 37 senior citizens with posterior semicircular canal BPPV and also of 37 elderly without complaints of dizziness and/or vertigo, and we studied the audiologic characteristics of the two groups. RESULTS: Both groups had high rates of hearing loss, especially the descending curve sensorineural type, and

  17. 良性阵发性位置性眩晕的误诊漏诊研究%Analyze on Misdiagnosis and Mistherapy of Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    王洪娇; 陈学贤

    2015-01-01

    Objective To investigate the reason of misdiagnosis and wrong therapy for Benign paroxysmal positional vertigo,discuss how to improve its’diagnosis rate. Methods 86 patients were investigated and analyzed. Results 29 cases were diagnosed firstly(33.72%),mistherapy was 48 cases(55.81%), misdiagnosis 9 cases(10.47%). Using Dix-Hal pike and Rol test,posterior semicircular canal was 71 cases,horizontal semicircular canal was 13 cases and mixed type was 2 cases. Conclusion BPPV has typical symptoms and signs and has high misdiagnosis rate. It should be attented. Dix-Hal pike and Rol test is effective means.%目的:研究良性阵发性位置性眩晕(BPPV)误诊漏诊的原因,探讨如何提高良性阵发性位置性眩晕的确诊率。方法选取2012年10月~2014年6月在我院耳鼻喉科诊治的 BPPV 患者86例,调查分析所有患者的诊断经历,研究 BPPV 的误诊漏诊原因。结果86例患者中首次确诊患者29例(33.72%),误诊患者48例(55.81%),漏诊患者9例(10.47%)。采用 Dix-Hal pike 和 Rol test 检查方法,确诊后半规管 BPPV 71例,水平半规管 BPPV 13例,混合型 BPPV 2例。结论 BPPV 有典型的症状及体征,但误诊漏诊率却较高,应引起相关科室医生的重视,减少误诊漏诊情况的发生。Dix-Hal pike 和 Rol test 是明确诊断的有效手段。

  18. Resultados do Balance Rehabilitation Unit na Vertigem Posicional Paroxística Benigna Results from the Balance Rehabilitation Unit in Benign Paroxysmal Positional Vertigo

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    Cristiane Akemi Kasse

    2010-10-01

    Full Text Available A posturografia é um instrumento útil e novo para o estudo da influência das doenças vestibulares no equilíbrio corporal. OBJETIVO: Comparar os resultados da posturografia estática do Balance Rehabilitation Unit (BRU em idosos com Vertigem Postural Paroxística Benigna (VPPB pré e pós a manobra de Epley. MATERIAL E MÉTODO: Estudo prospectivo de 20 pacientes idosos com diagnóstico de VPPB. Os pacientes foram submetidos à posturografia estática do BRU, e o limite de estabilidade (LE e a área de elipse foram medidos. Aplicou-se também o questionário "Dizziness Handicap Inventory" versão brasileira (DHI para verificar a eficácia do tratamento. RESULTADOS: 80% pacientes eram do gênero feminino, com a média etária de 68,15 anos. Após a manobra, o LE aumentou significantemente (p=0,001. A área de elipse nas condições de conflitos sensoriais, visuais e vestibulares da BRU (condições 2,7,8,9 e o escore do DHI diminuíram significantemente (pPosturography is a useful new tool to study the influence of vestibular diseases on balance. AIM: to compare the results from the Balance Rehabilitation Unit (BRU static posturography in elderly patients with Benign Paroxysmal Positional Vertigo (BPPV, before and after Epley's maneuver. MATERIALS AND METHODS: a prospective study of 20 elderly patients with a diagnosis of BPPV. The patients underwent static posturography and the limit of stability (LE and ellipse area were measured. We also applied the Dizziness Handicap Inventory (DHI questionnaire to study treatment effectiveness. RESULTS: 80% were females, with a mean age of 68.15 years. After the maneuver, the LE increased significantly (p=0.001. The elliptical area of somatosensory, visual and vestibular conflicts (2,7,8,9 situations in BRU and the DHI scores decreased significantly (p<0.05 after treatment. CONCLUSION: the study suggests that elderly patients with BPPV may present static postural control impairment and that the maneuver

  19. Quantas manobras são necessárias para abolir o nistagmo na vertigem posicional paroxística benigna? The number of procedures required to eliminate positioning nystagmus in benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Ricardo Schaffeln Dorigueto

    2005-12-01

    Full Text Available OBJETIVO: Avaliar o número de manobras necessárias para abolir o nistagmo posicional em pacientes com Vertigem Posicional Paroxística Benigna e verificar possíveis influências do substrato fisiopatológico e/ou canal semicircular acometido. FORMA DE ESTUDO: clínico prospectivo com coorte transversal. MATERIAL E MÉTODO: Sessenta pacientes com Vertigem Posicional Paroxística Benigna foram tratados por meio das manobras de reposicionamento de estatocônios, repetidas semanalmente até a abolição do nistagmo. A Análise de Variância foi aplicada para verificar diferenças entre as variáveis dos fatores "substrato fisiopatológico" e "canal semicircular acometido". RESULTADOS: Foram necessárias de 1 a 8 manobras, em média 2,13 para abolir o nistagmo posicional. A cupulolitíase necessitou de um número maior de manobras que a ductolitíase (p=0,0002* e não houve diferença entre os canais semicirculares (p=0,5213. Nos canais anterior e posterior, a ductolitíase precisou em média de uma a duas manobras e a cupulolitíase precisou em média de três manobras. No canal lateral, tanto a ductolitíase quanto a cupulolitíase precisaram de duas manobras, em média. CONCLUSÕES: São necessárias de uma a oito manobras semanais de reposicionamento de estatocônios, em média duas, para eliminar o nistagmo posicional na Vertigem Posicional Paroxística Benigna. A cupulolitíase necessita de maior número de manobras que a ductolitíase. O canal semicircular acometido não influencia o número de manobras terapêuticas.AIM: To evaluate the number of weekly canalith repositioning procedures needed to eliminate positioning nystagmus in patients with benign paroxysmal positional vertigo and to verify influences of canalithiasis or cupulolithiasis and/or semicircular canal involvement. STUDY DESIGN: clinical prospective with transversal cohort. MATERIAL AND METHOD: Sixty patients with benign paroxysmal positional vertigo were consecutively

  20. Vértigo posicional paroxístico benigno relacionado con los tratamientos dentales Benign paroxysmal positional vertigo related with dental work

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    R. Crovetto Martínez

    2012-08-01

    Full Text Available Introducción. El vértigo posicional paroxístico benigno (VPPB es el vértigo más frecuente, con una prevalencia anual del 1,6% en la población general. Puede ser causado por traumatismo craneal. El VPPB se desencadena con determinados movimientos cefálicos, como tumbarse en el sillón odontológico en posición supina. Los objetivos de este estudio son determinar la incidencia de presentación de VPPB durante los procedimientos dentales y analizar la incidencia de VPPB yatrógeno tras traumatismos craneales realizados con el osteótomo dental. Material y métodos. El estudio se ha realizado en un Centro Odontológico Integral, sobre pacientes consecutivos. Es un estudio observacional prospectivo. En cada paciente tratado, se investigó, por anamnesis y observación directa, temor a presentar vértigo al reclinar el sillón hasta la horizontal o desencadenamiento del mismo al hacerlo, o si hubo vértigo en los días ulteriores al uso el osteótomo. Se han excluido pacientes menores de 30 años y aquellos con antecedentes vestibulares. Resultados. Hemos encontrado que un 1,7% de pacientes mayores de 30 años tienen temor a presentar vértigo si van a ser tumbados en posición horizontal, pero sólo el 0,17% de los mismos han presentado un verdadero VPPB al hacerlo. 1.3% de los sujetos en los que se uso el osteótomo durante el procedimiento dental presentaron un VPPB yatrógeno. Discusión. El VPPB puede presentarse en los pacientes en el momento de tumbarles en situación horizontal para realizar trabajos dentales. Además, hemos encontrado que el uso del osteótomo en odontología puede ser un factor yatrógeno en el VPPB.Introduction. Benign paroxysmal positional vertigo (BPPV is the most common type of vertigo with an annual prevalence of 1.6% in the general population. It can be caused by head injury. BPPV are triggered when certain head movements, as happens to lie in supine during the dental encounter. The objetive of this study is to

  1. Benign Paroxysmal Positional Vertigo: comparison of two recent international guidelines Vertigem Posicional Paroxística Benigna: comparação de duas recentes diretrizes internacionais

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    André Luís dos Santos Silva

    2011-04-01

    Full Text Available Benign Paroxysmal Positional Vertigo (BPPV is characterized by vertigo, lasting for a few seconds and usually managed by head positioning maneuvers. To educate clinicians concerning the state-of-the art knowledge about its management, the international societies developed guidelines. AIM: the aim of this paper is to discuss, in a practical fashion, the current options available to manage BPPV. METHOD: Study design: non-systematic review. This study reviews two recent guidelines regarding the evaluation and treatment of BPPV. The first one was published by the American Academy of Otolaryngology Head and Neck surgery (AAO-HNS and the other by the American Academy of Neurology (AAN. The similarities were presented in different tables. RESULTS: Those guidelines presented differences regarding methods. Only the AAO-HNS guidelines recommend the Dix-Hallpike test for the diagnosis of BPPV. Only canalith repositioning maneuver, Semont maneuver and vestibular rehabilitation had showed some benefit and were recommended as good treatment options. CONCLUSIONS: Both guidelines fulfilled all the aspects required for clinicians to diagnosed and manage BPPV; only the AAO-HNS's guidelines were more comprehensive and of better quality.A Vertigem Posicional Paroxística Benigna (VPPB é caracterizada por tontura rotatória com duração de segundos e tratada com manobras cefálicas. Para sistematizar a conduta e conduzir os clínicos no atual conhecimento no seu controle, sociedades internacionais desenvolveram diretrizes. OBJETIVO: Discutir de forma prática e didática o estado da arte da abordagem atualmente disponível para VPPB. MATERIAL E MÉTODOS: Revisão assistemática com análise crítica comparando os resultados de duas recentes diretrizes internacionais a respeito da avaliação e controle da VPPB. Uma pesquisa foi elaborada pela American Academy of Otolaryngology (AAO-HNS e a outra preparada pela American Academy of Neurology (AAN. Os tópicos em

  2. Reabilitação Vestibular em portadores de Vertigem Posicional Paroxística Benigna Vestibular rehabilitation in patients with benign paroxysmal positional vertigo

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    João Simão de Melo Neto

    2012-01-01

    Full Text Available OBJETIVO: verificar, por meio do questionário handicap de tontura, o efeito de um protocolo de Reabilitação Vestibular (RV em portadores de Vertigem Posicional Paroxística Benigna (VPPB sete dias após primeira intervenção e seis meses após a segunda intervenção. MÉTODO: pacientes submetidos à confirmação diagnóstica de VPPB pela positividade da manobra Dix-Hallpike foram avaliados (coleta pelo questionário Dizziness Handicap Inventory - brasileiro (DHI-brasileiro, antes da primeira intervenção, após a segunda (intervalo de sete dias e seis meses após a segunda intervenção. As intervenções constavam de relaxamento cervical, manobra de Epley e restrições posturais e foram aplicadas logo após a primeira avaliação e antes da segunda avaliação, com intervalo de sete dias. Os resultados obtidos foram submetidos à análise estatística. RESULTADOS: nove mulheres com média de 63 anos (desvio padrão 4,6 fizeram parte da amostra. Foram encontradas as seguintes pontuações no DHI-brasileiro: Aspecto Físico - apresentou média na coleta 1 de 2,6a(±0,17; coleta 2 de 0,82b (±0,24; coleta 3 de 1,43b(±0,43 com pPURPOSE: to evaluate, by means of the dizziness handicap questionnaire, the effect of a Vestibular Rehabilitation (VR protocol in patients with benign paroxysmal positional vertigo (BPPV, seven days after the first intervention and six months after the second intervention. METHOD: patients undergoing BPPV diagnosis confirmation by a positive Dix-Hallpike maneuver were assessed (collection by the Dizziness Handicap Inventory - Brazilian (DHI-Brazilian before the first intervention, after the second (seven day interval and six months after the second one. The interventions consisted of cervical relaxation, Epley and postural restrictions were applied after the first assessment and before the second evaluation, with an interval of seven days. The results were statistically analyzed. RESULTS: nine women with an average

  3. Vertigem posicional paroxística benigna sem nistagmo: diagnóstico e tratamento Benign paroxysmal positional vertigo without nystagmus: diagnosis and treatment

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    Gabriella Assumpção Alvarenga

    2011-12-01

    Full Text Available O aparecimento do nistagmo nos testes para diagnosticar a VPPB ainda é considerado importante na caracterização clínica da VPPB. Contudo, na prática cotidiana, existem casos de vertigem gerada pelos movimentos cefálicos, que não se acompanham deste sinal na manobra de Dix-Hallpike e no teste de girar. OBJETIVO: Caracterizar a VPPB sem nistagmo, bem como a condução terapêutica nesta situação. MATERIAL E MÉTODO: Revisão não sistemática do diagnóstico e tratamento da Vertigem Posicional Paroxística Benigna (VPPB sem nistagmo nos sites e nas bases de dados PUBMED, Registro de Estudos Controlados Cochrane, SCIELO, BIREME, MEDLINE e LILACS referentes aos anos entre 2001 e 2009. RESULTADOS: Foram localizados nove artigos que abordam a VPPB sem nistagmo, cujo diagnóstico foi baseado exclusivamente na história clínica e no exame físico. O tratamento da VPPB sem nistagmo foi realizado pelas manobras de Epley, Sémont, liberatória modificada para canal semicircular posterior e exercícios de Brandt-Daroff. CONCLUSÃO: De 50% a 97,1% dos pacientes com VPPB sem nistagmo tiveram remissão dos sintomas, enquanto, nos pacientes com VPPB com nistagmo, a remissão dos sintomas variou de 76% a 100%, diferenças que podem não ser significativas, o que demonstra a necessidade de mais estudos sobre a VPPB sem nistagmo.Nystagmus tests to diagnose BPPV are still relevant in the clinical evaluation of BPPV. However, in everyday practice, there are cases of vertigo caused by head movements, which do not follow this sign in the Dix-Hallpike maneuver and the turn test. AIM: To characterize BPPV without nystagmus and treatment for it. MATERIALS AND METHODS: A non-systematic review of diagnosis and treatment of benign paroxysmal positional vertigo (BPPV without nystagmus in the PubMed, SciELO, Cochrane, BIREME, LILACS and MEDLINE databases in the years between 2001 and 2009. RESULTS: We found nine papers dealing with BPPV without nystagmus, whose

  4. Clinical Efficacy of Epley Procedure for Treatment of Benign Paroxysmal Positional Vertigo of Posterior Semicircular Canal%Epley法治疗PC-BPPV的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    谢康; 杜双文; 高继君; 寿广丽; 蒋宏俨; 李有中

    2012-01-01

    目的 评价Epley法治疗后半规管良性发作性位置性眩晕(PC-BPPV)的临床疗效.方法 将入选的PCBPPV患者随机分为治疗组(Epley法加体位限制)与对照组(仅给予体位限制),分别进行治疗,采用痊愈、改善、无效的标准定期进行疗效评定.结果 治疗组于第4,7,10天时痊愈率为82.76%、93.10%、100.00%,而对照组同期为15.56%、24.44%、60.00%;治疗组于第4,7,10天时有效率为96.55%、100.00%、100.00%,而对照组同期为53.33%、68.89%、88.89%,治疗组与对照组比较差异有统计学意义(P <0.005).结论 应用Epley法加体位限制治疗PC-BP-PV,痊愈率和有效率明显提高,疗效优于单纯体位限制治疗.%Objective To assess the clinical efficacy of Epley procedure for treatment of benign paroxysmal positional vertigo of the posterior semicircular canal(PC-BPPV). Methods The patients with PC-BPPV enrolled in this study were randomly allocated to therapeutic group (Epley procedure in combination with postural restriction group) and control group (postural restriction alone group) ,the respective treatment were performed. The efficacy was evaluated by the standards of the following scales; cure, improvement,and no response. Results The cure rates in the therapeutic group were 82.76% ,93.10% ,100.00% on days 4,7, and 10,respectively,while the control group were 15. 56% ,24.44% ,60.00% at the same time,respectively;The response rates in the therapeutic group were 96.55% ,100.00% ,100.00% on days 4,7 and 10,respectively,while the control group were 53. 33% ,68. 89% ,88. 89% at the same time, respectively. There was significant difference between the two groups( P < 0.005 ). Conclusion Epley procedure in combination with postural restriction can obviously increase the curative rate and effective rate of PC-BPPV and is superior to postural restriction alone.

  5. Neurally mediated syncope presenting with paroxysmal positional vertigo and tinnitus.

    Science.gov (United States)

    Goto, Fumiyuki; Tsutsumi, Tomoko; Nakamura, Iwao; Ogawa, Kaoru

    2012-10-01

    A 72-year-old man with positional vertigo and tinnitus was referred to us. He did not want to perform provoking test except once due to his fear. No positional nystagmus was provoked. He found that his attacks usually occurred when he lay on his right ear. From his clinical history, benign paroxysmal positional vertigo was suspected. Conventional pharmacotherapy as well as non-specific physical therapy did not have significant effect. His feeling of positional vertigo with pyrosis was actually presyncope. We suspected cardiovascular disorders, and referred him to a cardiologist. Portable cardiogram monitoring revealed paroxysmal bradycardia. He was diagnosed with neurally mediated syncope, and a pacemaker was implanted. His paroxysmal dizziness soon disappeared. It is important to study the clinical history of the patients in detail, as they are not always able to accurately explain their symptoms. We should carefully rule out cardiovascular disorders, especially when we see the patients with suspected BPPV without the characteristic positional nystagmus.

  6. Benign infantile seizures and paroxysmal dyskinesia caused by an SCN8A mutation

    DEFF Research Database (Denmark)

    Gardella, Elena; Becker, Felicitas; Møller, Rikke S

    2015-01-01

    Objective: Benign familial infantile seizures (BFIS), paroxysmal kinesigenic dyskinesia (PKD), and their combination-known as infantile convulsions and paroxysmal choreoathetosis (ICCA)-are related autosomal dominant diseases. PRRT2 (proline-rich transmembrane protein 2 gene) has been identified...

  7. 水平半规管型良性阵发性位置性眩晕一例%A Case Report of a Fighter Pilot with Horizontal Canal Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    谢溯江; 贾宏博; 蒙果; 姚钦; 郑颖鹃; 陈珊; 尚璐飞

    2012-01-01

    Benign paroxysmal positional vertigo is the most common disorder of the peripheral vestibular system, characterized by intense positional vertigo provoked by head movement. This paper introduces a case of a navy fighter pilot who had an incident of HC-BPPV on the ground and discusses relevant aeromedical evaluation and verification results.%良性阵发性位置性眩晕(BPPV)是最常见的前庭外周疾病,其特点是头动引起的强烈的位置性眩晕.本文介绍了1例在地面发生HC-BPPV的海军飞行员病例,并对有关的航空医学评估与鉴定进行了讨论.

  8. 突发性聋伴良性阵发性位置性眩晕的预后分析%Prognosis of Idiopathic Sudden Sensorineural Hearing Loss with Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    龚桃根; 郑铨艺; 柯朝阳; 曾凡倩; 廖志芳

    2016-01-01

    目的:探讨突发性聋伴良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的预后。方法回顾性分析105例突发性聋患者的临床资料,根据有无伴眩晕以及体位试验的结果分为三组:突发性聋伴BPPV组(13例)、突发性聋伴非BPPV眩晕组(27例)、突发性聋不伴眩晕组(65例),比较三组患者治疗前后的听力情况。结果突发性聋伴BPPV组与突发性聋伴非BPPV眩晕组听力损失较突发性聋不伴眩晕组重,且预后相对较差。结论BPPV是突发性聋的不良预后因素,耳石手法复位对BPPV治疗有效。%Objective To report treatment outcomes of idiopathic sudden sensorineural hearing loss (ISSNHL) with be-nign paroxysmal positional vertigo (BPPV). Methods Clinical data from 105 patients with ISSNHL were reviewed retro-spectively. Patients were divided into 3 groups based on vertigo symptoms and results of positional test, namely, ISSNHL with BPPV (n=13), ISSNHL with non BPPV vertigo (n=27) and ISSNHL without vertigo (n=65),for analysis of rela-tionship between hearing improvement and BPPV. Results Patients with ISSNHL and BPPV or non BPPV vertigo displayed worse hearing loss and had significantly less improvement as compared to those without vertigo. Conclusions BPPV is a poor prognostic factor in ISSNHL, but successful otolith repositioning can be achieved by proper canalith repositioning tech-niques.

  9. 良性阵发性位置性眩晕手法治疗78例分析%Analysis of Manual Reduction Treatment for 78 Cases of Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    石磊; 马梽轩; 曲中源

    2013-01-01

    目的:主要通过我科2010年6月以来开展手法复位治疗良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)以来,对BPPV的临床特点及治疗方法进行总结.方法:采用Epley复位法、Lempert复位法对BPPV患者进行治疗.结果:BPPV患者经Epley复位法、Lempert复位法治疗后总有效率达94.8%.结论:BPPV在所有由内耳疾病引起的眩晕中最为常见,手法复位治疗简单易行,效果确切,副损伤小,患者费用负担轻,值得临床医师进行推广.

  10. 耳石复位法治疗良性阵发性位置性眩晕的护理%Nursing of Canalith Repositioning Procedure in Treating Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    张建华

    2012-01-01

    目的 探讨耳石复位法治疗良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的疗效和护理要点.方法 采用耳石复位法对145例BPPV患者进行治疗,同时进行心理护理、头位护理及康复指导.结果 治疗1周后有效率82.1%;3个月后有效率90.3%.结论 耳石复位法治疗BPPV疗效肯定,同时做好心理护理、头位护理及康复指导非常重要.

  11. Analysis of misdiagnosed cases with benign paroxysmal positional vertigo%良性阵发性位置性眩晕的误诊情况分析

    Institute of Scientific and Technical Information of China (English)

    靳哲; 庄建华; 赵忠新; 陈瑛; 李艳成

    2012-01-01

    Objective To analyze the misdiagnosed cases with benign paroxysmal positional vertigo (BPPV).Methods During October 2010 to January 2011,a total of 287 patients with dizziness visited the Dizziness Clinic at Changzheng Hospital,Second Military Medical University.Forty-eight misdiagnosed cases with BPPV were collected and their clinical data were analyzed.All 48 cases were diagnosed by the DixHallpike or Roll test maneuver.Results ( 1 ) Clinical features:there were 38 females and 10 males with an average age of 54 ± 12 years old( range:31 - 87).Posterior semicircular canal was involved in 75.0% ( 36/48) whereas the horizontal semicircular and multiple canals in 20.8% (10/48)and 4.2% (2/48)respectively.All patients were treated successfully.And 41 cases ( 85.4% ) were cured on the first visiting day.Recurrences of BPPV occurred in 6 cases during the follow-up.( 2 ) The initial visiting departments consisted of the department of general internal medicine 43.8% (21/48),department of neurology 27.1%(13/48),department of osteology 18.7% (9/48),ear,nose & throat (ENT) department 2.1% (1/48)and other departments 8.3% (4/48).In addition,68.7% (33/48) of them frequented the general outpatient clinics during their initial visits and the other 31.3% (15/48) used the emergency services.(3)The initial diagnoses included vertebrobasilar insufficiency/cerebral circulation insufficiency 27.1% ( 13/48),cervical spondylosis 27.1% ( 13/48),cerebral infarction 4.2% (2/48),Meniere's disease 2.1% (1/48)and others 10.4% (5/48); Besides,29.1% (14/48) of them had no diagnosis. (4) The average clinic visits per patient were 3.4 times (164 visits/48 cases).(5) The most commonly performed tests included brain computed tomography (CT) (28 person-times),cervical magnetic resonance imaging (MRI)( 19 person-times),brain MRI( 18 person-times),cervical radiography ( 18 person-times) and cervical CT (8 person-times).Conclusion In these misdiagnosed cases of BPPV

  12. Achados à prova calórica e canal semicircular acometido na vertigem posicional paroxística benigna Caloric test results and damaged semicircular canal in benign positional paroxysmal vertigo

    Directory of Open Access Journals (Sweden)

    Andréa Manso

    2009-01-01

    Full Text Available OBJETIVO: Caracterizar os achados da prova calórica em pacientes com vertigem posicional paroxística benigna, segundo o canal semicircular comprometido. MÉTODOS: Foram analisados 1033 prontuários de pacientes submetidos à pesquisa de nistagmo posicional e de posicionamento e à eletronistagmografia. Os achados da prova calórica, de acordo com os canais semicirculares acometidos, foram submetidos à análise estatística. RESULTADOS: No comprometimento de canal posterior, houve prevalência de normorreflexia (pPURPOSE: To characterize caloric test results in benign paroxysmal positional vertigo patients, according to the damaged semicircular canal. METHODS: The data of 1033 patients submitted to Dix-Hallpike testing, positional nystagmus and electronystagmography were analyzed. Caloric test results were compared to the damaged semicircular canals and were submitted to statistical analysis. RESULTS: In cases with posterior canal damage, there was prevalence of normal responses compared to abnormal results (p<0.0001; hypo activity was more prevalent than hyperactivity (p<0.0001 and directional preponderance (p<0.0001, and hyperactivity more prevalent than directional preponderance (p<0.0001. In cases with lateral canal damage, normal responses were more prevalent than hypo activity (p<0.0001 and hyperactivity (p<0.0001; there was a tendency of prevalence of hypo activity over hyperactivity (p=0.0771, and directional preponderance was not observed. In cases with anterior canal damage, normal responses were more prevalent than hypo activity (p<0.0001; hyperactivity and directional preponderance were not observed. CONCLUSION: In the caloric test of benign positional paroxysmal vertigo patients, normal responses, hypo activity, hyperactivity or directional preponderance of post-caloric nystagmus occur in decreasing order of prevalence when the posterior canal is damaged; normal responses are more prevalent than hypoactive or hyperactive caloric

  13. The characteristics of benign paroxysmal positional vertigo and application of Epley's maneuver in very old patients%高龄良性阵发性位置性眩晕特点及管石复位

    Institute of Scientific and Technical Information of China (English)

    吴智平; 周波; 陈海波; 姜磊

    2010-01-01

    Objective To analyze the characteristics of benign paroxysmal positional vertigo (BPPV) and the efficacy and safety of Epley's maneuver in very old patients.Methods A retrospective review of 29 ( 16.5% ) patients with BPPV out of 176 consecutively admitted patients aged 80 and over presented with a complaint of dizziness was performed.Results In all 29 patients the BPPV origin was attributed to posterior canal involvement;24 (82.8% ) disease, and 1 secondary to head trauma;18 (62.1%) were right-side involved;and 25(86.2%) were diagnosed previously as vertebral-basilar insufficiency.Cardio- and cerebrovascular diseases and the correlative risk factors were common both in patients with BPPV and those with non-BPPV dizziness.Twentyone patients underwent Epley's maneuver, all were free of vertigo after treatment, 14 of them after a single session and the remaining 2 to 4 sessions.No significant complications were observed except in one who experienced vomiting during the procedure.Patients who received Epley's maneuver had a higher cure rate and short recovery time than those who did not.Conclusions BPPV is not uncommon in very old patients with dizziness.Clinicians should have the knowledge to diagnose and treat this condition.Epley's maneuver is safe and effective in very old patients with BPPV.%目的 分析高龄良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的临床特点及Epley复位法的疗效和安全性.方法 对连续收治的176例≥80岁主诉头晕的高龄住院患者中确诊的29例(16.5%)BPPV患者进行回顾性分析.结果 29例BPPV患者均为后半规管受累,24例为特发性.心脑血管病及其危险因素在BPPV患者与非BPPV头晕患者均多见.21例实行Epley复位法的患者全部治愈,无明显不良反应.复位患者较未复位患者治愈率高而恢复时间短.结论 高龄头晕患者中BPPV较常见,应加强对此病的认识.Epley复位法应用于高龄BPPV患者安全有效.

  14. 突聋伴发良性阵发性位置性眩晕诊治分析%The Benign Paroxysmal Positional Vertigo and Sudden Deafness:The Clinical Charactevistics and Assessment

    Institute of Scientific and Technical Information of China (English)

    李菊兰; 蔡华成; 徐海; 巫燕

    2011-01-01

    目的 探讨突聋伴发良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特点.方法 24例突聋伴发BPPV的患者均行Dix- hallpike、Roll- test、Side-lying test变位实验确诊,按不同听力分型进行突聋治疗的同时行不同受累半规管的手法复位治疗,并对受累半规管、听力情况、年龄因素进行分析.结果 24例患者年龄主要为40岁以上,其中左侧11例(外半规管6例、后半规管3例、后+外半规管2例),右侧13例(外半规管7例、后半规管3例、后+外半规管3例),双侧发病率无统计学差异(P>0.05);听力曲线类型:全聋17人,平坦型(重度聋)5人,中频型(中重度聋)2人.结论 突聋的发病因素同时可导致耳石器功能障碍,双耳发病率无差别,听力损失越重耳石器受累越重.%Objective To explore the clinical characteristics of the benign paroxysmal positional vertigo(BPPV) secondary to the sudden deafness. Methods 24 patients with BPPV secondary to the sudden deafness has been diagnosed by Dix-hallpike, Roll-test, Side-lying test and and subsequently treated with Epley or Barbecue maneuver. The affected side and audiogram types and ages were retrospectively analyzed. Results The affected side between the two had no difference among these cases and profound all - frequency hearing loss was the most common type. Older than 40 y were the most. Conclusion The pathogenesis of sudden deafness could also be traced to cause the dysfunction of otolith organs . There were no difference between the two sides and the more severe hearing loss the otolith organs more easily affected.

  15. Semont方法治疗后半规管发作性位置性眩晕的配合及护理%Nursing and matching methods of using Semont therapy to cure posterior semicircular canal benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    蒋珍珍; 杨亚娟; 赵金娣

    2007-01-01

    良性发作性位置性眩晕(benign paroxysmal positional vertigo,BPPV)是一种在体位改变时以短暂眩晕发作为主要表现的内耳半规管疾病。该病发病率高,占周围性眩晕的17%-20%。由于半规管与椭圆囊的解剖关系,脱落的耳石最易进入后半规管(PC),其次为水平半规管(HC)。此病虽为耳鼻喉科疾病,但常在神经内科就诊。对该病采取手法复位可取得满意的疗效,常见的复位方法主要有颗粒复位手法,但也有报道采用Semont方法也可使患者症状缓解。我科采用Semont方法治疗40例PC—BPPV患者,现报道如下。

  16. The clinical characteristics of the benign paroxysmal positional vertigo associated with sudden sensorineural hearing loss%继发突发性聋的良性阵发性位置性眩晕

    Institute of Scientific and Technical Information of China (English)

    李鹏; 曾祥丽; 叶进; 张革化

    2011-01-01

    目的 回顾性分析继发于突发性聋的良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特点,并探讨该病的诊断与治疗特点.方法 突发性聋伴BPPV患者19例,全部进行了手法复位治疗,并评价其治疗效果.结果女性患者63.2%,男性36.8%;本组BPPV均继发于突发性聋后发作,其中后半规管管石症15例,均为同侧,外半规管管石症4例(1例为同侧嵴帽结石,3例为同侧管石);本组患者经多次复位治疗后BPPV均获得治愈.结论 BPPV可继发于突发性聋,并主要发生于听力下降2周内;全部为突发性聋责任耳侧的BPPV,并主要为后半规管BPPV;耳石复位是治疗继发突发性聋BPPV的有效治疗方法,需多次复位治疗.

  17. Diagnosis and CRP-therapy for the different types of benign paroxysmal positional vertigo%不同类型位置性眩晕的诊断及耳石复位治疗

    Institute of Scientific and Technical Information of China (English)

    田君海; 薛海涛; 董凯峰; 赵玉玲; 路虹

    2009-01-01

    目的 探讨不同类型位置性眩晕(benign paroxysmal positional vertigo,BPPV)的诊断方法和半规管耳石复位法对BPPV的治疗效果及存在的问题.方法 从2005年1月~2007年12月对疑似BPPV患者行变位性眼震试验,并对确诊为BPPV的96例患者行耳石复位治疗.结果 所有BPPV患者经1~2次耳石复位治疗,症状完全消失者84例(87.5%);眩晕消失但遗有与体位变换无关的头昏、头重脚轻感者12例(12.5%),其中10例头部症状于1周内消失,2例于2周内消失.结论 不同类型BPPV在诊断方式上存在差异,耳石复位治疗BPPV安全有效,应作为首选.

  18. Etiopathogenesis, Clinical Diagnosis and Therapy of Benign Paroxysmal Positional Vertigo%良性阵发性位置性眩晕的发病机理、临床诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    张素珍

    2006-01-01

    位置性眩晕,是前庭系器质性损害的重要临床表现,Bárány于1921年首先报道本病,他发现一右侧卧位突发眩晕及眼震的患者,30秒后症状消失,当时不认识此症的实质,称其为位置性眩晕。Dix-Hallpike认为是内耳耳石受损引起,直至1952年发表文章正式创立了良性阵发性位置性眩晕(Benign Paroxysmal Positional Vertigo,BPPV)的医学术语。提出BPPV之眼震的五大特点:(1)体位试验时,眼震出现前有短暂潜伏期约1~5秒;(2)旋转型眼震,

  19. Nursing of Particle Repositioning Maneuver in Treating Benign Paroxysmal Positional Vertigo%耳石复位法治疗良性阵发性位置性眩晕的护理

    Institute of Scientific and Technical Information of China (English)

    梅仕俊; 张长国

    2010-01-01

    目的 探讨耳石复位法治疗后半规管良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的疗效和护理要点.方法 采用耳石复位技术对某院2007年7月至2009年6月就诊的40例后半规管BPPV患者进行治疗,并加强健康教育,做好心理护理、头位护理及康复指导.结果 治疗1周后,40例患者中痊愈32 例(80.0%),改善5例(12 5%),无效3 例(7.5%),一次性治疗总有效率为92.5%.结论 耳石复位法对大多数后半规管BPPV患者有效,护理上要严格掌握适应证,认真配合操作,做好心理护理、头位护理及康复指导.

  20. Advances in treatment and nursing care of benign paroxysmal positional vertigo%良性阵发性位置性眩晕的治疗与护理进展

    Institute of Scientific and Technical Information of China (English)

    刘晶; 刘国军; 郑春泽; 黄小银; 胡俊

    2012-01-01

    良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)是耳鼻喉科和神经科一种常见的引起眩晕的疾病.临床上发病率高,是以头部位置变化诱发短暂性眩晕和眼震为特征性表现的周围性眩晕性疾病.可分为后半规管性BPPV(PSC-BPPV)、水平半规管性BPPV(HSC-BPPV)、前半规管性BPPV (ASC-BPPV)3种不同的临床类型.正确的手法复位和复位后的护理对该病治疗有重要的作用.本文对各种不同类型的BPPV的诊断、治疗和护理作一综述.

  1. Horizontal Canal Benign Positional Vertigo

    Directory of Open Access Journals (Sweden)

    Mohtaram Najafi

    1998-03-01

    Full Text Available Benign paroxysmal positional vertigo (BPPV is a syndrome characterized by transient episodes of vertigo in association with rapid changes in head position in Dix-Halpike Maneuver. This kind of vertigo is thought to be caused by migration of otoconial debris into canals other than the posterior canal, such as the anterior or lateral canals. It is also theoretically possible for many aberrant patterns of BPPV to occur from an interaction of debris in several canals, location of debris within the canal, and central adaptation patterns to lesions. The symptoms of BPPV are much more consistent with free-moving densities (canaliths in the posterior SCC rather than fixed densities attached to the cupula. While the head is upright, the particles sit in the PSC at the most gravity-dependent position. The best method to induce and see vertigo and nystagmus in BPPV of the lateral semicircular canal is to rotate head 90°while patient is in the supine position, nystagmus would appear in the unaffected side weaker but longer than the affected side. canal paresis has been described in one third of the patients with BPPV. Adaptation which is one of the remarkable features of BPPV in PSC is rarely seen in LSC. Rotations of 270° or 360° around the yaw axis (the so-called barbecue maneuver toward the unaffected ear are popular methods for the treatment of geotropic HC-BPPV. These maneuvers consist of sequential head turning of 90° toward the healthy side while supine. With these maneuvers, the free-floating otoconial debris migrates in the ampullofugal direction, finally entering the utricle through the nonampullated end of the horizontal canal. This kind of vertigo recovers spontaneously more rapidly and suddenly.

  2. Cognitive Findings in Benign Childhood Epilepsy with Occipital Paroxysms

    Directory of Open Access Journals (Sweden)

    Ebru Kolsal

    2014-12-01

    Full Text Available Aim: The aim of this study was to evaluate the cognitive and visual perceptive functions in children with childhood epilepsy with occipital paroxysms (CEOP. Material and Method: Hospital charts of children ages 1 to 18 years who admitted to pediatric neurology out-patient clinic between 2009 and 2010 were reviewed. Twenty one children with a diagnosis of CEOP were identified. Sixteen of these children who accepted to include the study were evaluated with neuropsychological tests. Results: Two of five patients who were evaluated with Denver developmental screening test were found to have lower scores than their reference standards. Remaining 11 patients were evaluated with Wechsler Scales of Intelligence tests, 4 were mildly mental retarded and 1 had null intelligence. Eleven patients were also evaluated with Bender Gestalt Visual Motor Test and 7of them had disturbances in visual perception. Reading speed and writing norm tests were applied to 9 literate patients and 7 of them showed slower reading ability and writing ability was found worse in 6 patients. Discussion: The absence of neurological and neuropsylogical deficits has long been considered as a prerequisite for diagnosis of benign childhood partial epilepsies. However, only a few studies describing the cognitive profile of patients with CEOP have been published. The present study has demonstrated that the patients with CEOP had varying degree of cognitive dysfunction and disturbance in visual perception. In order to provide appropriate intervention, cognitive functions should be assessed in children with CEOP.

  3. Analysis of Therapeutic Effect of Canalith Repositioning on Benign Positional Paroxysmal Vertigo%良性发作性位置性眩晕行管石复位治疗的效果分析

    Institute of Scientific and Technical Information of China (English)

    陈颖

    2015-01-01

    Objective To investigate the clinical efficacy of pipe rock reset metho of benign paroxysmal positional vertigo.Methods 250 cases of Benign paroxysmal positional vertigo selected in our hospital from January 2012 to De-cember 2013 as research subjects.The posterior semicircular canal BPPV patients of 204 cases, the horizontal semicircu-lar canal BPPV patients of 46 cases.Take the Epley to treat the posterior semicircular canal BPPV patient,and the Barbe-cue to treat the horizontal semicircular Canal BPPV patients.A week later, a month later followed up, record the patient′s treatment.Results Follow-up after a week, posterior semicircular canal BPPV patients recovered in 162 cases, im-provement in 30 cases, 12 cases ineffective, the total effective rate was 98.03%;Horizontal semicircular canal BPPV pa-tients recovered 31 cases, improvement in 8 cases, 7 cases, the total effective rate was 95.65%;The total effective rate was 92.40%in 250 patients with BPPV.Follow-up after a month, posterior semicircular canal BPPV patients recovered in 187 cases, 12 cases improved, invalid in 5 cases, the total effective rate was 99.02%;Horizontal semicircular canal BPPV patients recovered 39 cases, improvement in 4 cases, 3 had no effect, the total effective rate was 97.83%;The to-tal effective rate was 96.80%in 250 patients with BPPV.Conclusions Pipe rock reset method is simple, the curative effect is obvious, position in treating benign recurrent vertigo has significant clinical value.%目的:探讨管石复位法治疗良性复发性位置性眩晕( Benign paroxysmal positional vertigo,BPPV)的临床疗效。方法选取2012年1月~2013年12月收治的250例良性复发性位置性眩晕患者作为研究对象,其中后半规管性BPPV患者204例,水平半规管性BPPV患者46例。后半规管性BPPV患者行Epley法管石复位治疗,水平半规管性BPPV患者行 Barbecue翻滚法管石复位治疗。分别与一周后及一个月后随访,记录患者

  4. Analysis of the Factors Affecting Recurrence of Benign Paroxysmal Positional Vertigo%良性阵发性位置性眩晕复发的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    张祎; 邹怡; 刘博

    2013-01-01

    Objective To investigate the factors affecting recurrence of benign paroxysmal positional vertigo(BPPV) patients. Methods Hundred BPPV patients who were diagnosed and treated in Beijing Tongren Hospital of Capital Medical University from September 2009 to October 2010 were enrolled in our study. All the patients were followed up by phone call. The data of the patients including age, gender, modality of treatment, the result of bithermal caloric test, and co-morbidities (cervical spondylosis, hypotension or hypertension, posterior circulation ischemia, hyperlipidemia, diabetes) were analyzed. The factors affecting recurrence rate of BPPV were studied by applyingχ2 test and the Logistic regression. Results The recurrence rate of BPPV in older patients(38.89%) is higher than that in adolescents(14.29%)(P=0.018). Abnormal blood pressure(P=0.032, 95% confidence interval[CI]=1.097~7.634, odds ratio[OR]=2.893) and non-reduction treatment for BPPV(P=0.014, 95%CI 1.261~7.940, OR 3.165) contributes significantly to recurrence; however there were no significant differences in cervical spondylosis, posterior circulation ischemia, hyperlipidemia, diabetes, and abnormal result of bithermal caloric test between both groups. Conclusion Older patients are prone to recur. The factors affecting recurrence of BPPV include abnormal blood pressure and the modality of treatment.%  目的探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)复发的影响因素。方法收集2009年9月~2010年10月在首都医科大学附属北京同仁医院耳鼻咽喉头颈外科眩晕中心确诊并治疗的100例BPPV患者的资料,于诊治后12个月进行电话随访。对出现复发患者的年龄、性别、治疗方法、双温试验结果和共患颈椎病、高/低血压病、后循环缺血、高脂血症、糖尿病等情况比较,并采用二值Logistic回归分析BPPV复发的影响因素。结果年龄≥45岁的患者(38.89%

  5. Clinical Analysis of Benign Paroxysmal Positional Vertigo Secondary to Otogenic Diseases%继发于耳源性疾病的良性阵发性位置性眩晕的临床分析

    Institute of Scientific and Technical Information of China (English)

    滕锦楠; 纪洋洋; 徐林根

    2012-01-01

    Objective:To analyze the clinical characteristics of benign paroxysmal positional vertigo (BPPV) secondary to otogenic diseases. Methods: The clinical data of 67 patients with otogenic BPPV admitted to department of otolaryngology in Third People's Hospital of Yancheng City from January 2010 to June 2012 was retrospectively analyzed. The outcome of patients with otogenic BPPV was compared with the idiopathic BPPV. All of the patients were treated with the canalith repositioning procedure (CRP). Results: Among the 67 patients, 22 cases were secondary to sudden deafness, 17 cases were secondary to labyrinthitis, 13 cases were secondary to Meniere's disease, 8 cases were secondary to operations on the middle or inner ear, and 7 cases were secondary to vestibular neuronitis. There were no statistical difference in age, gender, lesion location in semicircular canal between otogenic BPPV patients and idiopathic BPPV patients (P>0. 05). The patients secondary to sudden deafness were significantly older than idiopathic BPPV patients (P<0. 001), while CRP times of BPPV patients secondary to Meniere's disease was significantly more than that of idiopathic BPPV patients (P = 0. 003). Conclusions: The causes of otogenic BPPV is diverse, and prognosis of the otogenic BPPV is associated with the causes.%目的:探讨继发于耳源性疾病的良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特征.方法:回顾分析盐城市第三人民医院耳鼻咽喉科2010年1月 2012年6月收治的67例继发于耳源性疾病的BPPV(耳源性BPPV)患者的临床资料,并与同期119例原发性BPPV患者对照比较,分析耳源性BPPV的临床特点、病因及预后.所有患者均采用管石复位法治疗.结果:耳源性BPPV患者中包括突发性耳聋22例(32.8%),迷路炎17例(25.4%),梅尼埃病13例(19.4%),中-内耳手术后8例(11.9%),前庭神经元炎7例(10.4%).耳源性BPPV与原发性BPPV两组患者年龄、性别、半

  6. 突发性聋继发良性阵发性位置性眩晕的临床观察%A clinical observation of patients with benign paroxysmal positional vertigo after sudden deafness

    Institute of Scientific and Technical Information of China (English)

    吴子明; 张素珍; 刘兴健; 杨伟炎; 韩东一

    2010-01-01

    目的 了解继发于突发性聋的良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的发病情况并探讨其治疗策略.方法 观察眩晕门诊及耳内科病房中心2004年1月~2010年1月收治的210例突发性聋患者(包括伴有眩晕的突发性聋)合并BPPV的发病情况,并与同期183例原发性BPPV相比较.结果 本组突发性聋病例并发BPPV为19.0%(40/210);40例患者均为高频感音神经性聋或平坦型感音神经性聋.本文40例继发于突发性聋的BPPV,出现时间均在突发性聋发病后1周内.继发性BPPV的手法复位效果与原发性BPPV相似,大多数都于1~2次就诊后治愈.结论 突发性聋继发的BPPV是临床常见的现象;继发于突聋的BPPV与原发性BPPV都是以后半规管BPPV多见,并与原发性BPPV手法复位的疗效相似.

  7. Characteristic of nystagmus and treatment of horizontal semicircular canal benign paroxysmal positional vertigo%水平半规管良性阵发性位置性眩晕的眼震特点和治疗

    Institute of Scientific and Technical Information of China (English)

    户红艳; 董明敏; 曹华琳

    2011-01-01

    目的:探讨水平半规管(horizontal semicircular canal,HSC)良性阵发性位置性眩晕(benign paroxysmal positional vertigo BPPV)的眼震特点和管石复位的疗效.方法:回顾分析2010年8月至2010年12月郑州大学第一附属医院耳科门诊诊治的48例水平半规管BPPV患者的资料.对所有的患者全面采集病史,并行红外视频眼动电图(Infrared video-oculography)记录变位试验的服震结果.结果:48例确诊患者中,水平向地性眼震39(81.3%)例,水平背地性眼震9(18.8%)例,经变位试验和Gufoni法可转变为向地性眼震的4例,不能转变的5例.所有确诊患者均行Barbecue复位和联合强迫侧卧位疗法.随访半年治愈36(75%)例,有效48(100%)例,复发7(14.6%)例.结论:根据典型病史和体位诱发试验的眼震特点,可明确区分HSCBPPV及其它原因引起的眩晕,并可判断耳石症的类型.不论是管结石还足嵴顶结石均可行Barbecue翻滚法,在VNG的辅助下复位可提高复位的精确度和准确性.

  8. 管石复位治疗良性阵发性位置性眩晕的疗效%Curative Effect of Canalith Repositioning in Treatment of Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    胡俊; 邹文; 童晓欣; 吴军; 张海鸥

    2010-01-01

    目的 探讨管石复位治疗良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床疗效.方法 260例BPPV患者经Dix-Hallpike试验及仰卧侧头试验进行确诊.212例后半规管性BPPV患者采用Epley法行管石复位治疗,48例水平半规管性BPPV患者采用Barbecue翻滚法行管石复位治疗.结果 212例后半规管BPPV患者随访治疗后1周,总有效率为98.1%,复发率为0.0%;随访治疗后3个月,总有效率为94.3%,复发率为5.7%.48例水平性半规管患者随访治疗后1周,总有效率为95.8%,复发率为2.1%;随访治疗后3个月,总有效率为81.3%,复发率为18.8%.结论 管石复位治疗BPPV具有简单、有效及明显缩短病程等优点,可作为首选治疗方法.

  9. 不同类型良性阵发性位置性眩晕的诊治及护理%Diagnosis,treatment and nursing for patients with benign paroxysm position vertigo of inhomogenity

    Institute of Scientific and Technical Information of China (English)

    陈水英; 区永康; 林海燕; 植少娟; 陶朵

    2007-01-01

    目的 探讨不同类型良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的诊治方法和护理要点.方法 对我科2004年4月~2006年3月就诊的BPPV 131例,应用红外线视频眼动记录分析变位试验诱发的眼震特点,进行分型、定侧,并采用相应的耳石复位技术治疗,加强健康教育,做好心理护理、头位护理及康复指导.结果 131例病例中,治疗1周后痊愈97例(74%),改善15例(11.5%),无效19例(14.5%),有效率85.5%;3月后共痊愈109例(83.2%),改善12例(9.2%),无效8例(6.1%),复发2例(1.5%),有效率92.4%.结论 BPPV的诊断和治疗,应根据不同变位试验诱发的眼震特征,判别不同半规管及不同发病机理类型,并选择合适的耳石复位技术治疗,护理上要严格掌握适应证,认真配合操作,做好心理护理、头位护理及康复指导.

  10. Treatment of Semont maneuver for 38 patients with posterior semicircular canal benign paroxysmal positional vertigo%耳石复位Semont方法治疗良性位置性眩晕38例效果观察

    Institute of Scientific and Technical Information of China (English)

    于圣立

    2011-01-01

    目的 探讨Semont方法对良性位置性眩晕(BPPV)的治疗效果.方法 对38例(BPPV)患者按Semont方法进行治疗.结果 经一次Semont方法治疗后31例症状消失首次治疗成功率81.58%;3例经2次、2例经3次治疗后症状消失,总治疗成功率94.74%,2例无效.随访1年,4例复发,复发率11.11%,复发者再用同法治疗仍有效.结论 手法复位的Semont方法治疗BPPV安全有效.%Objective To evaluate the effectiveness of Semont maneuver for benign paroxysmal positional vertigo (BPPV). Methods Totally 38 patients with BPPV were treated with Semont maneuver. Results After a single treatment session of Semont maneuver, the symptoms disappeared completely in 31 patients, the first success rate was 81.58%. The symptoms disappeared in 3 patients after twice, 2 patients after 3 times of Semont maneuver sessions, the total success rate was 94.47%. No effectiveness was found 2 patients ;A year later, BPPV recurred in 4 patients during follow - up and the recurrent rate was 11.11%. It was still effective for another Semont maneuver therapy session. Conclusions The Semont maneuver therapy is safe and effective for BPPV. Repeated Semont maneuver therapy is still effective for them.

  11. Factors associated with poor short-term outcomes following positional maneuvers in patients with benign paroxysmal positional vertigo%良性阵发性位置性眩晕复位短期疗效不佳的分析

    Institute of Scientific and Technical Information of China (English)

    熊彬彬; 赵晓明; 刘劲; 林春梅; 伍慧卿; 梁勇

    2016-01-01

    more than 3 sessions of posi-tional maneuvers during the first two weeks were more prevalent in patients older than 60 years of age. Cupulolithiasis, multiple-canal involvement, head trauma and inner ear ischemia may be factors that can lead to poor curative effect. It is difficult for these patients to recover through single repositioning maneuver. Most of them need several repositioning ma-neuver approaches, combined with postural training and drugs. Repositioning maneuver may not be effective in a small number of these patients. Even for some of these patients to whom repositioning maneuvers are effective, it is easy for BP-PV to reoccur.%目的:探讨短期内多次手法复位疗效不佳的良性阵发性位置性眩晕(benign paroxysmal positional vertigo, BPPV)的影响因素。方法回顾性分析2014年1月-2015年6月39例在本院耳鼻喉门诊首诊,2周以内经反复(3次以上)手法复位疗效不佳的BPPV患者其2周后的临床表现、治疗及随诊结果,探讨其影响因素。结果此类患者占同期全部BPPV患者的9.8%(39/396),其中,男15例,女24例,年龄26岁~81岁,平均63.0±14.5岁,60岁以上的28例,占71.8%。单侧后半规管BPPV 5例,单侧后半规管嵴顶BPPV 7例,单侧水平半规管BPPV 7例,单侧水平嵴顶BPPV 10例,上半规管BPPV 3例,混合型BPPV 7例。其中特发性的25例,继发性的14例(头部外伤7例,梅尼埃病2例,前庭神经炎1例,突发性耳聋1例,中耳炎1例,偏头痛2例)。所有患者均经过超过2周3次以上的手法复位,后半规管及后半规管壶腹嵴受累者采用Epley+Semont法,水平半规管及水平壶腹嵴顶受累者多采用Barbecue+Gufoni或Casani+强迫健侧卧位法,上半规管受累者采用Yacovino法进行复位,39例中28例结合Brandt-daroff体位训练及其药物辅助治疗。2周后-1个月内眩晕和变位性眼震能够完全缓解的19例,1个月后能够完全缓解的26

  12. Repositioning chairs in benign paroxysmal positional vertigo

    DEFF Research Database (Denmark)

    West, Niels; Hansen, Søren; Møller, Martin Nue

    2016-01-01

    %) experienced relapse within the ½-year follow-up period. Horizontal cupulolithiasis and multi-canal affection constituted the most resilient cases. The literature search identified 9 repositioning chair studies. The EO and the TRV are highly valuable assets in diagnosis and management of BPPV of particularly...

  13. 不同类型良性阵发性位置性眩晕的诊断和治疗%Diagnosis and treatment of various benign paroxysmal positional vertigo variants

    Institute of Scientific and Technical Information of China (English)

    区永康; 郑亿庆; 陈玲; 杨海弟; 梁象逢; 许耀东

    2006-01-01

    目的 探讨不同类型良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的诊断和治疗方法.方法 对我科2004年4月-2006年3月就诊的BPPV病人131例,应用红外线视频眼动记录分析变位试验诱发的眼震特点,进行分型、定侧,并采用相应的耳石复位技术治疗.结果 (1)后半规管BPPV 94例(71.8%),随机分组采用Epley管石复位法和Semont管石解脱法各47例.(2)水平半规管BPPV 29例(22.1%),水平向地性眼震者16例,另13例为水平背地性眼震者,自行或采用Gufoni疗法后转换为水平向地性9例,方向不能转换4例.采用barbecue翻滚和/或强迫侧卧体位疗法.(3)前半规管BPPV 6例(4.6%),采用Epley管石复位法.(4)混合型BPPV 2例(1.5%),行上述相应半规管的疗法.1周后随访总有效率85.5%(112/131),3个月后92.4%(121/131).结论 BPPV的诊断和治疗应根据不同变位试验诱发的眼震特征判别不同半规管及不同发病机理类型,并选择合适的耳石复位技术治疗.

  14. The Characteristics of Postural Stability in Patients with Benign Paroxysmal Positional Vertigo%良性阵发性位置性眩晕患者的静态平衡功能特点研究

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    目的 探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者视觉和/或本体觉受干扰后的静态平衡功能特点.方法 对比分析132例BPPV患者及124例健康对照者在4种静态平衡测试模式[睁眼状态下站立于坚硬平板上(YEO);闭眼状态下站立于坚硬平板上(YEC);睁眼状态下站立于海绵垫上(HEO);闭眼状态下站立于海绵垫上(HEC)]下动摇总轨迹长(L).结果 不同年龄组和管型的BPPV患者治疗前、后动摇总轨迹长(L)均高于健康对照组;治疗前BPPV患者动摇总轨迹长(L)高于治疗后.治疗前,老年P-BPPV及M-BPPV患者在YEC和HEC模式下、中青年P-BPPV及M-BPPV患者在HEC模式下的L均与对照组有显著性差异(P<0.05);治疗后,老年M-BPPV与对照组在YEC模式下有显著性差异(P<0.05).治疗前后,老年P-BPPV及M-BPPV患者在HEC模式下测试结果有显著性差异(P<0.05).结论 良性阵发性位置性眩晕患者存在平衡障碍问题,特别是老年患者.进行复位治疗后大部分患者的平衡障碍问题能够得到改善,不过部分患者仍存在平衡障碍问题.积极对这类患者实施复位以及康复训练,可以有效促进其平衡功能的康复.

  15. Efficacy of repositioning maneuvervs drug treatment for benign paroxysmal positional vertigo%手法复位与药物治疗良性阵发性位置性眩晕的疗效对比

    Institute of Scientific and Technical Information of China (English)

    刘兴健; 李剑挥; 王新; 李北成; 雷磊

    2015-01-01

    ObjectiveTo compare the efficacy of repositioning maneuver as well as drug treatment for the treatment of benign paroxysmal positional vertigo (BPPV).Methods A total of 106 patients diagnosed as BPPV who admitted in Hainan Branch of Chinese PLA General Hospital from August 2012 to October 2014 were recruited in this study. They were randomly divided into 2 age- and gender-matched groups, with 53 patients in each group. The patients of group A were treated with repositioning maneuver, while those from group B with drug therapy. All patients were followed up at 1 week and 3 months after treatment. The efficacies of the 2 treatments were compared between the 2 groups.Results Group A got a total effective rate of 91.57%, significantly higher than group B (76.23%,P<0.05).Conclusion Repositioning maneuver is superior to drug therapy for BPPV.%目的:观察比较手法复位与药物治疗良性阵发性位置性眩晕(BPPV)的疗效。方法选取2012年8月至2014年10月在解放军总医院海南分院确诊的BPPV患者,共106例,其中男49例,女57例,平均年龄63.14(32~86)岁。将106例BPPV患者随机分为两组,每组53人。A组用手法复位,B组用药物治疗,分别于治疗后1周和3个月随访,比较两组的疗效。结果 A组总有效率91.57%,高于B组的76.23%,差异有统计学意义(P<0.05)。结论手法复位治疗BPPV疗效优于药物治疗。

  16. Aspectos clínicos e funcionais do equilíbrio corporal em idosos com vertigem posicional paroxística benigna Clinical and functional aspects of body balance in elderly subjects with benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Daniela Patricia Vaz

    2013-04-01

    Full Text Available Vertigem Posicional Paroxística Benigna (VPPB pode alterar o equilíbrio corporal em pacientes idosos. OBJETIVO: Observar os efeitos da manobra de Epley em idosos com VPPB, avaliando os aspectos clínicos e funcionais do equilíbrio corporal. Forma de estudo: clínico e prospectivo. MÉTODO: Após o diagnóstico da doença (teste de DixHallpike, os testes Time Up and Go (TUGT, Clinical test of Sensory Interaction and Balance (CTSIB e o teste de membros inferiores (MMI foram realizados antes e após a manobra de reposicionamento de Epley modificada. RESULTADOS: O gênero feminino foi o mais prevalente e a média etária foi de 70,10 anos (DP = 7,00. Todos os pacientes apresentaram ductolitíase de canal posterior. Os seguintes sintomas melhoraram após a manobra: a instabilidade postural (p = 0,006, náusea e vômito (p = 0,021 e zumbido (p = 0,003. Em relação ao TUGT e o escore do teste de MMII, observou-se diminuição significante do tempo pós-manobra de Epley (p Benign paroxysmal positional vertigo (BPPV may compromise the balance of elderly subjects. OBJECTIVE: To observe the effects of the Epley maneuver in elderly subjects with BPPV and assess clinical and functional aspects of body balance. METHOD: This is a prospective clinical study. Patients diagnosed with BPPV (Dix-Hallpike test were submitted to the Timed Up & Go (TUG test, the Clinical Test of Sensory Interaction and Balance (CTSIB, and lower limb testing before and after they were repositioned using the modified Epley maneuver. RESULTS: Most subjects were females, and the group's mean age was 70.10 years (SD = 7.00. All patients had canalithiasis of the posterior canal. The following symptoms improved after the maneuver: postural instability (p = 0.006, nausea and vomiting (p = 0.021, and tinnitus (p = 0.003. Subjects improved their times significantly in the TUG and lower limb tests after the Epley maneuver (p < 0.001. Patients performed better on the CTSIB after the Epley

  17. Manobra de Epley na vertigem posicional paroxística benigna associada à doença de Ménière Epley’s maneuver in benign paroxysmal positional vertigo associated with Meniere’s disease

    Directory of Open Access Journals (Sweden)

    Cristina Freitas Ganança

    2007-08-01

    Full Text Available Os efeitos da manobra de Epley na vertigem posicional paroxística benigna (VPPB associada à doença de Ménière são controvertidos. OBJETIVO: Avaliar a vertigem e o nistagmo de posicionamento após uma ou mais manobras de Epley na vertigem posicional paroxística benigna (VPPB associada à doença de Ménière e na recorrência da VPPB. MATERISL E MÉTODO: Estudo retrospectivo de 62 pacientes com VPPB associada à doença de Ménière submetidos à manobra de Epley e acompanhados durante 12 meses após a extinção do nistagmo de posicionamento. RESULTADOS: Para abolir o nistagmo de posicionamento, foi necessária uma manobra de Epley em 80,7% dos pacientes, duas em 16,1% e três em 3,2%. A vertigem foi eliminada em 71,0% dos pacientes, melhorou em 27,4% e permaneceu inalterada em 1,6%. Quatro semanas após a extinção do nistagmo de posicionamento, todos os pacientes ficaram assintomáticos. Recorrência da VPPB foi observada em 19,4% dos casos, com eliminação da vertigem e nistagmo de posicionamento à manobra específica para o canal afetado. CONCLUSÕES: Na VPPB associada à doença de Ménière, vertigem e nistagmo de posicionamento foram eliminados com uma, duas ou três manobras de Epley. A recorrência da VPPB foi resolvida com uma manobra para o canal envolvido.The effects of Epley’s maneuver in benign paroxysmal positional vertigo (BPPV associated with Menière’s disease are controversial. AIMS: To evaluate the progression of positional vertigo and nystagmus after one or more of Epley’s maneuvers in BPPV associated with Menière’s disease, and the recurrence of BPPV. METHOD: a retrospective study of 62 patients with BPPV associated with Menière’s disease, that underwent Epley’s maneuver, and that were monitored during 12 months after elimination of positional nystagmus. RESULTS: One Epley’s maneuver was required to eliminate positional nystagmus in 80.7% of the patients, two in 16.1%, and three in 3.2%; after

  18. Occlusion the posterior semicircular canal using laser for treatment the complex benign paroxysmal positional vertigo%激光后半规管封闭术治疗难治性良性阵发性位置性眩晕一例

    Institute of Scientific and Technical Information of China (English)

    林顺涨; 孙爱华; 田树昌; 曹鹏宇

    2005-01-01

    良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV),大部分患者可通过耳石复位法等保守治疗得以好转或治愈;但对于难治性良性BPPV的患者。治疗较为棘手。作者对1例患者进行后半规管激光封闭术,疗效满意,报道如下。

  19. Analysis of risk factors for residual dizziness in patients with benign paroxysmal positional vertigo%良性发作性位置性眩晕患者残余头晕的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王兆霞; 张新江; 刘斌; 李华东

    2013-01-01

    Objective To study the incidence and duration of residual dizziness after successful repositioning treatment in patients with benign paroxysmal positional vertigo (BPPV) as well as the clinical factors associated with the residual dizziness.Methods Two hundred and eighty-four cases of confirmed BPPV patients were followed up for 3 months after particle repositioning,and the incidence and duration of residual dizziness were analyzed; The risk factors for residual dizziness were analyzed by logistic regression.Results (1) Two hundred and eighty-four cases of confirmed BPPV were included in this study,and 158 cases (55.63%,158/284) complained of residual dizziness.Two hundred and forty-five cases completed the 3-month's follow-up,the rate of residual dizziness in the 30th was 13.67% (38/278),the 60th was 9.29% (25/269),and 7.75% (19/245) in the 90th day.The average age of the residual dizziness group was significantly older than non-dizzy group (61.46 ± 9.38 vs 56.93 ± 7.62,t =2.121,P =0.015).In addition,the incidence of residual dizziness in female was higher than that seen in male(62.41% (88/141)vs 37.59% (53/141),x2 =7.984,P =0.005).(2) Logistic regression analysis showed that the duration of vertigo before treatment was an independent risk factor for residual dizziness (OR =2.988,95% CI 1.688-5.292,P =0.000).Conclusions (1) More than half of the patients included in this study complain of residual dizziness after particle repositioning,and symptoms disappear naturally within one month.(2)The duration of vertigo pre-treatment is an independent risk factor for residual dizziness.%目的 研究良性发作性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者治愈后残余头晕的发生率和持续时间以及残余头晕的危险因素.方法 连续性前瞻性收集确诊的284例BPPV患者,在颗粒复位后随访3个月,统计患者残余头晕的发生率和持续时间;应用Logistic回归分析其残

  20. Horizontal canal paroxysmal positional vertigo (HCPPV) vs classical BPPV (new concepts about mechanism and domiciliary repositioning of particles)

    OpenAIRE

    Ghosh, P.

    2002-01-01

    Some new modificutiont of existing diagnostic and therapeutic manoeuvres (repositioning of particles) have been proposed, basing an the applications of the principles of hydrodynamics, inertial and gravitational forces in the semicircular canals. The above has been tried successfully on patients with benign paroxysmal positional vertigo (BPPV) and horizontal eanal paroxysmal positional vertigo (HCPPV) which can be executed by the patients themselves at home without the kelp of a therapist.

  1. The clinical characteristics of the benign paroxysmal positional vertigo associated with Meniere's disease%继发梅尼埃病良性阵发性位置性眩晕的临床特点

    Institute of Scientific and Technical Information of China (English)

    李鹏; 曾祥丽; 李永奇; 张革化; 叶进

    2010-01-01

    Objective To explore the clinical characteristics of the benign paroxysmal positional vertigo (BPPV) associated with Meniere's disease (MD) in retrospect in an effort to improve the diagnosis and efficacy of treatment Method Fifteen cases (1 male and 14 female, aged 46 to 68 years old) of BPPV associated with MD from July 2007 to June 2009 were retrospectively analyzed. Patient clinically characterized with positional paroxysmal vertigo were diagnosed as MD by ECochG and glycerol test and were confirmed as BPPV associated with MD by Dix Hallpike test or roll test They were treated with Epley maneuver or Barbecue rol maneuver according to the type of BPPV, and the efficacy was evaluated. Result (1) Most cases involved female patients in this study; (2) BPPV occurred after MD in al of the cases, of which 13 cases were posterior semicircular canal lithiasis (9 cases in the same ear, 2 in the other and 2 in both) and 2 cases were horizontal semicircula canal lithiasis (cupula lithiasis in the same ear) ; (3) in this study, 10 patients were cured after 3-4 times of posture treatment (66.7% ), 4 patients were cured after 5 times and 1 patient received endolymphatic sac decompression because of recurrent vertigo. Conclusion (1) BPPV can result from MD, for which a possible mechanism may be the hydrolabyrinth that lead to eardust falling off. (2) Most cases of BPPV occurred in the posterior semicircular canal in the same ear. Most cases in incidence rate have obvious sexual bias in female. (3) Eardust reposition is an effective treatment for BPPV caused by MD; while it is refractory compared to ordinary BPPV and requiremultiple treatments, which may be related to the recurrence of hydrolabyrinth.%目的 回顾性分析继发于梅尼埃病(MD)的良性阵发性位置性眩晕(BPPV)的临床特点,并探讨该病的诊断与治疗特点.方法 自2007年7月至2009年6月于中山大学附属第三医院入院的梅尼埃病伴BPPV患者15例,男1例,女14例;年龄46~69

  2. A Clinical Analysis of 968 Cases of Benign Paroxysmal Positional Vertigo%良性阵发性位置性眩晕患者发病特点及手法复位疗效分析

    Institute of Scientific and Technical Information of China (English)

    覃继新

    2016-01-01

    目的 探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的发病特点及手法复位治疗的疗效.方法 回顾性分析2008年1月~2013年12月广西右江民族医学院附属医院耳鼻咽喉一头颈外科确诊并治疗的968例BPPV患者的临床资料,分析该病发病特点及手法复位疗效.结果 ①968例BP-PV患者中男577例(59.61%),女391例(40.39%),男女比例为1.48:1,发病平均年龄51.36±10.63岁(23~96岁);后半规管BBPV 921例(95.14%,921/968),其中管结石症877例(95.22%,877/921),嵴顶结石症44例(约4.78%,44/921);水平半规管BBPV 39例(4.03%,39/968),其中管结石症35例(89.74%,35/39),嵴顶结石症4例(10.26%,4/39);上半规管BBPV 5例(0.52%,5/968),混合型BBPV 3例(0.31%,3/968).②921例后半规管BBPV行传统Epley法复位治疗,首次有效率为91.64%,远期(半年)有效率92.73%;水平半规管BBPV行Barbecue法复位治疗,首次有效率92.31%,远期(半年)有效率94.87%;上半规管BBPV行前翻法复位治疗,首次有效率60.00%,远期(半年)有效率80.00%;混合型半规管BBPV行联合复位治疗,首次有效率66.67%,远期(半年)有效率66.67%;③968例患者中半年内复发92例,复发率9.50%(92/968).结论 本组BPPV患者发病以男性患者和后半规管BPPV多见,手法复位能有效治疗BPPV,尤以后半规管BPPV及水平半规管BPPV疗效显著.

  3. 老年人良性阵发性位置性眩晕与血清同型半胱氨酸水平的关系%Relationship between serum homocysteine level and benign paroxysmal positional vertigo in elderly patients

    Institute of Scientific and Technical Information of China (English)

    朱晓东; 戴利菊; 司马国旗; 季巍伟

    2016-01-01

    Objective To investigate the relationship between serum homocysteine (Hcy) level and benign paroxysmal positional vertigo (BPPV) in elderly patients. Methods One hundred and thirteen patients with over 60 years admitted in the Jiaxing First Hospital from January 2014 to September 2015 (BPPV), and 84 healthy subjects over 60 years (control group) were enrol ed in the study. The serum homocysteine and other blood biochemical parameters were measured, blood pressure was examined. The information of hypertension, diabetes, coronary heart disease, hyperlipidemia, smoking, alcohol consumption and other risk factors of cardiac and cerebral vascular disease were col ected in two groups. Results There were significant differences in serum homocysteine in two groups;however, there were no significant differences in age, gender, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, fasting blood glucose, systolic blood pressure, diastolic blood pressure, albumin level, creatinine;and also there were no significant differences in risk factors of cardiac and cerebral vascular disease, include hypertension, diabetes, coronary heart disease, hyperlipemia, cerebral infarction, cerebral hemorrhage, smoking and drinking history. Logistic regression analysis showed that high homocysteine and younger age were the risk factors of BPPV in elderly patients. Conclusion Homocysteine is an independent risk factor for BPPV in elderly patients.%目的:探讨血清同型半胱氨酸(Hcy)水平和老年人良性阵发性位置性眩晕(BPPV)发病的关系。方法收集年龄≥60岁的BPPV患者113例和年龄≥60岁的体检者84例,分别测定并分析Hcy、血生化检查及血压,以及高血压、糖尿病、冠心病、高脂血症、吸烟、饮酒等心脑血管疾病相关的危险因素。结果 BPPV组和对照组Hcy水平比较差异有统计学意义(P<0.05),而两组间的年龄、性别、TC、TG、HDL、LDL、空腹血糖

  4. The Application of DHI Scale to Evaluation of Quality of Life in Patients with Benign Paroxysmal Positional Vertigo%眩晕障碍量表在 BPPV 患者生活质量评估中的应用

    Institute of Scientific and Technical Information of China (English)

    修世国; 邢东升; 胡玮; 樊新; 张雪; 李东洙

    2014-01-01

    Objective This paper attempts to explore the application of dizziness handicap inventory (DHI) in evaluation of health -related quality of life (QOL ) changes of patients with benign paroxysmal positional vertigo (BPPV) before and after the treatment with canalith repositioning procedure (CRP) .Methods The DHI was em-ployed to investigate and evaluate the dizziness handicap of 120 patients with BPPV before and after 3 months of CRP treatment (treatment group) and 60 healthy controls (control group) ,while the DHI scoring results were com-pared .Results As indicated by DHI evaluation ,the scoring of each DHI items of patients with BPPV before treatment was higher than that of control group ,treatment group before treatment :functional score 22 .60 ± 6 .54 ,emotional score 18 .50 ± 8 .28 ,physical score 17 .90 ± 5 .05 ,total composite score 59 .00 ± 14 .32 .For the control group:functional score 1 .35 ± 1 .74 ,emotional score 1 .00 ± 1 .01 ,physical score 1 .37 ± 1 .86 ,total composite score 3 .72 ± 3 .46 ,with the differ-ence statistically significant (P0 .05) .Conclusion CRP is effective to treat BPPV .The DHI is available for the evaluation of QOL of BPPV patients .%目的:探讨眩晕障碍量表(dizziness handicap inventory ,DHI)对良性阵发性位置性眩晕(BPPV )患者健康相关生活质量(quality of life ,QOL)评估的意义。方法采用汉化的英文版DHI分别对120例施行管石复位法(canalith repositioning procedure ,CRP)治疗的BPPV患者(治疗组)治疗前及治疗后3个月和60名健康体检者(对照组)进行评估,比较两组患者功能、情感、躯体三个方面的得分及总分。结果治疗组治疗前功能、情感、躯体评分分别为22.60±6.54、18.50±8.28、17.90±5.0分,总分为59.00±14.32分,对照组功能、情感、躯体分别为1.35±1.74、1.00±1.01、1.37±1.86分,总分为3.72±3.46分,治疗前治疗组D H I各项

  5. Manobras para o tratamento da vertigem posicional paroxística benigna: revisão sistemática da literatura Maneuvers for the treatment of benign positional paroxysmal vertigo: a systematic review

    Directory of Open Access Journals (Sweden)

    Lázaro Juliano Teixeira

    2006-02-01

    Full Text Available A Vertigem Posicional Paroxística Benigna (VPPB é uma das mais freqüentes patologias do sistema vestibular e é caracterizada por episódios de vertigens recorrentes desencadeados por movimentos da cabeça ou mudanças posturais. Há várias opções para o seu tratamento, porém as efetividades terapêuticas das mesmas permanecem controversas. OBJETIVO: Avaliar a efetividade terapêutica das manobras específicas disponíveis para o tratamento da VPPB. METODOLOGIA: Realizou-se uma busca eletrônica nas principais bases de dados, selecionando-se estudos clínicos randomizados envolvendo adultos com diagnóstico de VPPB confirmado com o teste de Dix-Hallpike e tratamento com manobras específicas (Epley ou Semont, por exemplo. Considerou-se como desfecho clínico a negativação do teste de Dix-Hallpike e a melhora das queixas subjetivas. Agruparam-se em metanálise os estudos com Escala de Jadad igual ou superior a três. RESULTADOS: Cinco estudos clínicos preencheram os critérios de inclusão, ou seja, ensaios randomizados de fase I comparando a manobra de Epley com placebos e controles. A metanálise mostra evidência dos efeitos benéficos da manobra de Epley para o tratamento do canal semicircular posterior (magnitude do efeito de 0,11 [IC 95% 0.05, 0.26] de melhora objetiva (Dix-Halpike após uma semana, 0.24 [IC 95% 0.13, 0.45] após um mês e 0.16 [IC 95% 0.08, 0.33] de melhora referida pelos pacientes após a primeira semana. CONCLUSÃO: Evidencia-se boa eficácia clínica da manobra de Epley para o tratamento da VPPB do canal semicircular posterior. Contrariamente, trabalhos com a manobra de Semont e as propostas de manejo dos demais canais semicirculares não obtiveram qualidade metodológica satisfatória, não sendo possível demonstrar a efetividade dos mesmos.Benign Paroxysmal Positional Vertigo (BPPV is one of the most frequent diseases of the vestibular system and it is characterized by episodes of recurrent vertigo

  6. 良性阵发性位置性眩晕与血清尿酸关系的研究%Relationship between serum level of uric acid and benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    袁俊亮; 陈以丽; 陈宇丹; 牛世芹; 李淑娟; 董谦; 胡文立

    2015-01-01

    Objective To confirm the possible relationships between serum level of uric acid (UA) and benign paroxysmal positional vertigo (BPPV).Methods A total of 87 patients with BPPV and 36 ageand gender-matched control subjects were recruited from our hospital between July 1,2013 and July 1,2014.All patients underwent a complete audio-vestibular test battery,such as Dix-Hallpike maneuver for posterior semicircular canal and supine roll test for horizontal semicircular canal.All risk factors such as the histories of heart and cerebral vascular diseases,and routine hematological and biochemical analyses were analyzed between two groups.Results No significant inter-group differences existed in age,gender,histories of hypertension,diabetes mellitus,hyperlipidemia,coronary heart disease,smoking or drinking (P > 0.05).No significant differences existed between systolic blood pressure,diastolic blood pressure,ejection fraction,whole blood count,lipid profile,homocysteine,prealbumin and blood urea nitrogen in patients with BPPV compared with controls (P > 0.05).However,the values of UA (267 ± 86 vs 325 ± 75)μmol/L,hemoglobin a1 c (5.6 ± 1.4 vs 6.5 ± 1.0) %,albumin (36 ± 4 vs 40 ± 4) g/L and creatinine (72 ±20 vs 81 ± 22) μmol/L were much lower in patients with BPPV versus controls (P < 0.05).According to multiple Logistic regression model,the lower levels of hemoglobin a1 c and albumin were independently associated with BPPV (P < 0.05) with the odds ratio of 1.473 (95% CI 1.066-2.037) and 1.162 (95% CI 1.025-1.318),respectively.However,the level of UA was not independently correlated with the occurrence of BPPV [OR =1.005 (95 % CI 1.000-1.011),P =0.063].Conclusion The lower levels of hemoglobin a1 c and albumin are independently associated with BPPV.Although the value of UA is lower in patients with BPPV versus controls,it is not an independent risk factor for BPPV.Due to limited patient data,further studies are needed to clarify the association in a

  7. The Bithermal Test and Pure Tone Test for Patients with Idiopathic Benign Paroxysmal Positional Vertigo%原发性良性阵发性位置性眩晕患者双温试验及纯音测听分析

    Institute of Scientific and Technical Information of China (English)

    李代波; 戴晴晴; 尹蓉; 郑虹

    2011-01-01

    Objective To investigate the clinical features of results of bithermal test and pure tone test for patients with idiopathic benign paroxysmal positional vertigo (BPPV), and discuss strategies for prevention. Methods A total of 54 patients diagnosed to have BPPV during June 2009 to June 2010 underwent bithermal caloric test and pure tone test before particle repositioning maneuver. Then, we analyzed the clinical features of the test results.Results The course of 40 patients with canal paresis (CP) was (4. 25±2. 75) weeks, which had a significant difference from the course of 14 patients with CP in the abnormal side, which was (9.21±5.85) weeks (t=4.235,P<0.05). Among the 39 patients with posterior semicircular canal benign paroxysmal positional vertigo (PSCBPPV), 11 cases of canal paresis were found in the abnormal ear, and of the 15 patients with horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV), 3 cases of canal paresis were found. There was no statistical difference in the rate of canal paresis between the two groups of patients mentioned above (x2 = 2.679, P>0.05).Sixteen out of the 39 PSC-BPPV patients and seven out of the 15 HSC-BPPV patients had hearing loss (HL) in the abnormal ear with no statistical difference between the two groups of patients in the incidence of hearing loss (x2 =0.141,P>0. 05). Conclusion The incidence of CP and HL in the abnormal ear of patients with HSC-BPPV and PSCBPPV is similar, and patients with long course of disease are more likely to have CP.%目的 了解原发性良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的双温试验及纯音测听结果临床特点.方法 2009年6月-2010年6月诊断为原发性BPPV患者54例,于手法复位前行双温试验及纯音听阈测试,分析原发性BPPV患者的双温试验、纯音测听结果的临床特点.结果 40例患耳无半规管轻瘫,其病程为((4.25±2.75)周,14例患耳半规管轻瘫,其病程为(9.21±5.85)

  8. Analysis of factors affecting the recurrence of benign paroxysmal positional vertigo in elderly patients%老年人良性阵发性位置性眩晕复发影响因素分析

    Institute of Scientific and Technical Information of China (English)

    王春燕; 夏菲; 王彦君; 王宁宇; 刘茉; 温晓慧; 付欣; 李金兰

    2015-01-01

    Objective To analyze factors for the recurrence of benign paroxysmal positional vertigo (BPPV) in the elderly.Methods A total of 59 elderly patients with BPPV who received diagnosis and treatment at our hospital,and experienced recurrence during a 24-month follow-up were selected as the recurrent group and 59 elderly patients without BPPV recurrence after treatment were randomly selected as the non-recurrent group.Factors,including age,gender,semicircular canal involvement,precipitating factors,time of recurrence,magnetic resonance imaging of the head,hypertension,diabetes mellitus,hyperlipidemia,posterior circulation ischemia,and obstructive sleep apnea-hypopnea syndrome (OSAHS),were compared between the two groups,and their relevance to BPPV recurrence was analyzed using binary logistic regression.Results The peak time of recurrence was 6-9 months after initial recovery.Posterior semicircular canal involvement was common in both groups at the onset of BPPV and there was no significant difference (x2 =6.318,P=0.097).In the recurrent group,recurrence affected the same semicircular canal in 31 patients (52.5 %),a different semicircular canal on the same side in 16 patients (27.1%),and semicircular canals on the opposite side or both sides in 12 patients (20.3%).Possible precipitating factors for BPPV recurrence included insomnia,psychological factors,fatigue,migraine,upper respiratory infection and cough,with the first two showing the strongest association (x2=4.933,P=0.026).The combination of hyperlipidemia and posterior circulation ischemia increased the risk for BPPV recurrence (OR=5.822,95% CI:2.317-14.629,P =0.000;OR=1.078,95% CI:1.044 8.267,P=0.041).The incidence of lacunar infarction was significantly higher in the recurrent group than in the non-recurrent group (x2 =5.446,P=0.020),and the infarcts were more often found in the frontal lobe (x2 4.259,P=0.039) and the parietal lobe (x2 =8.859,P=0.003),indicating that arteriolar sclerosis or occlusion

  9. Inlfuence of positional change speed on the recovery rate and discomfort degree in benign paroxysmal positional vertigo patients%良性阵发性位置性眩晕治疗中体位改变速度的影响

    Institute of Scientific and Technical Information of China (English)

    朱思翔; 彭本刚

    2016-01-01

    OBJECTIVETo explore the influence of positional change speed on the recovery rate and discomfort degree of the patients with benign paroxysmal positional vertigo.METHODSPatients with detailed records from September 2012 to September 2015 were reviewed. 358 patients were divided into quick maneuver (0.05). The VAS is 7.70±3.95 and 5.18±3.56 respectively in the quick and slow maneuver group, there is significant differences between the groups (t=3.38,P<0.05).CONCLUSION Positional changing speed does not influence the recovery rate of the BPPV, while the slow maneuver can reduce the discomfort degree.%目的:探讨良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)诊治过程中体位改变速度对治疗效果及患者不适程度的影响。方法分析2012年9月~2015年9月我科就诊有详细资料的BPPV患者358例,由一名医师进行复位治疗。上述患者随机分为两组,每组179例。一组采取快速复位(体位变换时间<2 s),另外一组采取慢速复位(体位变换时间5~10 s),比较两组患者有效率,并对两组患者复位过程产生的不适感进行视觉模拟量表(visual analog scale,VAS)。结果快速复位组治疗有效率97.7%;慢速复位组有效率为97.2%,两组在治疗有效率上无明显统计学差异(P>0.05)。快速复位组VAS平均分(7.70±3.95),慢速复位组VAS平均分(5.18±3.56),两组比较有明显差异(t=3.38,P<0.05)。结论 BPPV手法复位效果与复位过程中的速度无关,慢速复位组患者复位过程中不适感较快速复位组轻。

  10. Revised criteria for suspicion of non-benign positional vertigo.

    Science.gov (United States)

    Soto-Varela, A; Rossi-Izquierdo, M; Sánchez-Sellero, I; Santos-Pérez, S

    2013-04-01

    Benign paroxysmal positional vertigo (BPPV) is the most commonly diagnosed vestibular vertigo. BPPV can be diagnosed by clinical examination and its treatment is based on particle repositioning manoeuvres, and specialized equipment is not required. Therefore, most patients could be diagnosed and treated by their general practitioner. Unfortunately, not all positional vertigos are benign. Symptoms similar to those of BPPV can be caused by diseases that affect the central nervous system. It must be possible to define criteria that allow us to suspect, in a patient with symptoms of positional vertigo, the possibility of a cerebral origin ('non-benign PV'). Requests for magnetic resonance imaging must be justified by the fulfillment of these criteria. That is especially relevant in primary care, because these criteria should make possible to distinguish between patients with positional vertigo that could be treated by general practitioner and patients that need to be directed to especialized units. We propose the following revised criteria for suspected non-benign PV: (i) association with signs or symptoms of neurological disorder, (ii) nystagmus without dizziness in positional diagnostic tests, (iii) atypical nystagmus direction, (iv) poor response to therapeutic manoeuvres and (v) recurrence (confirmed by positional tests) on at least three occasions.

  11. The treatment effect of different time of postural restriction therapy on posterior semicircular canal benign paroxysmal positional vertigo patients after Epley manual therapy%后半规管良性阵发性位置性眩晕Epley手法治疗后不同体位限制时间对疗效的影响

    Institute of Scientific and Technical Information of China (English)

    洪安辉; 雷伟东; 吴杰贤; 黄小良

    2015-01-01

    目的:探讨后半规管良性阵发性位置性眩晕Epley手法治疗后体位限制时间对治疗效果的影响。方法选取入院治疗的后半规管良性阵发性位置性眩晕(PC-BPPV)患者73例作为研究对象,根据体位限制时间分为对照组和观察组,对照组35例限制时间为72h,观察组38例限制时间为24h,观察两组临床疗效,行DARS评分(眩晕量表评分系统),随访9~12个月记录两组复发率及时间。结果观察组治疗有效率为84.21%与对照组82.86%比较差异无统计学意义(P>0.05)。两组复发率和中位复发时间差异无统计学意义(P>0.05),观察组DARS评分为(11.03±3.25)分显著低于对照组(16.69±2.15)分,差异具有统计意义(P<0.05)。结论 Epley手法治疗PC-BPPV后体位限制时间对临床疗效无明显影响,但短时间体位限制可提高舒适度。%Objective To investigate the effect of time limit of semicircular canal benign paroxysmal positional vertigo postural restriction therapy on posterior of different time patients after Epley manual therapy.Methods Selected 73 hospitalized patients of posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) were randomly divided into a control group and a observation group according to the postural restriction time, the postural restriction time of the control group of 35 cases was 72h, the observation group of 38 cases was 24h, observed clinical curative effect of two groups and DARS score, followed up for 9 to 12 months recording recurrence rate.ResultsThe effective rate of observation group was 84.21%, compared with 82.86% of control group, differences had no statistically significant (P>0.05),the recurrence rate and median time of relapse had no significant difference (P>0.05), the DARS score of control group (16.69±2.15) was significantly higher than observation group (11.03±3.25), the difference was statistically significant (P<0

  12. Avaliação vestibular na vertigem posicional paroxística benigna típica e atípica Vestibular evaluation in typical and atypical benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Gisiane Munaro

    2009-01-01

    Full Text Available OBJETIVO: verificar a prevalência da vertigem posicional paroxística benigna típica e atípica, correlacionar a sintomatologia e resultados da avaliação vestibular, de ambas as formas. MÉTODOS: entre janeiro de 2007 e março de 2008, verificou-se todos os pacientes que apresentaram nistagmo e/ou vertigem às provas de posicionamento, descrevendo a história clínica e avaliação vestibular por vectoeletronistagmografia modelo Vecwin, Neurograff. Foram estabelecidos dois grupos: o que apresentou nistagmo às provas de posicionamento e os que somente referiram vertigem. RESULTADOS: de 399 pacientes avaliados no Centro Clínico Mãe de Deus, Porto Alegre, 86 (31,73% apresentaram história clínica de vertigem posicional, 45 (49,45% com vertigem posicional típica e 41 (45,05% com vertigem atípica, idade média de 61 e 52 anos, respectivamente. Houve predomínio do sexo feminino e histórico familiar positivo para o quadro em 28 (30,76% pacientes, maior acometimento bilateral, em ambas as formas. 39,02% dos pacientes da forma típica demoraram em torno de um mês para buscar atendimento, 22,22% dos pacientes da forma atípica levaram mais de cinco anos. O nistagmo espontâneo e pré-calórico esteve presente em ambas as formas, com normorreflexia em 35 (40,6%, predomínio direcional em 27 (31,03%, hiperreflexia bilateral em 9 (10,4% e unilateral em 10 (11,6% dos pacientes. Avaliação audiológica foi realizada em apenas 56 (65,11% dos casos. CONCLUSÃO: a queixa principal foi a mesma em ambos os grupos, que concordaram em diversos aspectos. Os pacientes da forma típica e atípica diferiram, principalmente, no tempo de acometimento e ocorrência de patologias associadas.PURPOSE: to check the prevalence of typical and atypical benign positional paroxistic vertigo and relate clinical history and results of vestibular evaluation for both types. METHODS: all patients that showed nystagmus and/or vertigo in positional tests, between January 2007

  13. Prognosis characteristics in idiopathic sudden sensorineural hearing loss patients with benign paroxysmal positional vertigo%并发良性阵发性位置性眩晕的突发性聋患者预后相关性分析

    Institute of Scientific and Technical Information of China (English)

    于立民; 刘鸣; 肖玉丽; 韩东旭; 王超; 金德均

    2015-01-01

    目的 探讨并发良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的突发性聋病例特征及BPPV与突发性聋预后相关性.方法 对2007年3月~2013年3月,278例突发性聋病例进行回顾性分析.对治疗前及治疗后的纯音听阈结果进行分析,并对其预后进行多因素回归分析.结果 36例突发性聋病例并发BPPV(12.95%).并发BPPV的突发性聋患者治疗前及治疗后听力损失重,并发BPPV的突发性聋者预后更差,多因素结果分析显示老龄(>60岁)、治疗前听力的损失程度、前庭功能异常与突发性聋预后密切相关.结论 并发BPPV的突发性聋者,显示前庭功能受损更重,预后更差.

  14. Diagnosis and treatment of persistent vertigo due to horizontal semicircular canal benign paroxysmal positional vertigo%以持续性眩晕为表现的水平半规管良性阵发性位置性眩晕的诊治

    Institute of Scientific and Technical Information of China (English)

    赵正卿; 庄建华; 陈瑛; 靳哲; 李艳成; 赵忠新

    2014-01-01

    目的 探讨以持续性眩晕为表现的良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者的诊治.方法 回顾性分析2例以持续性眩晕为表现的BPPV患者的临床资料.结果 此2例患者在坐位及平躺位见方向向患侧的水平自发持续性眼震,甩头试验健侧阳性,平卧侧头试验双侧均诱发出水平离地性眼震,平躺后头部向患侧连续转360°时分别出现2个眼震消失点和2个眼震最强点,给予手法复位后患者眩晕症状缓解.结论 水平半规管BPPV患者偶可表现为持续性眩晕发作,其病因为壶腹嵴帽耳石症,临床表现与耳石重力因素和水平半规管空间位置相关.

  15. 改良式耳石复位法治疗良性阵发性位置性眩晕疗效观察%Observation of curative effect of modified canalith reposition on 48 cases with benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    兰俊

    2012-01-01

    Objective To investigate the therapeutic efficacy of the canalith repositioning maneuver in benign paroxysmal positional vertigo (BPPV). Methods The modified Epley procedure, Semont maneuver and Barbecue maneuver were applied in 48 cases of BPPV. Followed for one year, the curative effects were observed. Results After treatment in modified canalith reposition, the recovery rate was 89.58%, and effective rate was 100% . Followed for one year, the recurrence rate was 6.25% . Conclusion Modified canalith reposition for BPPV has no contraindications, and no special adverse reactions. It is simple and can fastly relieve symptoms. The cost and recurrence rate are low. It is suitable for clinical application.%分别采用三种不同改良式耳石复位法治疗良性阵发性位置性眩晕患者,治愈率达89.58%(43/48),有效率100%,随访1年复发率6.25%(3/48).改良式耳石复位法治疗良性阵发性位置性眩晕无明显禁忌证.操作方法 简单.无特殊不良反应,具有缓解症状迅速、治疗费用低、复发率低等优点,适宜临床推广应用.

  16. Qualidade de vida em pacientes com vertigem posicional paroxística benigna e/ou doença de Ménière Quality of life in patients with benign paroxysmal positional vertigo and/or Ménière's disease

    Directory of Open Access Journals (Sweden)

    Patrícia Rumi Handa

    2005-12-01

    Full Text Available Pacientes com vertigem posicional paroxística benigna e/ou doença de Ménière relatam prejuízos na qualidade de vida. OBJETIVO: Comparar o impacto da tontura na qualidade de vida destes pacientes e avaliar a influência do gênero, faixa etária e canal semicircular afetado. FORMA DE ESTUDO: clínico com coorte transversal. MATERIAL E MÉTODO: Estudo prospectivo realizado na Universidade Federal de São Paulo, em 2003/04. O Dizziness Handicap Inventory foi aplicado em 70 pacientes com vertigem posicional, 70 com doença de Ménière e 15 com ambas. Utilizou-se o teste de igualdade de duas proporções e a análise de variância para a avaliação estatística. RESULTADOS: Os escores obtidos com a aplicação do questionário foram superiores, na crise e fora dela, no grupo com doença de Ménière, em relação ao com vertigem posicional, mas apenas na crise em relação ao grupo com associação (pPatients with benign paroxysmal positional vertigo and/or Ménière's disease relate damages in quality of life. AIM: To compare the impact of dizziness on quality of life, in patients with benign paroxysmal positional vertigo and/or Ménière's disease, in crisis and out of crisis, and to evaluate the influence of gender, age and impaired semicircular canal. STUDY DESIGN: clinical with transversal cohort. MATERIAL AND METHOD: The prospective study was realized in 2003/04 at Federal University of São Paulo. The Dizziness Handicap Inventory was applied in seventy patients with positional vertigo, seventy with Ménière's disease and fifteen with both. Two-proportion equality test and the Analysis of variance were employed in this study. RESULTS: When comparing the groups, Dizziness Handicap Inventory results evidenced higher averages in crisis and out of crisis for Ménière's disease group than for positional vertigo group. The same occurred only during the crisis period in the group when comparing with both disorders (p<0,05. No significant

  17. Clinical observation on ginger-partitioned moxibustion plus manual repositioning for benign paroxysmal positional vertigo (BPPV)%隔姜灸联合手法复位治疗良性阵发性位置性眩晕临床观察

    Institute of Scientific and Technical Information of China (English)

    倪斐琳; 张丽萍; 胡珊珊; 韩丑萍

    2016-01-01

    Objective:To investigate the clinical effect of ginger-partitioned moxibustion combined with manual repositioning for benign paroxysmal positional vertigo (BPPV). Methods:A total of 76 BPPV cases were randomly allocated into an observation group (n=38) and a control group (n=38). Patients in the observation group received ginger-partitioned moxibustion at Tinggong (SI 19) plus manual repositioning, whereas patients in the control group received the same manual repositioning alone. Results: After 48 h of treatment, the total effective rate was 94.7% in the observation group, versus 86.8% in the control group; after 7 d of treatment, the total effective rate was 78.9% in the observation group, versus 73.7% in the control group, both showing between-group statistical differences (P<0.05). The follow-up after 3 months showed that 2 cases (6.7%) got relapse in the observation group, versus 8 cases (28.6%) in the control group, showing a statistical difference (P<0.05). The adverse reaction rate was 2.6% in the observation group, versus 21.1% in the control group, showing a statistical difference (P<0.05).Conclusion: Ginger-partitioned moxibustion at Tinggong (SI 19) plus manual repositioning can obtain better effect for BPPV than manual repositioning alone. In addition, this therapy has stable efficacy and causes less adverse reactions.%目的:探讨隔姜灸联合手法复位治疗良性阵发性位置性眩晕(benign paroxysmal positional vertigo, BPPV)的临床疗效.方法:将76例BPPV患者按随机数字表随机分为两组, 每组38例.观察组患者予隔姜灸听宫穴后手法复位治疗,对照组仅予与观察组相同的手法复位治疗.结果:治疗48 h后,观察组总有效率为94.7%,对照组总有效率86.8%;治疗7 d后,观察组总有效率为78.9%,对照组总有效率为73.7%.两组在2个观察点的总有效率差异均有统计学意义(P<0.05).治疗结束3个月后随访, 观察组中2例复发, 复发率6.7%; 对照组中8例复发,

  18. Necessity of concurrent mastoid oscillation with canalith repositioning procedure for treatment of benign paroxysmal positional vertigo: a systematically review%良性阵发性位置性眩晕患者行手法复位后联合乳突振荡治疗必要性的Meta分析

    Institute of Scientific and Technical Information of China (English)

    谭敏; 胡志兵; 戴建武; 曹莹; 梁冬蕾

    2010-01-01

    目的 评价良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者行手法复位治疗后联合乳突振荡治疗的必要性.方法 采用Cochrane系统评价的方法,电子检索Pubmed、Ovid、Cochrane图书馆、中国期刊全文数据库、万方数据库、中文科技期刊全文数据库、中国生物医学文献数据库(CBM)及相关参考文献.纳入随机对照试验,评价单次治疗的疗效.疗效评估根据Dix-Hallpike检查或患者主观感受变化评定.运用RevMan4.2.3软件进行系统评价.根据异质性检验结果,应用固定效应模型或随机效应模型,计算相对危险度(RR)值和95%CI,并进行敏感性分析.结果 共纳入5个随机对照试验,415例患者,Meta分析结果显示,固定效应模型RR=0.82,95%CI=0.59~1.13;随机效应模型RR=0.69,95%CI=0.37~1.27;敏感性分析RR=0.96,95%CI=0.64~1.26.结论 手法复位治疗联合乳突振荡与单纯手法复位治疗BPPV疗效相当.

  19. Application of the reformed canalith repositioning maneuver by videonystagmography guarding for benign paroxysmal positional vertigo%眼震电图监视下改良手法复位在良性阵发性位置性眩晕中的应用

    Institute of Scientific and Technical Information of China (English)

    张晓惠; 孙红霞; 孙晓萍; 郭爱萍

    2014-01-01

    目的 探讨眼震电图监视下改良手法复位治疗良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床价值.方法 经眼震电图监视下行位置诱发试验(Dix-Hallpike test)及滚转试验(turning head test)确诊为BPPV的56例患者,对其中44例PC-BPPV的患者采取改良Epley或改良Semont加改良Epley手法复位法,对12例HC-BPPV患者用改良Barbecue手法复位法.结果 改良Epley或改良Semont加改良Epley手法复位法治疗PC-BPPV患者,治愈38例(86.36%),有效4例(9.09%),无效2例(4.55%).改良Barbecue手法复位法治疗HC-BPPV患者,治愈8例(66.67%),有效4例(33.33%).复位过程中1例后半规管结石误入水平半规管,经采用改良Barbecue手法复位治愈.结论 眼震电图监视下手法复位治疗良性位置性眩晕,治疗效果好,简单,安全,值得推广.

  20. Clinical characteristics and observation of curative effect of benign paroxysmal positional vertigo after sudden hearing loss%突发性聋伴发良性阵发性位置性眩晕的临床特点及疗效观察

    Institute of Scientific and Technical Information of China (English)

    原红艳; 张淑香; 闫亚平; 韩倩

    2016-01-01

    目的:探讨突发性聋伴发良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的临床特点,观察其疗效。方法观察2012年10月~2014年6月耳鼻咽喉科收治的36例突发性聋伴发BPPV发病情况,并与同期原发性BPPV患者40例及突发性聋不伴眩晕患者40例进行疗效比较。结果伴发BPPV的36例突发性聋患者,受累半规管均与突发性聋发病侧一致,其中水平半规管BPPV 6例,占16.7%(6/36);后半规管BPPV 27例,占75.0%(27/36);混合管BPPV 3例,占8.3%(3/36)。36例患者出现BPPV的时间均在突发性聋发病后数小时至数天(<10天)发生。突发性聋伴发BPPV组1次治愈率明显低于原发性BPPV组,但两种治疗方法的总治愈率均为100%。不伴眩晕突发性聋组的痊愈率、显效率及有效率均高于伴发BPPV组。结论伴发于突发性聋的BPPV以后半规管多见,与原发性BPPV经耳石复位治疗后均可取得较好疗效。而不伴眩晕的突发性聋其疗效优于伴发BPPV的突发性聋。%[ABSTRACT]OBJECTIVETo explore the clinical characteristics of benign paroxysmal positionalvertigo(BPPV) after sudden hearing loss and to observe the curative effect. METHODS36 patients with BPPV after sudden hearing loss were observed.And their therapeutic findings were compared with that of the 50 patients with primary BPPV and 40 patients of sudden hearing loss without vertigo. RESULTSBPPV after sudden hearing loss occurred in the hearing loss ears, of which 27 cases were posterior semicircular canal lithiasis and 3 cases were horizontal semicircular canal lithiasis. The 36 patients with BPPV after sudden hearing loss and 40 patients with primary BPPV were cured after several times of reposition maneuver treatment.The efficiency of 40 patients of sudden hearing loss without vertigo was higher than that of 36 patients with BPPV after sudden hearing loss.CONCLUSIONBPPV after the sudden hearing loss

  1. [Horizontal canal benign paroxysmal positional vertigo (HC-BPPV) with direction-changing apogeotropic nystagmus: a case with the more-triggering side altering over a short-term].

    Science.gov (United States)

    Takaya, Shigetoshi; Yamamoto, Toru

    2002-04-01

    We report a 44-year-old man who had apogeotropic nystagmus with the rotation of his head to either side from the supine position. His nystagmus lasted more than 2 minutes and was difficult to treat with. There were no neurological abnormalities except for the nystagmus and no findings suggesting intracranial disease on MRI. The head-position in which more intense nystagmus was evoked changed again and again in a short term. We diagnosed his illness as cupulolithiasis of horizontal canal, however, the affected ear could not be explained by any of the previously supposed mechanisms. In our case, we speculate the following mechanism. Otoliths were located on the right utricular side of the cupula. All of them were attached on the cupula at the beginning(attached phase) and then, some of them were detached from it(detached phase). The extent of the cupular deviation differed in each phase when the otoliths were beneath the cupula with his head turned to the left lateral position. According to Ewald's second law, more intense nystagmus is evoked when the cupula deviates toward the utricle than away from it. The patient's head-position in which more intense nystagmus was evoked changed according to the balance between the effect of Ewald's second law and the amount of otoliths detached from cupula. Our case showed that, in HC-BPPV with direction-changing apogeotropic nystagmus, we could not be certain about which ear was diseased. Therefore, it may be difficult to apply exercise therapy by determining the affected ear based on the head-position in which more intense nystagmus is evoked.

  2. Manobra de Epley repetida em uma mesma sessão na vertigem posicional paroxística benigna Epley’s maneuver in the same session in benign positional paroxysmal vertigo

    Directory of Open Access Journals (Sweden)

    Gustavo Polacow Korn

    2007-08-01

    Full Text Available OBJETIVO: Avaliar se a repetição de manobras de Epley em uma mesma sessão resulta em um menor número de sessões para abolir o nistagmo de posicionamento do que uma única manobra por sessão. MÉTODO: A manobra de Epley foi realizada em 123 pacientes com VPPB unilateral por ductolitíase do canal posterior. O grupo I foi composto por 75 pacientes submetidos a uma única manobra de Epley por sessão semanal e o grupo II foi constituído por 48 pacientes submetidos a quatro manobras na primeira sessão. RESULTADOS: O grupo II apresentou latência e duração do nistagmo maiores do que o grupo I (pAIM: To assess whether more than one Epley’s maneuver in the same session, compared to a single one, decreases the number of sessions necessary to suppress positional nystagmus. METHOS: Epley’s maneuver was done in 123 patients with BPPV due to unilateral posterior semicircular canal canalolithiasis. The number of sessions for positional nystagmus suppression was compared in two groups of patients. Group I consisted of 75 patients submitted to a single Epley’s maneuver on weekly sessions and group II consisted of 48 patients that were submitted to four Epley’s maneuvers during the first session. RESULTS: Group II showed greater nystagmus latency and duration than group I (p<0.05. The number of sessions and standard deviation showed by group I was greater than in group II (p=0.008. We observed a significant association between number of sessions and group (p=0.039 studied. Group II had 21.4% more nystagmus-free patients following only one session (CI95% [7.7% - 35.1%]. CONCLUSION: Repeated Epley’s maneuvers in less sessions rendered more positional nystagmus-free patients when compared to those submitted to more sessions of single maneuvers.

  3. Avaliação da manobra de reposicionamento de Epley em indivíduos com vertigem posicional paroxística benigna Assessing Epley's maneuver for benign paroxysmal positioning vertigo

    Directory of Open Access Journals (Sweden)

    Viviane de Souza Pinho Costa

    2010-10-01

    Full Text Available OBJETIVO: avaliar os parâmetros estabilométricos após a manobra de reposicionamento de Epley em indivíduos com Vertigem Posicional Paroxística Benigna (VPPB previamente confirmada através da manobra de Dix-Hallpike. MÉTODOS: estudo experimental que incluiu pacientes que apresentaram VPPB com nistagmo de posicionamento à prova de Dix-Hallpike, avaliados no ano de 2008, no Ambulatório Multidisciplinar de Vertigem, e que foram submetidos à manobra de reposicionamento de Epley e avaliados quanto ao equilíbrio postural pelo exame de Estabilometria, antes e após a citada manobra. RESULTADOS: os 13 indivíduos do gênero feminino com idade variando de 15 a 78 anos com VPPB, previamente confirmados e selecionados para a pesquisa, apresentaram melhora estatisticamente significante em parâmetros estabilométricos verificados da primeira para a segunda avaliação, confirmando melhora do equilíbrio postural, após a manobra de Epley. CONCLUSÃO: nesta pesquisa a manobra de reposicionamento de Epley mostrou-se como um procedimento de intervenção importante para a melhora das respostas do equilíbrio postural em indivíduos com VPPB avaliados pela estabilometria.PURPOSE: to evaluate the stabilometry parameters after Epley's maneuver in individuals with BPPV previously confirmed through Dix-Hallpike maneuver. METHODS: an experimental study which included patients with BPPV with positional nystagmus taking Dix-Hallpike's test and assessed in 2008, at the Multidisciplinary Vertigo Ambulatory, and who were also submitted to Epley's maneuver and assessed as for their postural balance through a stabilometry exam, both before and after such maneuver. RESULTS: the 13 female subjects with ages ranging from 15 to 78 years with previously confirmed BPPV, who were selected for the research, showed a significant statistically improvement regarding their postural balance after Epley's maneuver in all analyzed parameters as for both exams. CONCLUSION: in

  4. Caloric test for recurrent and non-recurrent patients with benign paroxysmal positional vertigo patients%复发和非复发良性阵发性位置性眩晕患者温度试验结果比较

    Institute of Scientific and Technical Information of China (English)

    刘姣; 王斌全

    2015-01-01

    目的 比较复发和非复发良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者温度试验特点.方法 收集同期就诊79例BPPV患者,随访后分为复发组26例和非复发组53例,均采用冷热温度试验检测一侧减弱(unilateral weakness,UW)发生率,并对结果进行比较分析.结果 复发组UW19例(73.08%),非复发组UW26例(49.06%),二者比较差异有统计学意义(x2=4.11,P<0.05).复发组温度试验UW正常或轻度减弱10例(38.46%),非复发组37例(69.81%),二者比较差异有统计学意义(x2=7.11,P<0.01).后半规管BPPV患者UW31例(56.36%),外半规管BPPV患者UW14例(58.33%),二者比较差异无统计学意义(x2=0.02,P>0.05).45例温度试验异常的BPPV患者中,减弱侧和病变侧不一致率高(57.78%).两组优势偏向(directional preponderance,DP)异常率比较差异无统计学意义(x2=0.16,P>0.05).结论 复发组UW发生率高于非复发组,且复发组UW程度较非复发组严重.温度试验为BPPV患者的治疗及预后提供参考依据.

  5. Short and long-term outcome of the rapid repositioning manoeuvre for multiple canals benign paroxysmal positional vertigo%快速手法复位治疗多半规管良性阵发性位置性眩晕的近远期疗效分析

    Institute of Scientific and Technical Information of China (English)

    李进让; 张昊; 郭鹏飞

    2015-01-01

    目的 探讨多半规管良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的诊断和快速手法复位的疗效.方法 回顾性分析2009年7月~2014年7月诊治的317例行快速手法复位的BPPV患者的临床特征,其中单半规管BPPV 258例,两个或两个以上半规管BPPV 59例,根据变位试验检查确定受累半规管并行快速手法复位治疗,随访1周至3个月.结果 59例多半规管BPPV患者,双侧后半规管BPPV 1例(1.7%),双侧水平半规管BPPV6例(10.2%),后半规管合并上半规管BPPV10例(16.9%),水平半规管合并上半规管BP-PV 14例(23.7%),后半规管合并水平半规管BPPV 28例(47.5%).所有患者随访1周,总有效52例(88.1%),随访3个月总有效56例(94.9%),与同期258例单半规管BPPV患者的近远期疗效差异无统计学意义(P>0.05).结论 多半规管BPPV并不罕见,并对临床医生的诊断提出了更高的要求,明确诊断后快速手法复位法对治疗多半规管BPPV效果确切能获得与单半规管BPPV同样好的治疗效果.

  6. 原发性良性阵发性位置性眩晕患者水平半规管和耳石器功能特点分析%The Functional Characteristics of Horizontal Semicircular Canal and Otolith in Patients with Primary Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    目的 探讨原发性良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)患者水平半规管、球囊及椭圆囊功能特点.方法 对40例原发性BPPV患者进行分组,后半规管BPPV组29人,水平半规管BPPV组11人,正常对照组23人,分别对3组观察对象行冷热试验(caloric test)、颈肌前庭诱发肌源性电位(cervical vestibular evoked myogenic potential,cVEMP)及眼肌前庭诱发肌源性电位(ocular vestibular evoked myogenic potential,oVEMP)测试.对原发性BPPV患者的半规管、球囊及椭圆囊功能进行分析,进一步探讨BPPV的发生原因.结果 后半规管BPPV组与水平半规管BPPV组冷热试验异常率均明显高于正常对照组,差异有统计学意义(P<0.05);水平半规管与后半规管BPPV组冷热试验异常率差异无统计学意义(P>0.05).后半规管BPPV组、水平半规管BPPV组、正常对照组三者cVEMP异常率比较差异无统计学意义(P>0.05).后半规管与水平半规管BPPV患者oVEMP异常率相比,差异无统计学意义(P>0.05);后半规管及水平半规管BPPV患者与正常对照组相比,差异均有统计学意义(P<0.05).结论 原发性BPPV与椭圆囊关系密切,这为探讨BPPV患者的病理机制提供了思路,也有利于更好地评估BPPV患者的前庭功能,并可指导BPPV患者的前庭功能康复治疗和预后判断.

  7. 改良Epley复位法联合倍他司汀治疗后半规管良性阵发性位置性眩晕的临床研究%Research of Association of Modified Epley Maneuver and Betahistine for Treating Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo

    Institute of Scientific and Technical Information of China (English)

    洪娟; 毕涌; 方练

    2012-01-01

    目的 探讨改良Epley复位法联合倍他司汀治疗后半规管良性阵发性位置性眩晕(PC-BPPV)的疗效.方法 选择2008年7月-2011年9月本院治疗的192例单侧PC-BPPV患者,随机分为改良Epley复位法联合倍他司汀治疗组(EP+BE组)67例、改良Epley复位法治疗组(EP组)61例、倍他司汀治疗组(BE组)64例,观察患者的临床表现,分析治疗的有效率和平均有效时间.结果 EP+BE组治疗3 d和1周后有效率均高于EP组和BE组,EP组治疗3 d和1周后有效率高于BE组,EP+BE组3 d内的平均起效时间短于EP组和BE组.结论 改良Epley复位法联合倍他司汀治疗PC-BPPV安全有效,明显缩短病程.%Objective To evaluate the efficacy of modified Epley maneuver associated with Betahistine to treat posterior semicircular canal benign paroxysmal positional vertigo (PC - BPPV ). Methods 192 cases of unilateral PC - BPPV admitted in our hospital between July, 2008 and September, 2011 were randomly divided into EP + BE group treated by modified Epley maneuver associated with Betahistine ( 67 cases ), EP group treated by modified Epley maneuver ( 61 cases ) and BE group treated by Betahistine ( 64 cases ). We observed the patients' clinical presentations and analyzed the efficiency of the medicine and the averaged time needed for the medicine to have effect. Results After 3 and 7 days treatment, the effective rate of EP + BE group was significantly higher as compared with EP group and BE group ( P <0. 05 ); the effective rate of EP group was significantly higher than that in BE group ( P <0. 05 ). The averaged time needed for the medicine to have effect in EP + BE group was less than that in EP group and BE group 3 days later ( P <0. 05 ). Conclusion The combination of modified Epley maneuver with Betahistine can obviously shorten the averaged time needed for the medicine to have effect and is a safe and effective method in treating PC - BPPV.

  8. The comparison of therapeutic effects on benign paroxysmal positional vertigo and associated symptoms between flunarizine and betahistine%氟桂利嗪和倍他司汀治疗良性位置性眩晕及其伴随症状的临床疗效比较

    Institute of Scientific and Technical Information of China (English)

    许敏; 陆学胜

    2012-01-01

    目的 观察氟桂利嗪与倍他司汀治疗良性位置性眩晕(BPPV)及其伴随症状的临床疗效.方法 将182例BPPV的患者随机分为氟桂利嗪治疗组和倍他司汀治疗组.氟桂利嗪治疗组给予氟桂利嗪进行常规治疗,倍他司汀治疗组施以倍他司汀治疗.两组均治疗8周为1个疗程并进行随访.比较两种药物治疗眩晕及伴随症状的疗效.结果 治疗8周后,氟桂利嗪治疗眩晕的疗效高于倍他司汀(x2 =4.4138,P<0.05),在治疗头痛、自主神经伴随症状方面,氟桂利嗪的疗效也均高于倍他司汀(均P<0.01),而在治疗耳鸣方面,两组疗效比较无统计学差异(x2 =3.3442,P>0.05).结论 氟桂利嗪治疗BPPV及其伴随症状具有较好的疗效.%Objective To evaluate the therapeutic effects of flunarizine and betahistine on benign paroxysmal positional vertigo (BPPV) and associated symptoms. Methods In a multicenter double-blind study, one hundred and eighty-two adult patients with BPPV were treated with flunarizine (5/10 mg on bedtime) or betahistine dichlorhydrate (12 mg 3 times daily) for 8 weeks. The therapeutic effects of these two drugs on vertigo and associated symptoms (tinnitus, headache and neurovegetative disorders) were compared. Results Flunarizine was significantly more effective on vertigo attacks (X2 = 4. 4138, P0. 05). Conclusions This study indicates that the calcium antagonist flunarizine is superior to betahistine on the treatment of vestibular vertigo.

  9. Bilateral posterior semicircular canal aplasia and atypical paroxysmal positional vertigo: a case report.

    Science.gov (United States)

    Walther, L E; Nath, V; Krombach, G A; Di Martino, E

    2008-04-01

    Isolated congenital malformations of semicircular canals are rare abnormalities. Most inner ear abnormalities occur in syndromes and are associated with hearing loss. Unilateral or bilateral single aplasia of one semicircular canal does not usually result in vertigo, but these become clinically important if there are clinical complaints of vertigo. Computed tomography imaging and high resolution magnetic resonance imaging may reveal inner ear abnormalities. The case is presented here of a 46-year-old male with a 10-year history of recurrent positional vertigo with strong onset when changing position to the left side. Magnetic resonance imaging of the inner ear showed a bilateral posterior semicircular canal aplasia as well as an enlarged vestibule on both sides. Dix-Hallpike positional manoeuvre revealed a positional nystagmus in the left head-hanging position of short duration and latency of a few seconds. When rising, vertigo occurred, but no nystagmus was visible. The fast phase of the nystagmus was mainly vertical down-beating with a slight torsional component to the uppermost ear. Although benign paroxysmal vertigo of the anterior canal was suspected, physical therapy was not effective using a modified liberatory manoeuvre. Brandt-Daroff therapy was effective permanently.

  10. 改良Epley手法复位联合倍他司汀治疗后半规管-良性发作性位置性眩晕%Modified Epley maneuver associated with betahistine for treating posterior semicircular canal benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    曲海英

    2012-01-01

    Objective To analyze the efficacy of modified epley maneuver associated with betahistine for treating posterior semicircular canal benign paroxysmal positional vertigo(PC-BPPV).Methods 78 cases with unilateral PC-BPPV were divided into complexed therapy group(39 cases)and control group(39 cases)randomly.The complexed therapy group was treated by modified epley maneuver associated with betahistine 6mg per time,3 times daily for successive 1 month.the control group was treated by modified epley maneuver only.Results 78 patients after first treatment,56 cases were cured,control group(28 patients),complexed therapy group(28 cases),no statistically significant difference between the two groups.After 1 month of treatment,the control group were cured 30 cases,effective 3 cases,invalid 6 cases;the complexed therapy group were cured 37 cases,effective 1 case,invalid 1 case;complexed therapy group,the cure rate was 94.9%,significantly higher than the 76.9% of control group(x2=4.3365,P<0.05).Conclusion The modified epley maneuver associated with betahistine is effective to treat PCBPPV,which is worth being promoted.%目的 探讨改良Epley手法复位联合倍他司汀治疗后半规管-良性发作性位置性眩晕(PC-BP-PV)的疗效.方法 单侧PC-BPPV患者78例,随机分为手法复位组39例和联合治疗组39例;手法复位组采用改良Epley手法复位,联合治疗组采用改良Epley手法复位联合倍他司汀治疗,每次6 mg,每天3次,连服用1个月.比较两组临床疗效.结果 78例患者经过1次治疗,治愈56例,其中手法组28例,联合治疗组28例,两组差异无统计学意义(P>0.05).治疗1个月后,手法复位组治愈30例,有效3例,无效6例;联合治疗组治愈37例,有效1例,无效1例;联合治疗组治愈率94.9%,明显高于手法组的76.9%(x2=4.3365,P<0.05).结论 改良Epley手法复位联合倍他司汀治疗PC-BPPV疗效显著,值得推广应用.

  11. Analysis on clinical effect of different canalith repositioning procedures for benign paroxysmal and positional vertigo%不同耳石复位法应用于良性阵发性位置性眩晕的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    于吉友; 刘永海

    2014-01-01

    Objective To analyze the clinical effect of different canalith repositioning procedures for benign paroxysmal and positional vertigo. Methods 126 cases with BPPV treated in our hospital from January 2012 to January 2014 were selected and divided into two groups according to random method 1:1, the research group and the control group, each group for 63 cases. The control group received Epley canalith repositioning procedure. 45 cases in the research group received improved Epley canalith repositioning procedure, and 18 cases in the research group received Barbecue tumbling method. The clinical effect, improvement time of symptoms and recurrence times of two groups was analyzed. Results The recurrence rate of the research group was 7.94%, the recurrence rate of PC-BPPV was 6.67%, and recurrence rate of PC-BPPV was 5.56%, and that of the control group was 23.81%, 23.91%and 23.53%, which had statistical significance(P<0.05). The treatment times of the research group was(1.27±0.23) times, the seizure times for 1 month of the research group was(1.28±0.31) times, the treatment time was (5.06±3.12) d, and that of the control group was(2.34±0.46)times,(3.24±4.26)times and (8.87±3.29), which had statistical significance(P<0.05). The improvement time of vertigo, sense of fear, nausea and vomit and compulsive position in the research group was evidently lower than that of the control group. The vestibular function for treatment of 1 month was lower than that of the control group before treatment, which had statistical significance(P<0.05). Conclusion Improved Epley canalith repositioning procedure is the effective treatment method for patients with PC-BPPV, and Barbecue tumbling method is the reliable and effective treatment method treating HC-BPPV.Group treatment can evidently improve the clinical efficacy of BPPV.%目的:分析不同耳石复位法治疗良性阵发性位置性眩晕(BPPV)的临床效果。方法资料随机选自2012年1月~2014年1

  12. Comparison of three types of self-treatments for posterior canal benign paroxysmal positional vertigo: modified Epley maneuver, modified Semont maneuver and Brandt-Daroff maneuver%后半规管良性阵发性位置性眩晕三种自我治疗手法的疗效比较

    Institute of Scientific and Technical Information of China (English)

    章燕幸; 吴承龙; 肖桂荣; 钟芳芳

    2012-01-01

    Objective To compare the efficacy and recurrence rates of modified Epley maneuver,modified Semont maneuver and Brandt-Daroff maneuver in patients with posterior canal benign paroxysmal positional vertigo(PC-BPPV).Methods One hundred and sixty-eight patients with unilateral PC-BPPV were included in the study,which were divided into four groups randomly,45 with modified Epley maneuver ( group 1 ),43 with modified Semont maneuver( group 2 ),and 40 with Brandt-Daroff maneuver( group 3 ).There were 40 controls without physical therapy technique( group 4) included. The efficacy after one week and one month,the time to recovery,the frequency of side effects and recurrence rates among the four groups were evaluated.Results The efficacy of modified Epley maneuver was superior to the other three groups after one week ( x21,2 =8.55,P < 0.05 ; x21,3 =23.23,P < 0.01 ; x21,4 =44.00,P < 0.01 ) and to the Brandt-Daroff maneuver at follow-up evaluation after one month ( x2 =8.42,P < 0.05 ). The efficacy of modified Semont maneuver was superior to the control groups after one week ( x2 =14.49,P < 0.01 ),but there was no difference between the two groups after one month ( x2 =0.01,P > 0.05 ).The efficacy of Brandt-Daroff maneuver was not different with the control group at one week and one month follow-up evaluation ( x2 =3.35,P > 0.05 ; x2 =0.18,P > 0.05). Kaplan-Meier testing showed that the time to recovery was significantly shorter in the modified Epley group. The frequency of side effects was not significantly different among the three physical therapy groups.There was no difference in the frequency of recurrence among the four groups ( x2 =4.076,P =0.253 ).Duration of illness before self-treatment and age were the independent predictors of recurrence.Conclusions The modified Epley maneuver is more effective for selft-reatment of PC-BPPV than modified Semont maneuver and Brandt-Daroff maneuver.Daily routine of self-treatment does not prevent the recurrence of PC

  13. Epley maneuver associated with vertigo calming for treating posterior semicircular canal benign paroxysmal positional vertigo in young%Epley手法复位联合眩晕宁治疗青年后半规管良性阵发性位置性眩晕效果观察

    Institute of Scientific and Technical Information of China (English)

    王凯; 荣良群; 朱本亮; 王虎; 肖利杰

    2015-01-01

    目的 评估用Epley手法复位联合眩晕宁治疗青年后半规管良性阵发性位置性眩晕的效果.方法 选择青年后半规管良性阵发性位置性眩晕患者258例(18岁≤年龄≤50岁)为研究对象,采用随机数字表随机分为单纯手法复位组86例、甲磺酸倍他司汀组86例、眩晕宁组86例.单纯手法复位组采用Epley手法复位加安慰剂,2片/次,3次/d,疗程为1个月,随访1个月.倍他司汀组和眩晕宁组在Epley手法复位的基础上分别联用倍他司汀片(12 mg/次,3次/d)或眩晕宁片(2片/次,3次/d),疗程均为1个月.结果 258例患者经过1次治疗,治愈199例,其中单纯手法复位组治愈68例,倍他司汀组治愈66例,眩晕宁组治愈65例,3组比较差异无统计学意义(x2=0.308,P>0.05).治疗并随访1个月后,单纯手法复位组治愈72例,有效3例,无效11例;倍他司汀组治愈74例,有效3例,无效9例;眩晕宁组治愈81例,有效4例,无效1例;倍他司汀组、单纯手法复位组、眩晕宁组有效率分别为89.5%、87.2%、98.8%,3组有效率比较差异有统计学意义(x2=58.65,P<0.05),眩晕宁组高于其他两组(P均<0.05),而倍他司汀组和单纯手法复位组比较差异无统计学意义(P>0.05).结论 Epley手法复位的基础上联合使用眩晕宁治疗青年后半规管良性阵发性位置性眩晕的效果优于单纯Epley手法复位及手法复位联合甲磺酸倍他司汀,而Epley手法复位联合甲磺酸倍他司汀的效果并不优于单纯手法复位.%Objective To analyze the efficacy of epley maneuver associated with vertigo calming for treating posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV) in young.Methods Two hundred and fifty-eight cases(age was 18-50 years old) with PC-BPPV were randomly divided into maneuver group(86 cases),betahistine group(86 cases) and vertigo calming group(86 cases).The maneuver group was treated by epley maneuver associated with placebo,2 pills

  14. 小剂量劳拉西泮治疗老年人良性阵发性位置性眩晕成功复位后残余头晕的疗效评估%Effect of small-dose Lorazepam on residual dizziness in elderly benign paroxysmal positional vertigo after successful particle repositioning maneuver

    Institute of Scientific and Technical Information of China (English)

    章燕幸; 吴承龙; 钟芳芳

    2015-01-01

    目的 探讨小剂量抗焦虑药劳拉西泮治疗老年人良性阵发性位置性眩晕(BPPV)成功复位后残余头晕的疗效. 方法 选择268例管石复位成功的60岁及以上BPPV患者随机分为治疗组和对照组,治疗组给予劳拉西泮(0.25 mg/次、3次/d)1周,对照组不给予任何药物.管石复位前和复位后1周采用汉密尔顿焦虑量表(HAMA)评估患者的焦虑状态,并采用中文版眩晕障碍量表(DHI)和活动平衡信心量表(ABC)评估小剂量抗焦虑药劳拉西泮对老年BPPV患者管石复位术后残余症状的作用. 结果 治疗组和对照组复位前HAMA评分比较差异无统计学意义(t=-0.316,P=0.753),复位后治疗组和对照组HAMA评分均较复位前有改善(t=19.931、26.930,均P=0.000),治疗组复位后HAMA评分低于对照组(t=14.967,P=0.000).治疗组和对照组复位后DHI总评分、功能、情感、躯体各亚组评分较复位前均有改善(治疗组t=43.661、32.326、31.981、14.330,均P=0.000;对照组t=46.282、32.117、34.563、13.182,均P=0.000);复位后治疗组DHI总评分以及功能、情感和躯体亚组的评分均低于对照组(t=5.994、3.206、4.757、2.851,P=0.000、0.002、0.000、0.005).复位后治疗组和对照组ABC评分较复位前均有改善(t=-23.248、-24.536,均P=0.000),且治疗组ABC评分高于对照组(t=2.678,P=0.008),差异有统计学意义. 结论 老年BPPV患者伴有焦虑情绪,小剂量抗焦虑药劳拉西泮有助于减轻老年患者成功复位后的残余头晕.%Objective To evaluate the effect of small-dose Lorazepam on residual dizziness in elderly patients with benign paroxysmal positional vertigo (BPPV) after successful particle repositioning maneuver (PRM).Methods A total of 268 patients aged 60 years and over, who were diagnosed as BPPV and underwent successful treatment of PRM, were randomly assigned to medication group and control group.The patients in the medication group were prescribed low-dose lorazepam for 1

  15. 半夏白术天麻汤配合耳石复位法治疗良性阵发性位置性眩晕的临床疗效及对血脂代谢影响%Clinical Efficacy of Banxia Baizhu Tianma Decoction Plus Canalith Repositioning Procedure in Treating Benign Paroxysmal Positional Vertigo ( BPPV) and Their Influence on Blood Lipid Metabolism

    Institute of Scientific and Technical Information of China (English)

    雷华斌; 张恒

    2016-01-01

    Objective:To observe the clinical efficacy of Banxia Baizhu Tianma Decoction combined with canalith repositioning procedure in treating benign paroxysmal positional vertigo , and to explore the correlation between its pathogenesis and blood lipid metabolic abnormalities .Methods:A total of 53 cases conforming to the diagnostic criteria in department of internal medicine of traditional Chinese medicine of our hospital from January 2013 to January 2015 were selected and divided into two groups under completely random design by PEMS 3.0, with 23 cases in the treatment group and 30 cases in the control group based on sequen-tial order .Patients of the two groups were asked to stay in bed during the stage of attack , being given the persistent low flow oxy-gen therapy .At the same time, improved Epley respositioning procedure was applied to patients in the control group , while those in the treatment group were treated with both modified Epley respositioning procedure and modified Banxia Baizhu Tianma Decoc -tion .Then clinical curative effect of two days , two weeks and three months after treatment in both groups were recorded respective-ly, as well as changes of blood lipid level before and after treatment .Results:The total effective rate of two days in the treatment group was 73.91%, while that in the control group was only 60.00%, showing a significant difference between two groups (χ2 =6.782, P=0.0020.05).Conclusion:Banxia Baizhu Tianma Decoction combined with canalith repositioning procedure has a good clinical efficacy in treating BPPV , and lipid metabolism abnormality is closely associated with CRP , therefore , this scientific method , with high de-pendability , is worthy of clinical popularization and application .%目的:观察半夏白术天麻汤配合改良耳石复位法治疗良性阵发性位置性眩晕的临床疗效及探讨血脂代谢异常对本病发病机制的相关性;方法:将我院中医内科2013年1月至2015年1

  16. Diagnosis and management of posterior semicircular canal benign paroxysmal positional vertigo: A practical approach

    Directory of Open Access Journals (Sweden)

    Hanaa Hussein Elsanadiky

    2015-07-01

    Conclusion: Canalith repositioning Maneuver provides rapid relief of symptoms of BPPV. Patients with bilateral or severe BPPV required a special protocol to reach complete relief. In addition daily routine Brandt–Daroff exercises decrease the recurrence rate.

  17. Paroxysmal Hemicrania

    Science.gov (United States)

    ... Headache Definition Treatment Prognosis Clinical Trials Organizations Publications Definition Paroxysmal hemicrania is a rare form of headache that usually begins in adulthood. Patients experience severe throbbing, claw-like, or boring pain usually ...

  18. Benign infantile convulsions (IC) and subsequent paroxysmal kinesigenic dyskinesia (PKD) in a patient with 16p11.2 microdeletion syndrome.

    Science.gov (United States)

    Weber, Axel; Köhler, Angelika; Hahn, Andreas; Neubauer, Bernd; Müller, Ulrich

    2013-11-01

    Paroxysmal kinesigenic dyskinesia with infantile convulsions (PKD/IC) is caused by mutations in the gene PRRT2 located in 16p11.2. A deletion syndrome 16p11.2 is well established and is characterized by intellectual disability, speech delay, and autism. PKD/IC, however, is extremely rare in this syndrome. We describe a case of PKD/IC and 16p11.2 deletion syndrome and discuss modifiers of PRRT2 activity to explain the rare concurrence of both syndromes.

  19. Paroxysmal Hemicrania

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-05-01

    Full Text Available The clinical characteristics of paroxysmal hemicrania (PH are reported in a series of 31 patients, ages 5-68 years (mean age 37, identified and followed prospectively at the National Hospital and the Hospital for Sick Children, Great Ormond Street, London, UK from May 1995 to January 2007.

  20. Benign paroksysmal positionel vertigo kan opstå efter hovedtraumer hos børn

    DEFF Research Database (Denmark)

    Nørgaard, Maria Schøler; Rokkjær, Malene Sine; Berg, Jette;

    2015-01-01

    We present an eight-year-old boy with benign paroxysmal positional vertigo (BPPV) after a head trauma, successfully treated with Epley's manoeuvre. BPPV is a common cause of vestibular vertigo in adults, but it is rarely seen in children. Diagnostic work-up is challenging as children often lack...

  1. THE EFFECTIVENESS OF SEMONT LIBERATORY MANEUVER IN ACUTE BENINGN PAROXYSMAL POSITIONAL VERTIGO PATIENTS

    Directory of Open Access Journals (Sweden)

    Achyutha Kiran Kumar

    2014-08-01

    Full Text Available Background: People with vestibular dysfunction complain of problems with balance and dizziness which creates a negative impact on the people and affects their quality of life. Medications help in the control of symptoms. There has been an increase in the implementation of many protocols for the rehabilitation of vestibular patients with follow up exercises for the treatment of BPPV. Methods: Thirty BPPV patients were identified by doing Dix- Hall pike positioning and their DHI scores were recorded. All patients were exclusively treated with Semont Liberatory maneuver. The effectiveness of the treatment was documented at 1 week and 1 month. Repeated procedures were performed if necessary. Results: After the treatment session of Semont Liberatory maneuver, the symptoms disappeared in 20 patients and have negative DHI test by 1st week, and of patients have negative DHI test by 1 month. The first success rate was 78% and the total success rate was 89%. Semont Liberatory maneuver also showed decrease in score of DHI [post-test] in 1 month duration. The patient who visited within one week after the onset of symptoms had good prognosis with Semont Liberatory maneuver. This protocol was ineffective in 4 patients. Conclusion: The Semont Liberatory maneuver is a safe and effective technique for treating BPPV patients.

  2. Clinical features of benign paroxysmal positional vertigo (BPPV) in Taiwan: differences between young and senior age groups.

    Science.gov (United States)

    Kao, Chung-Lan; Hsieh, Wan-Ling; Chern, Chang-Ming; Chen, Liang-Kung; Lin, Ming-Hsien; Chan, Rai-Chi

    2009-12-01

    BPPV is a common cause of vertigo. Several treatment procedures can facilitate recovery. In this study, we aimed to identify the demographic features, resolution and recurrence rates and impacts on daily activities in BPPV patient between young and senior age groups in Taiwan. This retrospective study recruited 218 patients of BPPV. Medical history, canal involvement, treatment required for complete resolution, symptom free period and recurrence rates were evaluated between the two age groups. Up to 80.7% of patients were successfully treated by a single treatment. For patients aged more than 65 years, the recurrence rate was 1.7 times higher than that in the younger age group (p = 0.07). The symptom-free period before recurrence was nearly 2.2 times longer in the senior age group (p = 0.03). Work-related activities were influenced more by BPPV in the younger age group (p = 0.03). We conclude that BPPV is prone to occur and recur in people of senior age. Clinicians should have the knowledge to diagnose different types of BPPV and treat it accordingly to prevent further complications.

  3. Benign paroxysmal positional vertigo (BPPV): influence of pharmacotherapy and rehabilitation therapy on patients' recovery rate and life quality.

    Science.gov (United States)

    Maslovara, Sinisa; Soldo, Silva Butkovic; Puksec, Mirjana; Balaban, Branka; Penavic, Ivana Pajic

    2012-01-01

    This prospective clinical study includes 96 BPPV patients with the results of DHI testing ≥ 40 points. They were segregated to be taken into this study and randomly divided into two therapy groups: 48 patients in Group I were treated pharmacotherapeutically with Betahistine Chloride (BC) and 48 patients in Group II underwent a rehabilitation treatment by performing an Epley maneuver. Total study duration was eight weeks, during which the patients were first examined upon arrival, checked after one, and rechecked after eight weeks. The tests included otoneurological examination and VNG, as well as completing three questionnaires: DHI, SF-36®, and HADS®. During the first checkup after one week, 86.96% of patients in Group I and 93.33% in Group II had negative results at the Dix-Hallpike test. During the second checkup after an eight weeks' treatment, 95.65% in Group I and 97.78% patients in Group II had a negative result. At the beginning of the study, the values of patients' physical, emotional, and functional health (QoL) were equally distributed in both therapy groups, compared to standardized values of healthy population. During the first checkup, the values were significantly higher and by the second checkup, reached the statistic average, which corresponds with the healthy population. There was an obviously faster and more complete recovery of the patients in Group II, who underwent a rehabilitation treatment.

  4. Inner Ear Disease and Benign Paroxysmal Positional Vertigo: A Critical Review of Incidence, Clinical Characteristics, and Management

    Directory of Open Access Journals (Sweden)

    M. Riga

    2011-01-01

    Full Text Available Background. This study is a review of the incidence, clinical characteristics, and management of secondary BPPV. The different subtypes of secondary BPPV are compared to each other, as well as idiopathic BPPV. Furthermore, the study highlights the coexistence of BPPV with other inner ear pathologies. Methods. A comprehensive search for articles including in the abstract information on incidence, clinical characteristics, and management of secondary BPPV was conducted within the PubMed library. Results. Different referral patterns, different diagnostic criteria used for inner ear diseases, and different patient populations have led to greatly variable incidence results. The differences regarding clinical characteristics and treatment outcomes may support the hypothesis that idiopathic BPPV and the various subtypes of secondary BPPV do not share the exact same pathophysiological mechanisms. Conclusions. Secondary BPPV is often under-diagnosed, because dizziness may be atypical and attributed to the primary inner ear pathology. Reversely, a limited number of BPPV patients may not be subjected to a full examination and characterized as idiopathic, while other inner ear diseases are underdiagnosed. A higher suspicion index for the coexistence of BPPV with other inner ear pathologies, may lead to a more integrated diagnosis and consequently to a more efficient treatment of these patients.

  5. The canalith Reposifioning(CRP) for the treatment of Benign positional vertigo%良性阵发性位置性眩晕的耳石复位法(CRP)治疗

    Institute of Scientific and Technical Information of China (English)

    杨弋; 黄魏宁

    2004-01-01

    良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)是引起眩晕最常见的外周前庭疾病之一。Barany在1921年首次描述了位置性眩晕的概念.1952年Dix和Hallpike将其命名为良性阵发性位置性眩晕,并提出典型的位置性眩晕发生在头位变动时,患者感觉到剧烈的旋转性眩晕.持续时间通常短于40s,同时还可以观察到

  6. The relationship between malocclusion, benign joint hypermobility syndrome, condylar position and TMD symptoms.

    Science.gov (United States)

    Barrera-Mora, José Ma; Espinar Escalona, Eduardo; Abalos Labruzzi, Camilo; Llamas Carrera, José Ma; Ballesteros, Emilio Jiménez-Castellanos; Solano Reina, Enrique; Rocabado, Mariano

    2012-04-01

    The current study investigated the association between temporomandibular disorders, malocclusion patterns, benign joint hypermobility syndrome and the initial condylar position. One hundred sixty-two subjects were analyzed using the Rocabado Temporomandibular Pain Analysis; Helkimo Index parameters; the Carter-Wilkinson modified test; and a mounting cast with condylar position indicator registration (MPI). The study revealed a significant association between: 1. Delta H, skeletal pattern (p = 0.034); 2. Delta Y, transversal malocclusion (p = 0.04); 3. right and left, Delta Z, right and left posteroinferior synovial pain (p temporomandibular pain analysis joint (TPAJ) (p = 0.0034); 7. TMJ function impairment, left and right TPAJ (p = 0.007); and 8. mandibular motion, left and right TPAJ (p = 0.035, p = 0.015). The conclusion was that anterior crossbite and condylar displacements in the vertical plane are risk factors in developing TMJ symptoms.

  7. The analysis of clinical and electroencephalographic features in patients with benign epilespy of children with occipital paroxysms%儿童良性枕叶癫(癎)47例临床及脑电图分析

    Institute of Scientific and Technical Information of China (English)

    梅珍; 杨朋范; 安榕榕; 刘海云; 林巧; 钟忠辉

    2011-01-01

    Objective:To summarize the clinical characteristics and electroencephalographic features in patients with benign epilespy of children with occipital paroxysms (BECOP) and to gain better understanding of it. Methods; The clinical data of 47 patients with BECOP referred and followed up in Epilepsy Center of Fuzhou General Hospital between January 2005 and December 2010 were analysed, to illustrate the difference between early onset benign occipital seizure susceptibility syndrome (EBOS) and late onset children idiopathic occipital seizures (LOS) with regard to the age of onset, the frequency and duration of seizures, symptoms and signs, EEG changes and therapeutic responses to AEDs. Results: The mean age of onset of patients with EBOS [(5. 2±2. 8) years] was significantly younger than that of patients with LOS[(10. 3±3. 2) years]. Compared with LOS patients, EBOS patients had remarkable paroxysmal autonomic symptoms, less frequent seizures, longer seizure duration and more nocturnal seizures. LOS patients had more visual symptoms including hallucinations and tended to secondary generalized tonic-clonic seizures that occurred mostly in daytime. The interictal EEG showed occipital or occipital predominance of spike- and sharp-slow waves, more typical and limited in EBOS patients than those in LOS ones. Ictal EEG showed the occipital or frontal predominance and generalized rhythmic spike-wavecomplex. EBOS was controlled well by AED monotherapy, with 23(92%) seizure free; Seizures ceased in 14(63. 6%) cases of LOS, and were partially controlled or unchanged in 5 and 3 cases respectively. Conclusion: It is essential to distinguish EBOS from LOS by comprehensive analysis of their features with regard to the age of onset, the frequency and duration of seizures, paroxysmal autonomic symptoms, visual symptoms, EEG changes and therapueutic responses to AEDs.%目的:探讨儿童良性枕叶癫(癎)(BECOP)的临床表现及脑电图(EEG)特点,以期提高对

  8. Vestibular reflexes and positional manoeuvres

    OpenAIRE

    Bronstein, A

    2003-01-01

    Dizziness and vertigo are some of the more frequently encountered symptoms in neurology clinics. In turn, one of the most common causes of vertigo is benign paroxysmal positional vertigo (BPPV), accounting for a quarter of all patients with dizziness and vertigo. Reviewing the value of the positional manoeuvres available is relevant, particularly in the light of the efficient treatments available for BPPV. In this article I will deal with positional manoeuvres first, and then with how vestibu...

  9. [Non-epileptic motor paroxysmal phenomena in wakefulness in childhood].

    Science.gov (United States)

    Ruggieri, Víctor L; Arberas, Claudia L

    2013-09-06

    Paroxysmal events in childhood are a challenge for pediatric neurologists, given its highly heterogeneous clinical manifestations, often difficult to distinguish between phenomena of epileptic seizure or not. The non-epileptic paroxysmal episodes are neurological phenomena, with motor, sensory symptoms, and/or sensory impairments, with or without involvement of consciousness, epileptic phenomena unrelated, so no electroencephalographic correlative expression between or during episodes. From the clinical point of view can be classified into four groups: motor phenomena, syncope, migraine (and associated conditions) and acute psychiatric symptoms. In this paper we analyze paroxysmal motor phenomena in awake children, dividing them according to their clinical manifestations: extrapyramidal episodes (paroxysmal kinesiogenic, non kinesiogenic and not related to exercise dyskinesias, Dopa responsive dystonia) and similar symptoms of dystonia (Sandifer syndrome); manifestations of startle (hyperekplexia); episodic eye and head movements (benign paroxysmal tonic upward gaze nistagmus deviation); episodic ataxia (familial episodic ataxias, paroxysmal benign vertigo); stereotyped and phenomena of self-gratification; and myoclonic events (benign myoclonus of early infancy). The detection of these syndromes will, in many cases, allow an adequate genetic counseling, initiate a specific treatment and avoid unnecessary additional studies. Molecular studies have demonstrated a real relationship between epileptic and non-epileptic basis of many of these entities and surely the identification of the molecular basis and understanding of the pathophysiological mechanisms in many of them allow us, in the near future will benefit our patients.

  10. Nonepileptic paroxysmal sleep disorders.

    Science.gov (United States)

    Frenette, Eric; Guilleminault, Christian

    2013-01-01

    Events occurring during nighttime sleep in children can be easily mislabeled, as witnesses are usually not immediately available. Even when observers are present, description of the events can be sketchy, as these individuals are frequently aroused from their own sleep. Errors of perception are thus common and can lead to diagnosis of epilepsy where other sleep-related conditions are present, sometimes initiating unnecessary therapeutic interventions, especially with antiepileptic drugs. Often not acknowledged, paroxysmal nonepileptic behavioral and motor episodes in sleep are encountered much more frequently than their epileptic counterpart. The International Classification of Sleep Disorders (ICSD) 2nd edition displays an extensive list of such conditions that can be readily mistaken for epilepsy. The most prevalent ones are reviewed, such as nonrapid eye movement (NREM) sleep parasomnias, comprised of sleepwalking, confusional arousals and sleep terrors, periodic leg movements of sleep, repetitive movement disorders, benign neonatal myoclonus, and sleep starts. Apnea of prematurity is also briefly reviewed. Specific issues regarding management of these selected disorders, both for diagnostic consideration and for therapeutic intervention, are addressed.

  11. [Position statement for the diagnosis and treatment of men with benign prostate enlargement and lower urinary tract symptoms].

    Science.gov (United States)

    Greenstein, Alexander; Ferman, Zvi; Stav, Kobi; Gruenwald, Ilan; Matzkin, Haim; Ramon, Jacob

    2014-09-01

    Benign prostate enlargement causing lower urinary symptoms is a common progressive phenomenon in adult men. Lower urinary tract symptoms may emerge during the storage, voiding, and post micturition phases, harm quality of life and may be caused by a variety of factors. The purpose of evaluation is to identify benign prostate enlargement and factors other than enlarged prostate as the cause of symptoms, and recognize the risk factors for progression of the condition. The goal of treatment is to alleviate symptoms and improve quality of life, and to prevent deterioration of symptoms and development of complications. Medical therapy is the basic approach, whereas surgery and minimally invasive procedures are reserved for patients not interested in medical therapy or for those in whom symptoms were not alleviated by means of medical therapy. In the present position statement, we present the approach to the evaluation and treatment of lower urinary tract symptoms in men with benign prostate enlargement.

  12. Benign and malignant neoplasias in 261 necropsies for HIV-positive patients in the period of 1989 to 2008

    Directory of Open Access Journals (Sweden)

    Adilha Rua Micheletti

    2011-12-01

    Full Text Available Considering that there are some studies with autopsies from AIDS describing only malignant neoplasias and that changes can occur after the introduction of Highly Active Antiretroviral Therapy (HAART, our objectives were to analyze the frequency of benign and malignant neoplasms in AIDS patients in the periods of both pre- and post-HAART. This is a retrospective study with 261 autopsies of HIV-positive patients between 1989 and 2008 in Uberaba, Brazil. Sixty-six neoplasms were found (39 benign, 21 malignant and six premalignant in 58 patients. The most frequent malignant neoplasms were lymphoid, in 2.7% (four Non-Hodgkin lymphoma, one Hodgkin, one multiple myeloma and one plasmablastic plasmacytoma, and Kaposi's Sarcoma, in 2.3% (six cases. The most frequent benign neoplasms were hepatic hemangiomas in 11 (4.2% of 261 cases and uterine leiomyoma in 11 (15.7% of 70 woman. In the pre-HAART period eight (9.8% benign neoplasias and four (4.9% malignant occurred in 82 patients; in the post-HAART period, 29 (16.2% benign and 17 (9.5% malignant were present; however, the differences were not significant. We conclude that the introduction of HAART in our region doesn't look to have modified the frequency of neoplasms occurring in patients with HIV.

  13. PRRT2 phenotypes and penetrance of paroxysmal kinesigenic dyskinesia and infantile convulsions

    NARCIS (Netherlands)

    van Vliet, Rianne; Breedveld, Guido; de Rijk-van Andel, Johanneke; Brilstra, Eva; Verbeek, Nienke; Verschuuren-Bemelmans, Corien; Boon, Maartje; Samijn, Johnny; Diderich, Karin; van de Laar, Ingrid; Oostra, Ben; Bonifati, Vincenzo; Maat-Kievit, Anneke

    2012-01-01

    Objective: To describe the phenotypes and penetrance of paroxysmal kinesigenic dyskinesia (PKD), a movement disorder characterized by attacks of involuntary movements occurring after sudden movements, infantile convulsion and choreoathetosis (ICCA) syndrome, and benign familial infantile convulsions

  14. Left atrial myxoma presenting as paroxysmal supraventricular tachycardia.

    Science.gov (United States)

    Seol, Sang-Hoon; Kim, Doo-Il; Jang, Jae-Sik; Yang, Tae-Hyun; Kim, Dae-Kyeong; Kim, Dong-Soo

    2014-02-01

    Cardiac myxomas are benign intracavitary neoplasms. Their incidence in cardiac surgery is approximately 0.3%. Symptoms of cardiac myxomas are typically variable, from obstruction of mitral valve to coronary embolism resulting in acute myocardial infarction. In this case, left atrial myxoma is presented as paroxysmal supraventricular tachycardia.

  15. Paroxysmal Nonepileptic Events

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-11-01

    Full Text Available Paroxysmal events that mimic epilepsy, and their precipitants, prodromes, and distinguishing features are reviewed by researchers at Texas Tech University, Lubbock, TX, and American University of Beirut, New York.

  16. Benign anal lesions, inflammatory bowel disease and risk for high-risk human papillomavirus-positive and -negative anal carcinoma.

    OpenAIRE

    Frisch, M; Glimelius, B; van den Brule, A. J.; Wohlfahrt, J; Meijer, C. J.; Walboomers, J M; Adami, H. O.; Melbye, M.

    1998-01-01

    A central role in anal carcinogenesis of high-risk types of human papillomaviruses (hrHPV) was recently established, but the possible role of benign anal lesions has not been addressed in hrHPV-positive and -negative anal cancers. As part of a population-based case-control study in Denmark and Sweden, we interviewed 417 case patients (93 men and 324 women) diagnosed during the period 1991-94 with invasive or in situ anal cancer, 534 patients with adenocarcinoma of the rectum and 554 populatio...

  17. HOW BENIGN IS BPPV IN THE ELDERLY?

    Directory of Open Access Journals (Sweden)

    Rama Krishna

    2015-01-01

    Full Text Available Geriatric population in India is rapidly increasing. According to one estimate the number of persons above the age of 60 years is 76.6 million in India. India as the second most populous country in the world, with elderly people constituting 7.7% of total population. The morbidity in this age group is often due to increased incidence of falls. It is often preceded with spells of dizziness and often associated with vestibular disorders. Peripheral vestibular disorders often difficult to evaluate at the time of fall and only realized after the fall. Peripheral vestibular disorders like Benign Paroxysmal Positional Vertigo (BPPV, Vestibulopathy, Vestibular Neuritis are some of the disorders that affect geriatric population that affect the functional ability in ‘activities of daily living (ADL. BPPV has been frequently found to be more common with advancing age. One simple test to assess ADL (Activities of Daily Living is TUG test (Timed Up and Go. A score of 11.1 seconds or more on TUG test was correlated with 80% chance of a fall in the elderly. Hence a study is undertaken to evaluate peripheral vestibular disorders in elderly with special reference to BPPV along with their performance on TUG (Timed Up and Go test. Benign Paroxysmal Positional Vertigo (BPPV has been found to be most common vestibular disorder in the elderly . One out of four elderly with Peripheral vestibular disorder has a risk of ‘fall’. BPPV is the most common peripheral vestibular disorder leading to ‘risk of fall’ three times more among the elderly after 75years .

  18. Vertigem posicional paroxística benigna sem nistagmo: diagnóstico e tratamento Benign paroxysmal positional vertigo without nystagmus: diagnosis and treatment

    OpenAIRE

    Gabriella Assumpção Alvarenga; Maria Alves Barbosa; Celmo Celeno Porto

    2011-01-01

    O aparecimento do nistagmo nos testes para diagnosticar a VPPB ainda é considerado importante na caracterização clínica da VPPB. Contudo, na prática cotidiana, existem casos de vertigem gerada pelos movimentos cefálicos, que não se acompanham deste sinal na manobra de Dix-Hallpike e no teste de girar. OBJETIVO: Caracterizar a VPPB sem nistagmo, bem como a condução terapêutica nesta situação. MATERIAL E MÉTODO: Revisão não sistemática do diagnóstico e tratamento da Vertigem Posicional Paroxíst...

  19. Intracranially protruded bilateral posterior and superior SCCs with multiple dehiscences in a patient with positional vertigo: CT and MR imaging findings and review of literature

    Directory of Open Access Journals (Sweden)

    Nischal G Kundaragi

    2014-01-01

    Full Text Available We report a rare case of intracranially protruded posterior and superior semicircular canals beyond the margins of temporal bone with bony roof dehiscence in bilateral posterior and left superior semicircular canals in a patient with benign paroxysmal positional vertigo (BPPV.

  20. Benign paroksysmal positionel vertigo kan opstå efter hovedtraumer hos børn

    DEFF Research Database (Denmark)

    Nørgaard, Maria Schøler; Rokkjær, Malene Sine; Berg, Jette;

    2015-01-01

    We present an eight-year-old boy with benign paroxysmal positional vertigo (BPPV) after a head trauma, successfully treated with Epley's manoeuvre. BPPV is a common cause of vestibular vertigo in adults, but it is rarely seen in children. Diagnostic work-up is challenging as children often lack...... the ability to describe their symptoms accurately and to cooperate in clinical examination. The diagnosis should be suspected in children with a relevant medical history and verified by positional testing. BPPV of childhood is treated with otolith repositioning manoeuvres, and the prognosis is good....

  1. Dynamics of Paroxysmal Tachycardia

    Science.gov (United States)

    Glass, Leon

    2004-03-01

    Parosxysmal tachycardia refers to abnormally fast cardiac arrhythmias that suddenly start and stop. Paroxysmal tachycardias can occur in many regions of the heart and may be associated with many different mechanisms. In order to study paroxysmal tachycardias, we have analyzed tissue cultures of cells from embryonic chick heart that are imaged using calcium and voltage sensitive dyes. This model system displays a number of different types of dynamics including dynamics originating from pacemakers, triggered dynamics in which an excitation leads to the initiation of a sequence of waves originating from a single source, and spontaneously iniitiating and terminating rotating spiral waves. Theoretical models that include heterogeneity, spontaneous pacemaker activity, and fatigue or reduced excitability arising as a consequence of rapid excitation can be used to account for these behaviors.

  2. Paroxysmal cold hemoglobinuria.

    Science.gov (United States)

    Shanbhag, Satish; Spivak, Jerry

    2015-06-01

    Paroxysmal cold hemoglobinuria is a rare cause of autoimmune hemolytic anemia predominantly seen as an acute form in young children after viral illnesses and in a chronic form in some hematological malignancies and tertiary syphilis. It is a complement mediated intravascular hemolytic anemia associated with a biphasic antibody against the P antigen on red cells. The antibody attaches to red cells at colder temperatures and causes red cell lysis when blood recirculates to warmer parts of the body. Treatment is mainly supportive and with red cell transfusion, but immunosuppressive therapy may be effective in severe cases.

  3. Efeito da manobra de Epley na qualidade de vida dos pacientes com vertigem posicional paroxística benigna Effect of Epley's maneuver on the quality of life of paroxismal positional benign vertigo patients

    Directory of Open Access Journals (Sweden)

    Alcione Botelho Pereira

    2010-12-01

    Full Text Available A vertigem produz impactos significativos na qualidade de vida (QV. É necessário mensurar os efeitos das terapêuticas antivertiginosas na QV. OBJETIVO: Investigar o efeito da manobra de reposicionamento na qualidade de vida de pacientes com vertigem posicional paroxística benigna (VPPB. MATERIAL E MÉTODOS: Estudo retrospectivo, através da revisão dos prontuários de 21 pacientes com VPPB atendidos no serviço de Reabilitação Vestibular (RV de uma clínica escola de Belo Horizonte atendidos em 2007-2008. Foram analisados os escores físicos, funcionais e emocionais, pré e pós-terapia de RV com realização de manobras de reposicionamento de Epley, por meio do questionário Dizziness Handicap Inventory (DHI, específico para avaliação da interferência da tontura na QV. RESULTADOS: O intervalo mediano entre as avaliações foi de 21 dias. O número médio de manobras foi 2,3±1,1. A aplicação do DHI mostrou um significante impacto da VPPB na QV dos pacientes em todas as dimensões da vida diária, com os seguintes escores médios pré e pós-terapia: físico (17,5/3,7, funcional (17,3/3,9, emocional (13,2/3,2 e total (48,1/10,9, respectivamente (pQuality of life (QoL is significantly impaired by vertigo. The effect of specific treatments on QoL deserves investigation. AIM: To assess the effect of repositioning maneuvers on the QoL of benign paroxysmal positioning vertigo (BPPV patients. MATERIALS AND METHODS: A retrospective study design consiting of reviews of charts of BPPV patients in a vestibular rehabilitation unit at a teaching institution in Belo Horizonte, MG, Brazil, from 2007 to 2008. Pre- and post-therapy (Epley's repositioning maneuver scores on the physical, functional and emotional dimensions of the Dizziness Handicap Inventory (DHI were analyzed. RESULTS: Twenty-one patients were included, eighteen (86% were females; the average age was 53.2 years. Ten patients presented bilateral BPPV; in eleven it was unilateral

  4. Paroxysmal ataxia and dysarthria in multiple sclerosis.

    Science.gov (United States)

    Iorio, R; Capone, F; Plantone, D; Batocchi, A P

    2014-01-01

    Paroxysmal ataxia and dysarthria are part of the spectrum of transient neurological disturbances that can be frequently encountered in multiple sclerosis (MS). Prompt recognition of these symptoms is important because they can be the only manifestation of a MS relapse and symptomatic therapy is often beneficial. We report a patient who developed paroxysmal ataxia and dysarthria, documented by video imaging, while he was recovering from a MS relapse. Treatment with carbamazepine resulted in the complete reversal of the paroxysmal ataxia and dysarthria.

  5. Infantile masturbation and paroxysmal disorders.

    Science.gov (United States)

    Omran, Mohammadreza Salehi; Ghofrani, Mohammad; Juibary, Ali Ghabeli

    2008-02-01

    A recurrent paroxysmal presentation in children leads to different diagnoses and among them are neurologic and cardiac etiologies. Infantile masturbation is not a well known entity and cannot be differentiated easily from other disorders. Aim of this study is to elucidate and differentiate this condition from epileptic seizures. We report 3 cases of 10 to 30 mth old girls of infantile masturbation that their symptoms initiated at 2, 3 and 8 mth of age. These present with contraction and extension of lower extremities, scissoring of legs, perspiration, changing face color. In 2 cases body rocking and legs rubbing initiated then there after. Masturbation is one of the paroxysmal non-epileptic conditions of early infancy and is in differential diagnosis of epileptic seizures.

  6. Paroxysmal upgaze deviation: case report

    OpenAIRE

    Echeverría-Palacio CM; Benavidez-Fierro MA

    2012-01-01

    The paroxysmal upgaze deviation is a syndrome that described in infants for first time in 1988; there are just about 50 case reports worldwide ever since. Its etiology is unclear and though it prognosis is variable; most case reports indicate that during growth the episodes tend to decrease in frequency and duration until they disappear. It describes a 16-months old male child who since 11-months old presented many episodes of variable conjugate upward deviation of the eyes, compensatory neck...

  7. Paroxysmal kinesigenic choreoathetosis in hyperthyroidism.

    OpenAIRE

    Drake, M. E.

    1987-01-01

    Paroxysmal kinesigenic choreoathetosis is an unusual movement disorder often triggered by attempts to use the limbs, and has sometimes been associated with diffuse or focal brain injury. We report its occurrence in hyperthyroidism, with which choreoathetosis has rarely been described in the past without known cause. Choreoathetosis has also occurred with other metabolic and toxic disorders, and the mechanism is uncertain. The development of involuntary movements activated by limb motion durin...

  8. Epley and beyond: an update on treating positional vertigo.

    Science.gov (United States)

    Kaski, Diego; Bronstein, Adolfo M

    2014-08-01

    Benign paroxysmal positional vertigo (BPPV) is the commonest cause of dizziness. It is characterised by brief episodes of vertigo and imbalance with nystagmus. The direction of nystagmus allows the identification of the culprit semicircular canal. As it is readily treatable--and often curable--BPPV should not be missed. Although recurrent episodes of vertigo triggered by movement suggest BPPV, the diagnosis can only be confirmed with the Dix-Hallpike manoeuvre. Here we review the diagnostic manoeuvres required to diagnose BPPV, and the various repositioning manoeuvres for treating different types of BPPV.

  9. Unipolar Depression in Paroxysmal Schizophrenia

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    Alexander S. Bobrov

    2013-12-01

    Full Text Available Based on the current study, the clinical characteristics of unipolar depression in the clinical picture of schizophrenia with the paroxysmal type of disease course are presented. Given the concomitant depression with phobic symptoms, the following clinical variants are marked: depression with generalized social phobia and/or anthropophobia and depression with generalized pathological body sensations and hypochondriacal phobias. In other words, we are talking about a necessity to allocate a special type of schizophrenia with affective structure episodes and comorbid neurosis-like symptoms. Information on the basic treatment strategy of schizophrenia with depressive structure episodes and comorbid neurosis-like symptoms in everyday psychiatric practice is also provided.

  10. Factitious psychogenic nonepileptic paroxysmal episodes

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    Alissa Romano

    2014-01-01

    Full Text Available Mistaking psychogenic nonepileptic paroxysmal episodes (PNEPEs for epileptic seizures (ES is potentially dangerous, and certain features should alert physicians to a possible PNEPE diagnosis. Psychogenic nonepileptic paroxysmal episodes due to factitious seizures carry particularly high risks of morbidity or mortality from nonindicated emergency treatment and, often, high costs in wasted medical treatment expenditures. We report a case of a 28-year-old man with PNEPEs that were misdiagnosed as ES. The patient had been on four antiseizure medications (ASMs with therapeutic serum levels and had had multiple intubations in the past for uncontrolled episodes. He had no episodes for two days of continuous video-EEG monitoring. He then disconnected his EEG cables and had an episode of generalized stiffening and cyanosis, followed by jerking and profuse bleeding from the mouth. The manifestations were unusually similar to those of ES, except that he was clearly startled by spraying water on his face, while he was stiff in all extremities and unresponsive. There were indications that he had sucked blood from his central venous catheter to expel through his mouth during his PNEPEs while consciously holding his breath. Normal video-EEG monitoring; the patient's volitional and deceptive acts to fabricate the appearance of illness, despite pain and personal endangerment; and the absence of reward other than remaining in a sick role were all consistent with a diagnosis of factitious disorder.

  11. 原发性良性阵发性位置性眩晕与A型性格的关系%The relationship between the primary benign paroxysmal positional vertigo (BPPV) and the type A personality

    Institute of Scientific and Technical Information of China (English)

    何秋英; 张镭; 赵惠利; 程红武

    2014-01-01

    Objective: To investigate the relationship between the primary BPPV and type A personality, and give reference in preventive. Methods:52 patients with primary BPPV and 50 normal person were received the questionnaires of type A personality survey analysis. Results:In primary BPPV patients, the patients with type A personality were more than the patients with type B personality and the patients with type A personality in control group (P<0.05). Conclusion:Type A personality was related to primary BPPV, and might be one of pathogenic factor. Prevention and treatment of BPPV should be combined with psychological treatment.%目的:探讨原发性BPPV与心理因素的关系,为本病的防治提供参考。方法:对临床确诊的52例原发性BPPV患者以及健康对照组50例采用A型性格问卷法调查分析。结果:原发性BPPV患者中A型性格高于B型以及对照组中A型性格者(P<0.05)。结论:A型性格与原发性BPPV相关,可能是其致病原因之一,为防治原发性BPPV,应配合心理治疗。

  12. 2118例良性阵发性眩晕患者手法复位疗效观察%Canalith repositioning outcomes in 2118 patients with benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    尹时华; 韦顺莲; 舒竞铖; 刘渊

    2015-01-01

    Objective To report outcomes in 2118 patients with BPPV treated by the authors from January 2008 to May 2013. Methods Data from 2118 patients with BPPV who were treated with either modified canalith repositioning or tra-ditional Epley, Barbecue or Gufoni maneuvers were retrospectively studied. All patients were followed up for 6 months. Re-sults①Of the 2118 patients, 971were male and 1147 female, with a mean age of 49.36+11.73 (8 to 87) years. The lesion was located to the posterior semicircular canal in 2005 patients (94.66%), horizontal semicireular canal in 88 patients (4.16%), anterior canalsemicireular in 14 patients (0.66%), and multiple semicircular canals in 11 patients (0.52%).②Of the 2005 patients with PC-BBPV, 1366 were treated with the traditional Epley maneuver, yielding a first time treatment effec-tive rate of 90.6%and a long-term (6 months) effective rate of 93.8%;and 639 were treated with the modified three steps fast canalith repositioning maneuver with a first time effective rate of 89.8%and a 6 months effective rate of 95.8%(x2=3.293, P>0.05),③At six months following up, the rate of recurrence was 19.3%for those who received traditional Epley maneuvers and 18.3%for those who underwent the modified canalith repositioning maneuvers (x2=1.865,P>0.05).④All patients with recurrences in the Epley maneuver group returned for treatment, while only 18.3%of those with recurrences in the modified maneuver group returned for treatment (x2=2.824,P<0.005).⑤The rate of 1 to 2 recurrences was 43.4%with traditional Epley treatment and 71.2%with the modified three steps fast canalith repositioning;the rate of 3 recurrences or more was 56.6%and 27.9%, respectively, for the two therapies (x2=32.34, P<0.01). Conclusion The three-step fast reposi-tioning for PC-BPPV is effect, easy to learn and operate and well accepted by most patients, with improved long term effica-cy. It is the treatment of choice for PC-BPPV patients.%目的:收集在2008年1月~2013年12月广西医科大学第一附属医院耳鼻咽喉-头颈外科确诊并治疗的2118例BPPV患者的资料进行疗效分析。方法对2118例BPPV患者分别应用改良三步快速手法复位法、Epley复位法和Barbecue复位法进行复位治疗,于诊治后随访6个月。结果①2118名患者中男971例(45.85%),女1147例(54.15%);年龄8~87岁,发病平均年龄(49.36±11.73)岁,后半规管BBPV 2005例(94.66%)、水平半规管BBPV 88例(4.16%)、上半规管BBPV 14例(0.66%)、混合半规管BBPV 11例(0.52%)。②有1366例后半规管BPPV行传统Epley法治疗,639例行改良三步快速手法复位法治疗,两组首次有效率分别为90.6%、89.8%,远期(半年)有效率93.8%、95.8%,两组远期效率无统计学差异(χ2=3.293,P>0.05);水平半规管Barbecue和Gufoni治疗,首次有效率92.7%,远期(半年)有效率98.6%;上半规管Epley治疗,首次有效率78.6%,远期(半年)有效率85.7%;混合型半规管联合复位治疗,首次有效率78.6%,远期(半年)有效率85.7%;③传统Epley手法复位组复发率为19.39%,改良三步快速手法复位组复发率为18.3%,两组复发率比较无统计学差异(χ2=1.865,P>0.005)。④复发患者回院治疗率,传统Epley手法复位组为100%,改良三步快速手法复位组为18.3%,两组比较统计学差异显著(χ2=1.865,P>0.005)。⑤复发患者复发1~2次的所占比例传统Epley手法复位组及三步快速手法复位组分别为43.4%、71.2%,复发次数≥3次的比例两组分别为56.6%、27.9%。两组复发次数≥3次的比例进行比较,有统计学差异(χ2=32.34,P<0.01)。结论BPPV患者采用手法复位治疗疗效肯定,见效快,方法简单,远期疗效好,手法复位是BPPV患者的最佳的治疗方法。

  13. 主观性和客观性良性阵发性位置性眩晕的序贯治疗疗效评价%The assessment of sequential treatment for subjective and objective benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    李双; 王庆; 董洁; 周绪红

    2016-01-01

    目的:探讨主观性与客观性良性阵发性位置性眩晕(S-BPPV及O-BPPV)的序贯治疗疗效的差异.方法:回顾性分析2014-01-2015-07期间诊治的19例垂直半规管S-BPPV (A组)与45例垂直半规管O-BPPV(B组)患者的资料,评价其序贯治疗的疗效,同时报道5例水平半规管S-BPPV的序贯治疗疗效.结果:首次耳石复位次数A组为2~6次,平均(4.21±1.18)次;B组为2~3次,平均(2.29±0.46)次;复位次数A组比B组多,差异有统计学意义(P<0.01).A组首次治疗有效率为78.9%(15/19),B组为82.2%(37/45);序贯治疗1周后A组有效率为89.5%(17/19),B组为88.9%(40/45);2组间均差异无统计学意义(P>0.05).随访3个月后A组1例(5.3%)复发,B组2例(4.4%)复发,差异无统计学意义(P>0.05).5例水平半规管S-BPPV患者全部治愈.结论:序贯治疗对垂直半规管S-BPPV与O-BPPV或具有同样疗效,但S-BPPV首次耳石复位次数更多.水平半规管S-BPPV可用耳石复位加药物和仰卧位摇头法序贯治疗.

  14. Benign and Deleterious Cystic Fibrosis Transmembrane Conductance Regulator Mutations Identified by Sequencing in Positive Cystic Fibrosis Newborn Screen Children from California.

    Directory of Open Access Journals (Sweden)

    Danieli B Salinas

    Full Text Available Of the 2007 Cystic Fibrosis Transmembrane Conductance Regulator (CFTR mutations, 202 have been assigned disease liability. California's racially diverse population, along with CFTR sequencing as part of newborn screening model, provides the opportunity to examine the phenotypes of children with uncategorized mutations to help inform disease liability and penetrance.We conducted a retrospective cohort study based on children screened from 2007 to 2011 and followed for two to six years. Newborns that screened positive were divided into three genotype groups: those with two CF-causing mutations (CF-C; those with one mutation of varying clinic consequence (VCC; and those with one mutation of unknown disease liability (Unknown. Sweat chloride tests, pancreatic sufficiency status, and Pseudomonas aeruginosa colonization were compared.Children with two CF-causing mutations had a classical CF phenotype, while 5% of VCC (4/78 and 11% of Unknown (27/244 met diagnostic criteria of CF. Children carrying Unknown mutations 2215insG with D836Y, and T1036N had early and classical CF phenotype, while others carrying 1525-42G>A, L320V, L967S, R170H, and 296+28A>G had a benign clinical presentation, suggesting that these are non-CF causing.While most infants with VCC and Unknown CFTR mutations do not meet diagnostic criteria for CF, a small proportion do. These findings highlight the range of genotypes and phenotypes in the first few years of life following CF newborn screening when CFTR sequencing is performed.

  15. Management of a Benign Phyllodes Tumor in a 13-Year-Old Girl with Trans-position of the Nipple Areola Complex and Breast Reconstruction.

    Science.gov (United States)

    Erginel, B; Celet Ozden, B; Yesil Onder, S; Yuksel, S; Gun Soysal, F; Celik, A; Salman, T

    2015-01-01

    Phyllodes tumor is a rare primary tumor of the breast. In children and adolescents, it is even rarer with only 20 cases, treatment of which vary in the literature. Herein we report the case of a 13-year-old female patient with a giant benign phyllodes tumor eroding the bottom of the breast skin and causing nipple retraction. We performed breast conservative surgery by mobilizing the areola, using skin flaps and inserting an implant. Breast malignancy, including phyllodes tumor (PT), is very rare in adolescents. PT, previously called cystosarcoma phylloides, consists of leaf-like fronds, from which the tumor gets its name (1, 2). Although PT is most often seen in the fourth decade of life, almost 20 cases have been reported in the adolescent period, most of which are benign. The histologic types are benign, borderline, and malignant, depending on the mitotic rate of the tumor (3, 4).

  16. Cisplatin induced paroxysmal supraventricular tachycardia

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    Waseem Raja

    2013-01-01

    Full Text Available Cisplatin or cis-diamminedichloroplatinum (CDDP is the first member of a class of platinum-containing anti-cancer drugs that act by binding to and causing cross-linking of deoxyribonucleic acid, which ultimately triggers apoptosis. Cisplatin has a broad-spectrum antineoplastic activity against various types of human tumors. Unfortunately, the optimal usefulness of Cisplatin is limited secondary to its dose related toxicity especially nephrotoxicity. Cisplatin chemotherapy is also associated with cardiotoxic effects that may range from silent arrhythmias to heart failure and even sudden cardiac death. These effects are more pronounced when cisplatin is combined with other cardiotoxic drugs. Here, we report a case of patient of cancer lung who developed paroxysmal supraventricular tachycardia following administration of Cisplatin. A brief review of the literature follows.

  17. Cisplatin induced paroxysmal supraventricular tachycardia.

    Science.gov (United States)

    Raja, Waseem; Mir, M Hussain; Dar, Imtiyaz; Banday, Muzamil Ahmad; Ahmad, Irfan

    2013-10-01

    Cisplatin or cis-diamminedichloroplatinum (CDDP) is the first member of a class of platinum-containing anti-cancer drugs that act by binding to and causing cross-linking of deoxyribonucleic acid, which ultimately triggers apoptosis. Cisplatin has a broad-spectrum antineoplastic activity against various types of human tumors. Unfortunately, the optimal usefulness of Cisplatin is limited secondary to its dose related toxicity especially nephrotoxicity. Cisplatin chemotherapy is also associated with cardiotoxic effects that may range from silent arrhythmias to heart failure and even sudden cardiac death. These effects are more pronounced when cisplatin is combined with other cardiotoxic drugs. Here, we report a case of patient of cancer lung who developed paroxysmal supraventricular tachycardia following administration of Cisplatin. A brief review of the literature follows.

  18. Treatment of paroxysmal nocturnal hemoglobinuria

    Directory of Open Access Journals (Sweden)

    I. A. Lisukov

    2014-07-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria (PNH is a rare, life‑threatening clonal hematological disorder caused by an acquired mutation in the phosphatidylinositol glucan (PIG-A gene. PNH is characterized by chronic intravascular hemolysis, marrow failure, thrombophilia and other severe clinical syndromes. Until recently, the treatment of PNH has been symptomatic with blood transfusions, anticoagulation and supplementation with folic acid or iron. The only potentially curative treatment is allogeneic stem cell transplantation, but this has severe complications with high mortality rates. A new targeted treatment strategy is the inhibition of the terminal complement cascade with anti‑C5 monoclonal antibody (eculizumab. Eculizumab has shown significant efficacy in controlling of intravascular hemolysis resulting in improving quality of life and survival.

  19. Treatment of paroxysmal nocturnal hemoglobinuria

    Directory of Open Access Journals (Sweden)

    I. A. Lisukov

    2012-01-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria (PNH is a rare, life‑threatening clonal hematological disorder caused by an acquired mutation in the phosphatidylinositol glucan (PIG-A gene. PNH is characterized by chronic intravascular hemolysis, marrow failure, thrombophilia and other severe clinical syndromes. Until recently, the treatment of PNH has been symptomatic with blood transfusions, anticoagulation and supplementation with folic acid or iron. The only potentially curative treatment is allogeneic stem cell transplantation, but this has severe complications with high mortality rates. A new targeted treatment strategy is the inhibition of the terminal complement cascade with anti‑C5 monoclonal antibody (eculizumab. Eculizumab has shown significant efficacy in controlling of intravascular hemolysis resulting in improving quality of life and survival.

  20. Paroxysmal upgaze deviation: case report

    Directory of Open Access Journals (Sweden)

    Echeverría-Palacio CM

    2012-05-01

    Full Text Available The paroxysmal upgaze deviation is a syndrome that described in infants for first time in 1988; there are just about 50 case reports worldwide ever since. Its etiology is unclear and though it prognosis is variable; most case reports indicate that during growth the episodes tend to decrease in frequency and duration until they disappear. It describes a 16-months old male child who since 11-months old presented many episodes of variable conjugate upward deviation of the eyes, compensatory neck flexion and down-beat saccades in attempted downgaze. These events are predominantly diurnal, and are exacerbated by stressful situations such as fasting or insomnia, however and improve with sleep. They have normal neurologic and ophthalmologic examination, and neuroimaging and EEG findings are not relevant.

  1. Cortical hyperpolarization-activated depolarizing current takes part in the generation of focal paroxysmal activities

    Science.gov (United States)

    Timofeev, Igor; Bazhenov, Maxim; Sejnowski, Terrence; Steriade, Mircea

    2002-01-01

    During paroxysmal neocortical oscillations, sudden depolarization leading to the next cycle occurs when the majority of cortical neurons are hyperpolarized. Both the Ca2+-dependent K+ currents (IK(Ca)) and disfacilitation play critical roles in the generation of hyperpolarizing potentials. In vivo experiments and computational models are used here to investigate whether the hyperpolarization-activated depolarizing current (Ih) in cortical neurons also contributes to the generation of paroxysmal onsets. Hyperpolarizing current pulses revealed a depolarizing sag in ≈20% of cortical neurons. Intracellular recordings from glial cells indirectly indicated an increase in extracellular potassium concentration ([K+]o) during paroxysmal activities, leading to a positive shift in the reversal potential of K+-mediated currents, including Ih. In the paroxysmal neocortex, ≈20% of neurons show repolarizing potentials originating from hyperpolarizations associated with depth-electroencephalogram positive waves of spike-wave complexes. The onset of these repolarizing potentials corresponds to maximal [K+]o as estimated from dual simultaneous impalements from neurons and glial cells. Computational models showed how, after the increased [K+]o, the interplay between Ih, IK(Ca), and a persistent Na+ current, INa(P), could organize paroxysmal oscillations at a frequency of 2–3 Hz. PMID:12089324

  2. Paroxysmal nocturnal hemoglobinuria and telomere length predicts response to immunosuppressive therapy in pediatric aplastic anemia.

    Science.gov (United States)

    Narita, Atsushi; Muramatsu, Hideki; Sekiya, Yuko; Okuno, Yusuke; Sakaguchi, Hirotoshi; Nishio, Nobuhiro; Yoshida, Nao; Wang, Xinan; Xu, Yinyan; Kawashima, Nozomu; Doisaki, Sayoko; Hama, Asahito; Takahashi, Yoshiyuki; Kudo, Kazuko; Moritake, Hiroshi; Kobayashi, Masao; Kobayashi, Ryoji; Ito, Etsuro; Yabe, Hiromasa; Ohga, Shouichi; Ohara, Akira; Kojima, Seiji

    2015-12-01

    Acquired aplastic anemia is an immune-mediated disease characterized by severe defects in stem cell number resulting in hypocellular marrow and peripheral blood cytopenias. Minor paroxysmal nocturnal hemoglobinuria populations and a short telomere length were identified as predictive biomarkers of immunosuppressive therapy responsiveness in aplastic anemia. We enrolled 113 aplastic anemia patients (63 boys and 50 girls) in this study to evaluate their response to immunosuppressive therapy. The paroxysmal nocturnal hemoglobinuria populations and telomere length were detected by flow cytometry. Forty-seven patients (42%) carried a minor paroxysmal nocturnal hemoglobinuria population. The median telomere length of aplastic anemia patients was -0.99 standard deviation (SD) (range -4.01-+3.01 SD). Overall, 60 patients (53%) responded to immunosuppressive therapy after six months. Multivariate logistic regression analysis identified the absence of a paroxysmal nocturnal hemoglobinuria population and a shorter telomere length as independent unfavorable predictors of immunosuppressive therapy response at six months. The cohort was stratified into a group of poor prognosis (paroxysmal nocturnal hemoglobinuria negative and shorter telomere length; 37 patients) and good prognosis (paroxysmal nocturnal hemoglobinuria positive and/or longer telomere length; 76 patients), respectively. The response rates of the poor prognosis and good prognosis groups at six months were 19% and 70%, respectively (P<0.001). The combined absence of a minor paroxysmal nocturnal hemoglobinuria population and a short telomere length is an efficient predictor of poor immunosuppressive therapy response, which should be considered while deciding treatment options: immunosuppressive therapy or first-line hematopoietic stem cell transplantation. The trial was registered in www.umin.ac.jp with number UMIN000017972.

  3. Is "Benign Childhood Epilepsy with Centrotemporal Spikes” Always Benign?

    Directory of Open Access Journals (Sweden)

    Muhammad SAEED

    2014-07-01

    epileptiform discharges are associated with mood and behavior problems. Epilepsy Behav. 2011;22 (2:298-303.Jones JE, Watson R, Sheth R, Caplan R, Koehn M, Seidenberg M, et al. Psychiatric comorbidity in children with new onset epilepsy. Dev Med Child Neurol. 2007;49:493-7.Austin JK, Harezlak J, Dunn DW, Huster GA, Rose DF, Ambrosius WT. Behavior problems in children before first recognized seizures. Pediatrics. 2001; 107:115-22.Bhise VV, Burack GD, Mandelbaum DE. Baseline cognition, behavior, and motor skills in children with new-onset, idiopathic epilepsy. Dev Med Child Neurol. 2010;52:22-6.Kavros PM, Clarke T, Strug LJ, Halperin JM, Dorta NJ, Pal DK. Attention impairment in rolandic epilepsy: systematic review. Epilepsia. 2008; 49:1570-80.Beaussart M. Benign epilepsy of children with Rolandic (centro-temporal paroxysmal foci: A clinical entity: Study of 221 cases. 1972. Epilepsia 13 (6: 795–811. 

  4. Paroxysmal discharges triggered by hearing spoken language.

    Science.gov (United States)

    Tsuzuki, H; Kasuga, I

    1978-04-01

    We examined the modality of EEG activation by various kinds of acoustic stimulation in a middle-aged Japanese female with epilepsy. Paroxysmal discharges were triggered in the right frontal area (F4) by verval stimulation. For the activation of EEG, concentration of attention on the stimulation was essential; therefore paroxysmal discharges were triggered most easily by verbal stimuli when someone spoke to the patient directly. Stronger responses than usual were triggered by specific words, and apparently reflected the interest and concern of the patient. The latency from stimulation to paroxysmal discharges ranged from 230 to 1,300 msec, suggesting that the responses may have been a function of the perception and recognition of acoustic stimuli. "Heard-word epilepsy" or "Angesprochene Epilepsie" is suggested in this case.

  5. Compare of internal rotation stretching and paroxysmal pulling manipulation with traction manipulation in supination position in the treatment of external humeral epicondylitis%旋后牵伸手法与内旋伸肘顿拉手法治疗肱骨外上髁炎的临床对比研究

    Institute of Scientific and Technical Information of China (English)

    傅瑞阳; 顾钟忠; 王宝虎; 沈新云; 王娅玲; 朱仡; 李烨; 王恩萍

    2011-01-01

    目的:比较旋后牵伸手法与传统内旋伸肘顿拉手法治疗肱骨外上髁炎的临床疗效.方法:将符合标准的126例肱骨外上髁炎患者随机分为2组.Ⅰ组64例,采用旋后牵伸手法治疗;Ⅱ组62例,采用内旋伸肘顿拉手法治疗.治疗1个疗程后参照verhaar网球肘疗效评分标准,从疼痛、压痛、握力、关节功能、患者满意度6个方面对患者的疗效进行评价.同时严格记录患者在治疗期间出现的各种不良反应.结果:①治疗后两组患者疼痛、压痛、握力、关节功能、患者满意度均较治疗前改善,且Ⅰ组改善情况优于Ⅱ组(P<0.01);②Ⅰ组总体疗效优于Ⅱ组,差异有统计学意义(Z=5.869,P=0.000);③Ⅱ组8例患者有一过性的轻度疼痛加重.经1~3 d休息或理疗后消失,其余患者未出现任何不良反应.结论:采用旋后牵伸手法治疗肱骨外上髁炎,疗效优于内旋伸肘顿拉手法.%Objective:To compare the therapeutic effect of the internal rotation stretching and paroxysmal pulling manipulation with that of traction manipulation in supination position on external humeral epicondylitis. Methods: 126 patients were randomly divided into 2 groups with 64 cases in Group Ⅰ and 62 cases in Group Ⅱ. Patients in Group Ⅰ were treated with traction manipulation in supination position while those in Group Ⅱ were treated with internal rotation stretching and paroxysmal pulling manipulation. The indexes involving pain, tendemess, the grip strength of the affected hand, the function of the arthrosis and the satisfaction degree of the patients were documented after the 20 - day course of treatment. Verhaar cure effect appraisal system of tennis - ball elbow were used to evaluate the therapeutic effects.Adverse reactions were documented during the 20 - day course of treatment. Results: The indexes improved after the treatment in two groups and the improvements in Group Ⅰ were superior to that in Group Ⅱ ( P < 0

  6. Clinical Practice Guidelines for paroxysmal supraventricular tachycardia.

    Directory of Open Access Journals (Sweden)

    Brandy Viera Valdés

    2009-03-01

    Full Text Available Clinical Practice Guidelines for paroxysmal supraventricular tachycardia. These are arrhythmias in which structures placed above the bifurcation of the bundle of His are involved; characterized by tachycardia with abrupt starting and ending. We comment its classification, common characteristics, general treatment and specific conduct for its different variables. It includes assessment guidelines focused on the most important aspects to be accomplished.

  7. PAROXYSMAL ATRIAL FIBRILLATION: CHOICE OF CARDIOVERSION THERAPY

    Directory of Open Access Journals (Sweden)

    B. A. Tatarskii

    2007-01-01

    Full Text Available Characteristics and classification of different patterns of paroxysmal atrial fibrillation are presented. Main indications to restoration of sinus rhythm are discussed. The features of main medications used to terminate of atrial fibrillation are given. The choice of antiarrhythmic drug is considerate. Necessity of individual approach to therapy tactics is proved.

  8. Paroxysmal nocturnal hemoglobinuria: rare cause of acute renal failure

    Directory of Open Access Journals (Sweden)

    Vilma Takayasu

    2012-12-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria is a rare acquired disease, characterized by hemolytic anemia, recurrent infections, cytopenias, and vascular thrombosis. It occurs by non-malignant clonal expansion of one or more hematopoietic stem cells that acquired somatic mutations in PIG-A gene linked to chromosome X. This mutation results in lower erythrocyte expression of CD55 and CD59 surface proteins and consequently increased susceptibility to the complement system. The renal involvement is generally benign, resulting in mild impairment in urinary concentration. Acute renal failure requiring hemodialytic support accompanying PNH is rarely observed. The authors report a case of a 37-year-old male who presented with bicytopenia (hemolytic anemia and thrombocytopenia associated with acute renal failure requiring dialysis. Diagnosis was challenging because of the rarity and unfamiliarity with this entity, but was confirmed by flow cytometry. In the course of the disease, acute pyelonephritis with multiple renal abscesses was diagnosed requiring prolonged antibiotic therapy. Patient outcome was favorable after the control of hemolysis and the infection treatment.

  9. [Affective respiratory and reflex paroxysms--evaluation of anamnestic data, clinical manifestations and therapy].

    Science.gov (United States)

    Lnĕnicková, D; Makovská, Z; Lnĕnicka, J

    1993-08-01

    The authors elaborated data, using the retrospective method, of a group of 146 patients with affective respiratory and reflex paroxysms. They focused attention on clinical manifestations of the disease, anamnestic data suggesting possible damage or immaturity of stem structures, the influence of heredity and the family environment. They found that in 63.7% the disease was manifested before the age of 1 year, most frequently at the age of 9-12 months. The cyanotic type of paroxysms was found in 67.5% of the patients, the pallid type in 21% and 3.5% of the patients suffered from both types of paroxysms. In 27.4% perinatal risks were recorded. The influence of a family-history was statistically significant in relation to the patient's age during the first attack: in patients with a positive family-history the mean age being by 1.8 months lower. 82.9% of the patients had a normal neurological finding, the EEG was evaluated as normal in 89.6% of 125 thus examined children. Psychological examinations made in 12 children revealed in all instances anomalies of personality with a predominance of lack of compliance and adaptability to the environment. Deterioration of the health status as a result of affective respiratory and reflex paroxysms was not recorded in any of the patients.

  10. [Initial evaluation and management of paroxysmal supraventricular tachycardia].

    Science.gov (United States)

    Rujic, Dragana; Sundbøll, Jens; Tofig, Bawer Jalal; Nielsen, Jens Cosedis; Pareek, Manan

    2016-01-18

    The paroxysmal supraventricular tachycardias (SVT) are commonly encountered arrhythmias and include atrioventricular nodal re-entrant tachycardia, atrioventricular reciprocating tachycardia, and focal atrial tachycardia. These tachycardias share several clinical features as well as similar management strategies. The probable mechanism of paroxysmal SVT can often be diagnosed from the clinical findings and a 12-lead ECG. This review describes the initial evaluation and treatment of patients with paroxysmal SVT, including distinctive features from the most important differential diagnoses.

  11. Paroxysmal Hypnogenic Dyskinesia Responsive to Doxylamine: A Case Report

    OpenAIRE

    Williams, Daniel M.

    2012-01-01

    Paroxysmal hypnogenic dyskinesia is a rare clinical entity characterized by intermittent dystonia and choreoathetoid movements that begin exclusively during sleep, often with consciousness preserved once the patient is awakened during the episodes. They occur almost every night and are often misdiagnosed as sleeping disorders. Paroxysmal hypnogenic dyskinesia is currently known to be a form of frontal lobe epilepsy, but not in all cases. We present a 19-year-old male patient with paroxysmal h...

  12. Balance Problems

    Science.gov (United States)

    ... fall may affect an older adult's life. BPPV (Benign Paroxysmal Positional Vertigo) There are many types of balance disorders. One of the most common is benign paroxysmal positional vertigo, or BPPV. In BPPV, you experience a brief, ...

  13. Acute tubular necrosis in a patient with paroxysmal nocturnal hemoglobinuria

    Directory of Open Access Journals (Sweden)

    Eranga S Wijewickrama

    2013-01-01

    Full Text Available Acute renal failure (ARF is a well-recognized complication of paroxysmal nocturnal hemoglobinuria (PNH. The predominant mechanism is intravascular hemolysis resulting in massive hemoglobinuria ARF. We report a case of acute tubular necrosis (ATN developed in the absence of overwhelming evidence of intravascular hemolysis in a 21-year-old man with anemia, who was eventually diagnosed to have PNH. The patient presented with rapidly deteriorating renal functions in the background of iron deficiency anemia, which was attributed to reflux esophagitis. There was no clinical or laboratory evidence of intravascular hemolysis. Renal biopsy revealed ATN with deposition of hemosiderin in the proximal tubular epithelial cells. Diagnosis of PNH was confirmed with a positive Ham′s test and flow cytometry. Our case emphasizes the need to consider ATN as a possible cause for ARF in patients suspected to have PNH even in the absence of overwhelming evidence of intravascular hemolysis.

  14. Benign prostate hyperplasia (BPH) - resources

    Science.gov (United States)

    Resources - benign prostatic hyperplasia (BPH); Prostate enlargement resources; BPH resources ... The following organizations provide information on benign prostatic hyperplasia ( prostate enlargement ... Urology Care Foundation -- www. ...

  15. [Solcoseryl--new preparation for the pathogenetic treatment of patients with paroxysmal forms of cerebrovascular pathology].

    Science.gov (United States)

    Rudenko, A Iu; Bashkirova, L M

    2003-01-01

    The central goal of the investigation was to study Solcoseryl (SolcoSwitzerland) therapeutic efficacy for patients suffering from early or chronic cerebrovascular diseases complicated with different forms of paroxysms. 29 patients were examined. (14 of them were with vegetovascular dystonia, 7 with discirculatory encephalopathy of degree of 1 and 8 with discirculatory encephalopathy of degree of II). The authors revealed Solcoseryl to be positive in decreasing incidence and duration of vegetovascular fits, complaints, pathologic symptoms.

  16. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Cosedis Nielsen, Jens; Johannessen, Arne; Raatikainen, Pekka;

    2012-01-01

    There are limited data comparing radiofrequency catheter ablation with antiarrhythmic drug therapy as first-line treatment in patients with paroxysmal atrial fibrillation.......There are limited data comparing radiofrequency catheter ablation with antiarrhythmic drug therapy as first-line treatment in patients with paroxysmal atrial fibrillation....

  17. Paroxysmal Supraventricular Tachycardia: Pathophysiology, Diagnosis, and Management.

    Science.gov (United States)

    Al-Zaiti, Salah S; Magdic, Kathy S

    2016-09-01

    Paroxysmal supraventricular tachycardia (PSVT) is a well-known and thoroughly studied clinical syndrome, characterized by regular tachycardia rhythm with sudden onset and abrupt termination. Most patients present with palpitations and dizziness, and their electrocardiogram demonstrates a narrow QRS complex and regular tachycardia with hidden or inverted P waves. PSVT is caused by re-entry due to the presence of inhomogeneous, accessory, or concealed conducting pathways. Hemodynamically stable patients are treated by vagal maneuvers, intravenous adenosine, diltiazem, or verapamil, hemodynamically unstable patients are treated by cardioversion. Patients with symptomatic and recurrent PSVT can be treated with long-term drug treatment or catheter ablation.

  18. The polyuria of paroxysmal atrial tachycardia

    Science.gov (United States)

    Kinney, M. J.; Stein, R. M.; Discala, V. A.

    1974-01-01

    Two patients with paroxysmal atrial fibrillation and an associated polyuria were studied to delineate the mechanism of the increase in urine flow. A striking saluresis was noted in both patients. The increased sodium excretion was probably due to decreased sodium reabsorption, perhaps at proximal tubular nephron sites. This inhibition of sodium reabsorption could explain both the saluresis and some part or all of the polyuria. Re-evaluation of earlier case reports reveals patterns of concomitant salt and water excretion consistent with this mechanism. The saluresis cannot be explained by the previously favored hypothesis of antidiuretic hormone inhibition.

  19. Developmental Venous Anomaly: Benign or Not Benign

    Science.gov (United States)

    AOKI, Rie; SRIVATANAKUL, Kittipong

    2016-01-01

    Developmental venous anomalies (DVAs), previously called venous angiomas, are the most frequently encountered cerebral vascular malformations. However, DVA is considered to be rather an extreme developmental anatomical variation of medullary veins than true malformation. DVAs are composed of dilated medullary veins converging centripetally into a large collecting venous system that drains into the superficial or deep venous system. Their etiology and mechanism are generally accepted that DVAs result from the focal arrest of the normal parenchymal vein development or occlusion of the medullary veins as a compensatory venous system. DVAs per se are benign and asymptomatic except for under certain unusual conditions. The pathomechanisms of symptomatic DVAs are divided into mechanical, flow-related causes, and idiopathic. However, in cases of DVAs associated with hemorrhage, cavernous malformations (CMs) are most often the cause rather than DVAs themselves. The coexistence of CM and DVA is common. There are some possibilities that DVA affects the formation and clinical course of CM because CM related to DVA is generally located within the drainage territory of DVA and is more aggressive than isolated CM in the literature. Brain parenchymal abnormalities surrounding DVA and cerebral varix have also been reported. These phenomena are considered to be the result of venous hypertension associated with DVAs. With the advance of diagnostic imagings, perfusion study supports this hypothesis demonstrating that some DVAs have venous congestion pattern. Although DVAs should be considered benign and clinically silent, they can have potential venous hypertension and can be vulnerable to hemodynamic changes. PMID:27250700

  20. Paroxysmal autonomic instability with dystonia in a patient with tuberculous meningitis: a case report

    Directory of Open Access Journals (Sweden)

    Ramdhani Navin A

    2010-09-01

    Full Text Available Abstract Introduction This case report describes an extremely rare combination of paroxysmal autonomic instability with dystonia and tuberculous meningitis. Paroxysmal autonomic instability with dystonia is normally associated with severe traumatic brain injury. Case presentation A 69-year-old man of Indonesian descent was initially suspected of having a community-acquired pneumonia, which was seen on chest X-ray and computed tomography of the chest. However, a bronchoscopy showed no abnormalities. He was treated with amoxicillin-clavulanic acid in combination with ciprofloxacin. However, nine days after admission he was disorientated and complained of headache. Neurological examination revealed no further abnormalities. A lumbar puncture revealed no evidence of meningitis. He was then transferred to our hospital. At that time, initial cultures of bronchial fluid for Mycobacterium tuberculosis turned positive, as well as polymerase chain reaction for Mycobacterium tuberculosis. Later, during his stay in our intensive care unit, he developed periods with hypertension, sinus tachycardia, excessive transpiration, decreased oxygen saturation with tachypnea, pink foamy sputum, and high fever. This constellation of symptoms was accompanied by dystonia in the first days. These episodes lasted approximately 30 minutes and improved after administration of morphine, benzodiazepines or clonidine. Magnetic resonance imaging showed an abnormal signal in the region of the hippocampus, thalamus and the anterior parts of the lentiform nucleus and caudate nucleus. Conclusions In patients with (tuberculous meningitis and episodes of extreme hypertension and fever, paroxysmal autonomic instability with dystonia should be considered.

  1. Benign Fibrous Histiocytoma

    Directory of Open Access Journals (Sweden)

    Pushpa Varma

    2014-01-01

    Full Text Available Fibrous histiocytomas (FHs are mesenchymal tumors that may be benign or malignant. Ocular involvement by FHs is infrequent and primarily limited to the orbit. Rarely, FHs can also involve the conjunctiva and perilimbal area. We report the case of a 38-year-old male with lid, conjunctival, and neck FHs. The diagnosis was confirmed by histopathology.

  2. Benign Prostatic Hyperplasia

    Science.gov (United States)

    ... prostate gets bigger, it may press on the urethra and cause the flow of urine to be slower and less forceful. "Benign" means the enlargement isn't caused by cancer or infection. "Hyperplasia" means enlargement. SymptomsWhat are the ...

  3. Idiopathic Paroxysmal Ventricular Tachycardia in Infants and Children

    Science.gov (United States)

    Hernandez, Antonio; And Others

    1975-01-01

    Laboratory tests including blood count serum electrolyte measures, and electroencephalograms were performed on seven children ages 1 day to 18 years with recurrent attacks of rapid heart action known as idiopathic paroxysmal ventricular tachycardia. (CL)

  4. Topiramate antagonism of L-glutamate-induced paroxysms in planarians

    Science.gov (United States)

    Raffa, Robert B.; Finno, Kristin E.; Tallarida, Christopher S.; Rawls, Scott M.

    2010-01-01

    We recently reported that NMDA (N-Methyl-D-aspartate) and AMPA (α-Amino-3-hydroxy-5-methylisoxazole-4-propionic acid) induce concentration-dependent paroxysms in planarians (Dugesia dorotocephala). Since the postulated mechanisms of action of the sulfamate-substituted monosaccharide antiepileptic drug topiramate include inhibition of glutamate-activated ion channels, we tested the hypothesis that topiramate would inhibit glutamate-induced paroxysms in our model. We demonstrate that: (1) L-glutamate (1–10 mM), but not D-glutamate, induced dose-related paroxysms, and that (2) topiramate dose-relatedly (0.3–3 mM) inhibited L-glutamate-induced paroxysms. These results provide further evidence of a topiramate-sensitive glutamate receptor-mediated activity in this model. PMID:20863783

  5. Isolated paroxysmal dysarthria caused by a single demyelinating midbrain lesion.

    Science.gov (United States)

    Codeluppi, Luca; Bigliardi, Guido; Chiari, Annalisa; Meletti, Stefano

    2013-10-16

    Paroxysmal dysarthria is an unusual condition characterised by brief episodes of dysarthria with the sudden onset and frequent recurrence. It has been mainly reported in multiple sclerosis and an association with midbrain lesions has been claimed; however, most of the reported patients had multiple brain alterations so it was difficult to associate this symptom with a specific lesion site. We illustrate the cases of two patients with an isolated demyelinating midbrain lesion presenting paroxysmal dysarthria as the only symptom; both participants had oligoclonal bands in the cerebrospinal fluid and an unremarkable follow-up. Both patients had benefit from carbamazepine treatment, similarly to previously reported cases. Our report confirms that a demyelinating midbrain lesion is sufficient to provoke paroxysmal dysarthria. It is noteworthy that an erroneous diagnosis of psychogenic disorders was initially made in both cases, highlighting the importance not to underestimate isolated paroxysmal symptoms in clinical practice.

  6. Plasmodium vivax: paroxysm-associated lipids mediate leukocyte aggregation

    Directory of Open Access Journals (Sweden)

    Mendis Kamini

    2007-05-01

    Full Text Available Abstract Background Paroxysms are recurrent febrile episodes, characteristic of Plasmodium vivax infections, which coincide with the rupture of schizont-infected erythrocytes in the patients' circulation. The present study describes the formation of prominent aggregates of leukocytes in vitro in the presence of parasite and host factors released during paroxysms. Methods Whole blood cells from uninfected malaria-naïve donors were incubated with plasma taken during a paroxysm or normal human plasma as a control and cell smears were observed under the microscope for the presence of leukocyte aggregates. Plasma factors involved in mediating the leukocyte aggregation were identified using immune depletion and reconstitution experiments. Furthermore, biochemical characterization was carried out to determine the chemical nature of the active moieties in plasma present during paroxysms. Results Leukocyte aggregates were seen exclusively when cells were incubated in plasma collected during a paroxysm. Immune depletion and reconstitution experiments revealed that the host cytokines TNF-alpha, GM-CSF, IL-6 and IL-10 and two lipid fractions of paroxysm plasma comprise the necessary and sufficient mediators of this phenomenon. The two lipid components of the paroxysm plasmas speculated to be of putative parasite origin, were a phospholipid-containing fraction and another containing cholesterol and triglycerides. The phospholipid fraction was dependent upon the presence of cytokines for its activity unlike the cholesterol/triglyceride-containing fraction which in the absence of added cytokines was much more active than the phospholipids fraction. The biological activity of the paroxysm plasmas from non-immune patients who presented with acute P. vivax infections was neutralized by immune sera raised against schizont extracts of either P. vivax or Plasmodium falciparum. However, immune sera against P. vivax were more effective than that against P. falciparum

  7. [Renal vein infarction, a complication of paroxysmal nocturnal hemoglobinuria].

    Science.gov (United States)

    de Charry, Charlotte; de Charry, Félicité; Lemoigne, François; Lamboley, Jean-Laurent; Pasquet, Florian; Pavic, Michel

    2012-12-01

    Paroxysmal nocturnal hemoglobinuria (Marchiafava-Micheli disease) is a rare acquired clonal disorder of the hematopoietic cell, to a somatic mutation in the phosphatidylinositol glycan (PIG-A). The most frequent clinical manifestations are hemolytic crisis and venous thrombosis of the mesenteric, hepatic, portal or cerebral territories. We report a case of paroxysmal nocturnal hemoglobinuria with renal vein thrombosis, a rare complication of this disease.

  8. Cryoballoon or Radiofrequency Ablation for Paroxysmal Atrial Fibrillation.

    OpenAIRE

    Chun, KR; Bestehorn, K; Pocock, SJ; FIRE AND ICE Investigators; , COLLABORATORS; Kuck, KH; Metzner, A; Ouyang, F; Chun, J; Fürnkranz, A; Elvan, A.; Arentz, T.; Kühne, M.; Sticherling, C; Gellér, L

    2016-01-01

    BACKGROUND: Current guidelines recommend pulmonary-vein isolation by means of catheter ablation as treatment for drug-refractory paroxysmal atrial fibrillation. Radiofrequency ablation is the most common method, and cryoballoon ablation is the second most frequently used technology. METHODS: We conducted a multicenter, randomized trial to determine whether cryoballoon ablation was noninferior to radiofrequency ablation in symptomatic patients with drug-refractory paroxysmal atrial fibrillatio...

  9. Optimizing Detection Rate and Characterization of Subtle Paroxysmal Neonatal Abnormal Facial Movements with Multi-Camera Video-Electroencephalogram Recordings.

    Science.gov (United States)

    Pisani, Francesco; Pavlidis, Elena; Cattani, Luca; Ferrari, Gianluigi; Raheli, Riccardo; Spagnoli, Carlotta

    2016-06-01

    Objectives We retrospectively analyze the diagnostic accuracy for paroxysmal abnormal facial movements, comparing one camera versus multi-camera approach. Background Polygraphic video-electroencephalogram (vEEG) recording is the current gold standard for brain monitoring in high-risk newborns, especially when neonatal seizures are suspected. One camera synchronized with the EEG is commonly used. Methods Since mid-June 2012, we have started using multiple cameras, one of which point toward newborns' faces. We evaluated vEEGs recorded in newborns in the study period between mid-June 2012 and the end of September 2014 and compared, for each recording, the diagnostic accuracies obtained with one-camera and multi-camera approaches. Results We recorded 147 vEEGs from 87 newborns and found 73 episodes of paroxysmal facial abnormal movements in 18 vEEGs of 11 newborns with the multi-camera approach. By using the single-camera approach, only 28.8% of these events were identified (21/73). Ten positive vEEGs with multicamera with 52 paroxysmal facial abnormal movements (52/73, 71.2%) would have been considered as negative with the single-camera approach. Conclusions The use of one additional facial camera can significantly increase the diagnostic accuracy of vEEGs in the detection of paroxysmal abnormal facial movements in the newborns.

  10. Benign Prostatic Hyperplasia

    OpenAIRE

    Gil Ortega, Joan

    2015-01-01

    Benign prostatic hyperplasia (BPH) is a prevalent disease but its molecular mechanism remains unknown. Using human tissue samples from 16 patients diagnosed with BPH, we performed an ultrastructural study to clarify the mechanism and the role of glandular cells in this pathology. We have made a description of all the changes that suffers the prostatic epithelium. We have shown that the glandular architecture presents many non-physiological forms such as papillae and papillary fronds. Basal c...

  11. Chronic paroxysmal hemicrania in paediatric age: report of two cases.

    Science.gov (United States)

    Tarantino, Samuela; Vollono, Catello; Capuano, Alessandro; Vigevano, Federico; Valeriani, Massimiliano

    2011-04-01

    Chronic paroxysmal hemicrania (CPH) is a rare primary headache syndrome, which is classified along with hemicrania continua and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) as trigeminal autonomic cephalalgia (TACs). CPH is characterised by short-lasting (2-30 min), severe and multiple (more than 5/day) pain attacks. Headache is unilateral, and fronto-orbital-temporal pain is combined with cranial autonomic symptoms. According to the International Classification of Headache Disorders, 2nd edition, the attacks are absolutely responsive to indomethacin. CPH has been only rarely and incompletely described in the developmental age. Here, we describe two cases concerning a 7-year-old boy and a 11-year-old boy with short-lasting, recurrent headache combined with cranial autonomic features. Pain was described as excruciating, and was non-responsive to most traditional analgesic drugs. The clinical features of our children's headache and the positive response to indomethacin led us to propose the diagnosis of CPH. Therefore, our children can be included amongst the very few cases of this trigeminal autonomic cephalgia described in the paediatric age.

  12. Radiofrequency catheter ablation maintains its efficacy better than antiarrhythmic medication in patients with paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Raatikainen, M J Pekka; Hakalahti, Antti; Uusimaa, Paavo;

    2015-01-01

    BACKGROUND: The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) is a randomized trial comparing radiofrequency catheter ablation (RFA) to antiarrhythmic drugs (AADs) as first-line treatment of paroxysmal atrial fibrillation (PAF). In order...

  13. Paroxysmal sympathetic hyperactivity in neurological critical care

    Directory of Open Access Journals (Sweden)

    Rajesh Verma

    2015-01-01

    Full Text Available Introduction: Paroxysmal sympathetic hyperactivity (PSH is a clinical disorder mainly caused by traumatic brain injury, stroke, encephalitis and other types of brain injury. The clinical features are episodes of hypertension, tachycardia, tachypnea, fever and dystonic postures. In this study, we described clinical profile and outcome of six patients of PSH admitted in neurocritical care unit. Materials and Methods: This was a prospective observational study conducted at neurology critical care unit of a tertiary care center. All patients admitted at neurology critical unit during 6-month period from August 2013 to January 2014 were screened for the occurrence of PSH. The clinical details and outcome was documented. Results: PSH was observed in 6 patients. Male to female ratio was 5:1. Mean age ± SD was 36.67 ± 15.19 years. The leading causes were traumatic brain injury (two patients, stroke (two patients and Japanese encephalitis (JE (one patient and tuberculous meningitis (one patient. Conclusion: PSH is an unusual complication in neurocritical care. It prolonged the hospitalization and hampers recovery. The other life-threatening conditions that mimic PSH should be excluded. The association with JE and tuberculous meningitis was not previously described in literature.

  14. Necrotizing Fasciitis in Paroxysmal Nocturnal Hemoglobinuria

    Directory of Open Access Journals (Sweden)

    Pusem Patir

    2015-01-01

    Full Text Available Paroxysmal nocturnal hemoglobinuria (PNH is a rare, progressive, and life-threatening hematopoietic stem cell disorder characterized by complement-mediated intravascular hemolysis and a prothrombotic state. Patients with PNH might have slightly increased risk of infections due to complement-associated defects subsequent to CD59 deficiency. Here, we report a rare case of a 65-year-old male patient with necrotic ulcers on both legs, where the recognition of pancytopenia and microthrombi led to the diagnosis of PNH based on FLAER (FLuorescent AERolysin flow cytometric analysis. He was subsequently started on eculizumab therapy, with starting and maintenance doses set as per drug labelling. Progression of the patient’s leg ulcers during follow-up, with fulminant tissue destruction, purulent discharge, and necrotic patches, led to a later diagnosis of necrotizing fasciitis due to Pseudomonas aeruginosa and Klebsiella pneumonia infection. Courses of broad-spectrum antibiotics, surgical debridement, and superficial skin grafting were applied with successful effect during ongoing eculizumab therapy. This case highlights the point that it is important to maintain treatment of underlying disorders such as PNH in the presence of life-threatening infections like NF.

  15. Radiotherapy of benign diseases

    Energy Technology Data Exchange (ETDEWEB)

    Haase, W.

    1982-10-11

    Still today radiotherapy is of decisive relevance for several benign diseases. The following ones are briefly described in this introductory article: 1. Certain inflammatory and degenerative diseases as furuncles in the face, acute thrombophlebitis, recurrent pseudoriparous abscesses, degenerative skeletal diseases, cervical syndrome and others; 2. rheumatic joint diseases; 3. Bechterew's disease; 4. primary presenile osteoporosis; 5. syringomyelia; 6. endocrine ophthalmopathy; 7. hypertrophic processes of the connective tissue; 8. hemangiomas. A detailed discussion and a profit-risk analysis is provided in the individual chapters of the magazine.

  16. Benign cephalic histiocytosis.

    Science.gov (United States)

    Gianotti, F; Caputo, R; Ermacora, E; Gianni, E

    1986-09-01

    Benign cephalic histiocytosis is a self-healing non-X, nonlipid cutaneous histiocytosis of children, characterized by a papular eruption on the head. Mucous membranes and viscera are always spared. In the 13 cases reported herein, the children were otherwise in good general health. The disease appeared during the first three years of life, and spontaneous regression was complete by the age of nine years in the four cases healed to date. The histiocytic infiltrate was localized in the upper and middle dermis and contained no lipids at any stage of evolution. All the histiocytes contained coated vesicles, and 5% to 30% also contained comma-shaped bodies in their cytoplasm.

  17. Paroxysmal Hypnogenic Dyskinesia Responsive to Doxylamine: A Case Report

    Directory of Open Access Journals (Sweden)

    Daniel M. Williams

    2012-01-01

    Full Text Available Paroxysmal hypnogenic dyskinesia is a rare clinical entity characterized by intermittent dystonia and choreoathetoid movements that begin exclusively during sleep, often with consciousness preserved once the patient is awakened during the episodes. They occur almost every night and are often misdiagnosed as sleeping disorders. Paroxysmal hypnogenic dyskinesia is currently known to be a form of frontal lobe epilepsy, but not in all cases. We present a 19-year-old male patient with paroxysmal hypnogenic dyskinesia who responded to antihistamines. This supports an alternative theory from 1977 (before the cases had been adequately described that the disorder lies in dysregulation in the basal ganglia. This description now appears similar to acute dystonic reactions such as extrapyramidal symptoms from antipsychotic medications, which also respond to antihistamines.

  18. Paroxysmal hypnogenic dyskinesia responsive to doxylamine: a case report.

    Science.gov (United States)

    Williams, Daniel M

    2012-01-01

    Paroxysmal hypnogenic dyskinesia is a rare clinical entity characterized by intermittent dystonia and choreoathetoid movements that begin exclusively during sleep, often with consciousness preserved once the patient is awakened during the episodes. They occur almost every night and are often misdiagnosed as sleeping disorders. Paroxysmal hypnogenic dyskinesia is currently known to be a form of frontal lobe epilepsy, but not in all cases. We present a 19-year-old male patient with paroxysmal hypnogenic dyskinesia who responded to antihistamines. This supports an alternative theory from 1977 (before the cases had been adequately described) that the disorder lies in dysregulation in the basal ganglia. This description now appears similar to acute dystonic reactions such as extrapyramidal symptoms from antipsychotic medications, which also respond to antihistamines.

  19. A case of congenital myopathy masquerading as paroxysmal dyskinesia

    Directory of Open Access Journals (Sweden)

    Harsh Patel

    2014-01-01

    Full Text Available Gastroesophageal reflux (GER disease is a significant comorbidity of neuromuscular disorders. It may present as paroxysmal dyskinesia, an entity known as Sandifer syndrome. A 6-week-old neonate presented with very frequent paroxysms of generalized stiffening and opisthotonic posture since day 22 of life. These were initially diagnosed as seizures and he was started on multiple antiepileptics which did not show any response. After a normal video electroencephalogram (VEEG was documented, possibility of dyskinesia was kept. However, when he did not respond to symptomatic therapy, Sandifer syndrome was thought of and GER scan was done, which revealed severe GER. After his symptoms got reduced to some extent, a detailed clinical examination revealed abnormal facies with flaccid quadriparesis. Muscle biopsy confirmed the diagnosis of a specific congenital myopathy. On antireflux measures, those episodic paroxysms reduced to some extent. Partial response to therapy in GER should prompt search for an underlying secondary etiology.

  20. Epley maneuver

    Science.gov (United States)

    ... Canalith-Repositioning Maneuvers; CRP; Benign positional vertigo-Epley; Benign paroxysmal positional vertigo-Epley; BPPV-Epley ... Bronston LJ, Cass S, et al. Clinical practice guideline: Benign ... vertigo. Otolaryngology: Head and Neck Surgery . 2008;139(5 ...

  1. Benign occipital lobe seizures: Natural progression and atypical evolution

    Directory of Open Access Journals (Sweden)

    Prithika Chary

    2013-01-01

    Full Text Available Benign occipital seizure syndromes are benign childhood epilepsy syndromes and are mainly of two types, Panayiotopoulos syndrome, an autonomic epilepsy and idiopathic childhood occipital epilepsy of Gastaut (ICOE-G including the idiopathic photosensitive occipital lobe epilepsy. Although both these types are categorized as occipital seizures, they are distinct in presentation and management. They can also be tricky to diagnose as visual symptoms may not always be the presenting feature and it is also not very easy to elicit visual hallucinations during history taking. These seizures have a good response to treatment; however, there could be atypical evolution and refractoriness to treatment especially with ICOE-G. We describe three children who presented with visual and non-visual symptoms and the electroencephalography (EEG in all the three cases showed occipital paroxysms. We have emphasized the clues in the clinical history and EEG leading to the diagnosis of these distinct epilepsy syndromes. We have also discussed the natural course of these epilepsy syndromes with some atypical evolution, which clinicians need to be aware of during treatment of these children.

  2. Paroxysmal supraventricular tachycardia: physiopathology and management

    Directory of Open Access Journals (Sweden)

    Paola Neroni

    2014-06-01

    Full Text Available Paroxysmal supraventricular tachycardia (PSVT is the most frequent arrhythmia in newborns and infants. Most supraventricular tachycardias affect structurally healthy hearts. Apart from occasional detection by parents, most tachycardias in this age group are revealed by heart failure signs, such as poor feeding, sweating and shortness of breath. The main symptom reported by school-age children is palpitations. The chronic tachycardia causes a secondary form of dilative cardiomyopathy. Treatment of acute episode usually has an excellent outcome. Vagal manoeuvres are effective in patients with atrioventricular reentrant tachycardia. Adenosine is the drug of choice at all ages for tachycardias involving the atrioventricular node. Its key advantage is its short half life and minimum or no negative inotropic effects. Verapamil is not indicated in newborns and children as it poses a high risk of electromechanical dissociation. Antiarrhythmic prophylaxis of PSVT recurrence is usually recommended in the first year of life, because the diagnosis of tachycardia may be delayed up to the appearance of symptoms. Digoxin can be administered in all forms of PSVT involving the atrioventricular node, except for patients with Wolff-Parkinson-White syndrome below one year of age. Patients with atrioventricular reentrant PSVT can be treated effectively by class Ic drugs, such as propaphenone and flecainide. Amiodarone has the greatest antiarrhythmic effect, but should be used with caution owing to the high incidence of side effects. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  3. The cost-effectiveness of radiofrequency catheter ablation as first-line treatment for paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Aronsson, Mattias; Walfridsson, Håkan; Janzon, Magnus;

    2014-01-01

    AIM: The aim of this prospective substudy was to estimate the cost-effectiveness of treating paroxysmal atrial fibrillation (AF) with radiofrequency catheter ablation (RFA) compared with antiarrhythmic drugs (AADs) as first-line treatment. METHODS AND RESULTS: A decision-analytic Markov model......, based on MANTRA-PAF (Medical Antiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation) study data, was developed to study long-term effects and costs of RFA compared with AADs as first-line treatment. Positive clinical effects were found in the overall population, a gain...... of an average 0.06 quality-adjusted life years (QALYs) to an incremental cost of €3033, resulting in an incremental cost-effectiveness ratio of €50 570/QALY. However, the result of the subgroup analyses showed that RFA was less costly and more effective in younger patients. This implied an incremental cost-effectiveness...

  4. How benign is benign tertian malaria?

    Directory of Open Access Journals (Sweden)

    Archna Sharma

    2009-06-01

    Full Text Available Objective: This retrospective study was conducted to determine the incidence of variouscomplications of Plasmodium vivax malaria based on review of case records.Methods: The case records of all confirmed cases of malaria over the period of one year (September2005–August 2006 were studied. Complete blood count, peripheral blood findings, liver and kidneyfunctions were reviewed. The results of rapid diagnostic test for malaria (OptiMAL test, DiamedAG, Switzerland were correlated with the peripheral blood smear findings in the patients in whomit was requested. All abnormal results like a positive direct Coomb’s test were noted. Findingswere clinically correlated.Results: There were 265 confirmed cases by peripheral blood examination. Of these 221 were dueto Plasmodium vivax and 41 due to P. falciparum. Two cases had mixed infection and in one casethe species could not be identified as it showed only malarial pigment. The peak incidence ofmalaria was seen in September 2005 and August 2006. The complications in P. vivax werethrombocytopenia, biochemical evidence of hepatic dysfunction, renal damage, positive DCT anddeath due to ARDS. Thrombocytopenia was seen in 213 patients with counts 3 mg/dl with normal liver enzymes. Liver enzymeswere elevated in 60 patients with seven patients showing liver enzymes level, three times the normal.Renal dysfunction was seen in 17 patients with serum creatinine ranging from 1.3–10.65 mg/dl.One patient went into acute renal failure following quinine therapy and showed red cell fragmentsin the peripheral blood. In two children DCT was positive with the peripheral smear showing RBCagglutinates around the parasitised RBC. There were three maternal deaths at about 32 weeksgestation due to ARDS. The peripheral blood smear in these patients showed WBC agglutinates.Conclusion: This paper is presented to highlight that P. vivax malaria though considered to be abenign entity can also have a severe and complicated course

  5. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇; 何红

    2003-01-01

    Objective: to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods: The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF). The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60℃. The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132±68 min for our patients. The average fluoroscopy time was 33±17 min. With a mean follow-up of 16±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion: Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

  6. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇; 何红

    2003-01-01

    Objective : to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods : The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF) . The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60℃ . The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132± 68 min for our patients. The average fluoroscopy time was 33 ±17 min. With a mean follow-up of 16 ±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion : Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

  7. Morphine-sensitive paroxysmal sympathetic storm in pontine intracerebral hemorrhage.

    Science.gov (United States)

    Ko, Sang-Bae; Kim, Chi Kyung; Lee, Seung-Hoon; Bae, Hee-Joon; Yoon, Byung-Woo

    2010-11-01

    Paroxysmal sympathetic storm (PSS) is a rare complication of severe traumatic brain injury or cerebrovascular disease. Various medications have been tried in patients with PSS, but the clinical responses of the patients were variable. We report a classic case of PSS after spontaneous pontine hemorrhage in which the patient's fluctuating blood pressure and body temperature were dramatically stabilized using morphine.

  8. Paroxysmal non-kinesigenic dyskinesia in antiphospholipid syndrome

    NARCIS (Netherlands)

    Engelen, M; Tijssen, MAJ

    2005-01-01

    We report on a patient with a mixed movement disorder classifiable as a paroxysmal nonkinesigenic dyskinesia, occurring as the first manifestation of primary antiphospholipid syndrome (PAPS). Possible pathophysiology is discussed based on recent literature, and we stress that PAPS must be considered

  9. Eculizumab in Pregnant Patients with Paroxysmal Nocturnal Hemoglobinuria

    NARCIS (Netherlands)

    Kelly, R.J.; Hochsmann, B.; Szer, J.; Kulasekararaj, A.; Guibert, S. de; Roth, A.; Weitz, I.C.; Armstrong, E.; Risitano, A.M.; Patriquin, C.J.; Terriou, L.; Muus, P.; Hill, A.; Turner, M.P.; Schrezenmeier, H.; Peffault de Latour, R.

    2015-01-01

    BACKGROUND: Eculizumab, a humanized monoclonal antibody against complement protein C5 that inhibits terminal complement activation, has been shown to prevent complications of paroxysmal nocturnal hemoglobinuria (PNH) and improve quality of life and overall survival, but data on the use of eculizumab

  10. Paroxysmal Tonic Upgaze: Age of Onset and Prognosis

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-01-01

    Full Text Available Six children who developed paroxysmal tonic upgaze (PTU at 2.6 to 7.4 years of age were examined at least once per year for a 10 year period of follow-up at the Departments of Paediatrics and Ophthalmology, University of Chieti, Italy.

  11. Paroxysmal extreme pain disorder: a molecular lesion of peripheral neurons

    NARCIS (Netherlands)

    Choi, J.S.; Boralevi, F.; Brissaud, O.; Sanchez-Martin, J.; Morsche, R.H. te; Dib-Hajj, S.D.; Drenth, J.P.H.; Waxman, S.G.

    2011-01-01

    BACKGROUND: a 3-month-old male infant presented, beginning on the second day of life, with paroxysmal painful events that started with tonic contraction of the whole body followed by erythematous harlequin-type color changes. INVESTIGATIONS: screening of the SCN9A gene, which encodes the voltage-gat

  12. Paroxysmal kinesigenic dyskinesia : Cortical or non-cortical origin

    NARCIS (Netherlands)

    van Strien, Teun W.; van Rootselaar, Anne-Fleur; Hilgevoord, Anthony A. J.; Linssen, Wim H. J. P.; Groffen, Alexander J. A.; Tijssen, Marina A. J.

    2012-01-01

    Paroxysmal kinesigenic dyskinesia (PKD) is characterized by involuntary dystonia and/or chorea triggered by a sudden movement. Cases are usually familial with an autosomal dominant inheritance. Hypotheses regarding the pathogenesis of PKD focus on the controversy whether PKD has a cortical or non-co

  13. Paroxysmal Atrial Fibrillation in a Mission-Assigned Astronaut

    Science.gov (United States)

    Bauer, Peter A.; Polk, J. D.

    2010-01-01

    This presentation will explore the clinical and administrative conundrums faced by the flight surgeon upon discovering asymptomatic paroxysmal atrial fibrillation seven months prior to scheduled long duration spaceflight. The presenter will discuss the decision-making process as well as the clinical and operational outcomes.

  14. Cryotherapy in the management of paroxysmal trigeminal neuralgia.

    OpenAIRE

    Zakrzewska, J. M.

    1987-01-01

    Cryotherapy for the relief of pain is widely used in many conditions. The results of 83 cryotherapy sessions in 29 patients with paroxysmal trigeminal neuralgia are reviewed over a five year period. Sixty three per cent of treated nerves, 41% of patients were pain free over one year and there was no permanent sensory loss.

  15. Der benigne paroxysmale Lagerungsschwindel

    Directory of Open Access Journals (Sweden)

    Wiest G

    2004-01-01

    Full Text Available Der benigne paroxysmale Lagerungsschwindel (BPPV ist eine häufige Störung des peripheren Vestibularorgans, welche bei allen Patienten mit lageabhängigem Schwindel suspiziert werden sollte. Obwohl kurzzeitige Drehschwindelattacken als pathognomonisches Symptom gelten, weisen viele Patienten auch unsystematisierten Schwankschwindel auf, was die Diagnosestellung oft erschwert. Auslöser des BPPV sind Klziumkarbonatkristalle (Otokonien, welche sich aus der Otolithenmatrix des Utriculus lösen und in einen der drei Bogengänge gelangen. Die Diagnosestellung erfolgt mit spezifischen Provokations- bzw. Lagerungstests, um den entsprechenden Lagerungsschwindel und Nystagmus zu induzieren. Die von Semont und Epley entwickelten Befreiungsmanöver zielen darauf ab, die in den Bogengängen lokalisierten Partikel in den Utriculus zu repositionieren, wo sie keinen Drehschwindel mehr auslösen. Zur Unterscheidung des BPPV von einem zentralen Lageschwindel bzw. Nystagmus können neben der Latenz auch der Verlauf und die Dauer des Lagerungsnystagmus beitragen, von entscheidender Bedeutung in der Differentialdiagnose ist allerdings die Schlagrichtung des induzierten Nystagmus.

  16. Nihilism: a benign denial.

    Science.gov (United States)

    Skandalakis, John E; Mirilas, Petros

    2003-06-01

    Nihilism is the belief that all possible knowledge on a given topic has been amassed and codified. Ranging from benign denial to deliberate attempts at excommunication, nihilism is often encountered in the history of medicine. Eustachius, Columbus, and Sylvius strongly criticized Vesalius and defended the authority of Galen. Riolan fervently rejected Harvey's monumental work on the circulation of blood. Gross stated that no honest and sensible surgeon would ever sanction thyroidectomy. Sandstrom's discovery of the parathyroids was met with silence. Transplantation of parathyroids by Mandl was not appreciated when announced. Aristotle's dictum that the heart cannot withstand serious injury led to Paget's statement that cardiac surgery had reached the limits set by nature, which no new techniques could overcome. The first Billroth I operation was welcomed as, "Hopefully, also the last." Pancreatic surgery was opposed because the organ was of no clinical interest and was impossible for surgeons to reach. Pancreatic transplantation was rejected for many years, despite good results. When Blundell used blood transfusion for postpartum hemorrhage, critics averred that his next exploit would be radical removal of the spleen. Bassini stated that it could be risky to publish more about radical treatment of inguinal hernias. Carcinomas of the lower sigmoid and upper rectum were deemed untreatable because of their inaccessibility. Colostomy during pediatric surgery was rejected many times. Although it is difficult for the human mind to move from a familiar point of view, this propensity should not infect science, thereby impeding advancement.

  17. Benign anatomical mistakes: incidentaloma.

    Science.gov (United States)

    Mirilas, Petros; Skandalakis, J E

    2002-11-01

    The concept of the "incidentaloma," a totally asymptomatic nonfunctional tumor that is clinically and biochemically silent and discovered "incidentally" in a totally asymptomatic patient, is a by-product of the evolving diagnostic techniques of the last three decades. Various authors have used the concept for "incidental" findings during diagnostic workup for symptoms unrelated to adrenal disease, or for "incidental" adrenal tumors unrelated to symptoms that could potentially be of adrenal origin. "Incidentaloma" has been used to encompass a wide and heterogeneous spectrum of pathologic entities including adrenocortical and medullary tumors, benign or malignant lesions, hormonally active or inactive lesions, metastases, infections, granulomas, infiltrations, cysts and pseudocysts, hemorrhages, and pseudoadrenal masses. The term "incidentaloma" does not indicate whether the mass is functional, or malignant, or adrenocortical in origin. "Incidentaloma" has also appeared in the literature in reference to other endocrine organs such as pituitary, thyroid, and parathyroids, as well as the liver or kidney. We question the scientific justification for this neologism and suggest that it should be abolished. Questionable lesions should be clearly and simply described as "incidentally found."

  18. Paroxysmal Atrial Fibrillation in the Course of Acute Pulmonary Embolism: Clinical Significance and Impact on Prognosis

    Directory of Open Access Journals (Sweden)

    Agnieszka Krajewska

    2017-01-01

    Full Text Available The relationship and clinical implications of atrial fibrillation (AF in acute pulmonary embolism (PE are poorly investigated. We aimed to analyze clinical characteristics and prognosis in PE patients with paroxysmal AF episode. Methods. From the 391 patients with PE 31 subjects with paroxysmal AF were selected. This group was compared with patients with PE and sinus rhythm (SR and 32 patients with PE and permanent AF. Results. Paroxysmal AF patients were the oldest. Concomitant DVT varies between groups: paroxysmal AF 32.3%, SR 49.5%, and permanent AF 28.1% (p=0.02. The stroke history frequency was 4.6% SR, 12.9% paroxysmal AF, and 21.9% permanent AF (p<0.001. Paroxysmal AF comparing to permanent AF and SR individuals had higher estimated SPAP (56 versus 48 versus 47 mmHg, p=0.01 and shorter ACT (58 versus 65 versus 70 ms, p=0.04. Patients with AF were more often classified into high-risk group according to revised Geneva score and sPESI than SR patients. In-hospital mortality was lower in SR (5% and paroxysmal AF (6.5% compared to permanent AF group (25% (p<0.001. Conclusions. Patients with PE-associated paroxysmal AF constitute a separate population. More severe impairment of the parameters reflecting RV afterload may indicate relation between PE severity and paroxysmal AF episode. Paroxysmal AF has no impact on short-term mortality.

  19. 颗粒复位手法治疗36例后半规管良性发作性位置性眩晕%The treatment of particle reposifioning maneuver for 36 patients with posterior semicircular canal benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    庄建华; 李焰生; 赵忠新; 黄坚; 王文昭; 田国红

    2005-01-01

    目的探讨颗粒复位手法(PRM)对后半规管良性发作性位置性眩晕(BPPV)的治疗效果.方法从2003年1~12月,对36例后半规管BPPV进行PRM治疗.结果经1次PRM治疗后,28例症状消失,首次治疗成功率为77.8%,其中病程在1周内的18例患者有16例症状消失.4例经2次PRM治疗,2例经3次PRM治疗后症状也消失,总治疗成功率为94.4%.2例无效者行Semont锻炼,症状缓解,随访至今,3例复发,复发率8.8%,复发者再行PRM治疗仍有效.结论PRM治疗后半规管BPPV安全有效,凡诊断明确均应给予PRM治疗.

  20. Control Study of Particle Repositioning Maneuver Therapy for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo%颗粒复位手法治疗后半规管良性发作性位置性眩晕的对照研究

    Institute of Scientific and Technical Information of China (English)

    胡文霞; 庄建华; 张琳; 陈小燕

    2009-01-01

    目的 评价颗粒复位手法(PRM)在治疗后半规管良性发作性位置性眩晕(PC-BPPV)中的作用.方法 将PC-BPPV患者随机分成2组,复位组给予PRM治疗,对照组给予假复位治疗.结果 复位组43例,对照组45例,第4天随访时复位组和对照组的治疗成功率分别为86.05%(37/43)和8.89%(4/45),两者差异显著(X2=49.56,P<0.01);第7天时,两者的成功率分别为95.35%(41/43)和17.78%(8/45),仍差异显著(X2=50.52,P<0.01).结论 PRM疗效明显高于对照组,凡PC-BPPV诊断明确者均应给予PRM治疗.

  1. The Comparison of Particle Repositioning Maneuver and Postural Restriction Therapy for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo%颗粒复位手法中的体位限制对治疗后半规管良性发作性位置性眩晕的作用

    Institute of Scientific and Technical Information of China (English)

    吴大玉

    2005-01-01

    目的:评价颗粒复位手法(PRM)中的体位限制在治疗后半规管良性发作性位置性眩晕(BPPV)中的作用.方法:将后半规管BPPV患者随机分成2组,复位组33例给予PRM治疗加体位限制;对照组32例仅给予体位限制治疗.结果:治疗后第4天复位组和对照组的成功率分别为75.8%(25/33)和15.6%(5/32),两者差异显著(x2=21.28,P<0.005);治疗后第7天两者的成功率分别为87.9%(29/33)和28.1%(9/32),具有显著差异(x2=21.49,P<0.005).结论:PRM治疗效果明显优于体位限制治疗,凡后半规管BPPV诊断明确者均应给予PRM治疗.

  2. 尼麦角林联合手法复位治疗后半规管原发性良性阵发性位置性眩晕的临床效果观察%Clinical effect of nicergoline combined with epley maneuver in treatment of posterior semicircular cannal benign paroxysmal positional vertigo

    Institute of Scientific and Technical Information of China (English)

    彭瑞强; 牛建平; 徐娜; 叶良灶

    2015-01-01

    目的 观察尼麦角林联合手法复位治疗后半规管原发性良性阵发性位置性眩晕(PC-BPPV)的效果.方法 选择2012年1月至2014年3月厦门医学高等专科学校附属厦门市第二医院神经内科收治的128例PC-BPPV患者,采用随机数字表法分为尼麦角林联合手法复位组和单纯手法复位组,各64例,2组均予Epley手法复位治疗,尼麦角林联合手法复位组同时予尼麦角林10 mg/次,3次/d,口服,疗程为2周.比较2组的治愈率.结果 治疗2周后单纯手法复位组治愈率为79.7%(51/64),尼麦角林联合手法复位组为92.2%(59/64),2组间差异有统计学意义(P<0.05).结论 对PC-BPPV患者手法复位联合尼麦角林治疗可明显改善患者的眩晕症状.

  3. Benign Breast Problems and Conditions

    Science.gov (United States)

    ... with a needle. Another example is a simple fibroadenoma . Simple fibroadenomas usually shrink or go away on their own. ... Cyst: A sac or pouch filled with fluid. Fibroadenoma: A type of solid, benign breast mass. Hormone: ...

  4. Laparoscopy for benign disease: robotics.

    Science.gov (United States)

    Talamini, Mark A

    2003-12-01

    Currently available robotic surgical systems appear to be particularly suited for use in benign diseases of the gastrointestinal system. Minimally invasive operations for foregut conditions, such as gastroesophageal reflux disease and achalasia, require excellent visibility and precise tissue dissection. Benign lower gastrointestinal diseases, including inflammatory bowel disease and diverticulitis, also can be approached using robotic assistance. Disadvantages include expense and the loss of tactile feedback. Early clinical results are promising.

  5. Mental Development of Children with Non-epileptic Paroxysmal States in Medical History

    Directory of Open Access Journals (Sweden)

    Turovskaya N.G.,

    2015-10-01

    Full Text Available The author studied mental functions disorders in children with a history of paroxysmal states of various etiologies and compared mental development disorder patterns in patients with epileptic and non-epileptic paroxysms. Study sample were 107 children, aged 6 to 10 years. The study used experimental psychological and neuropsychological techniques. According to the empirical study results, non-epileptic paroxysms unlike epileptic much less combined with a number of mental functions disorders and intelligence in general. However, non-epileptic paroxysmal states as well as epileptic seizure associated with increasing activity exhaustion and abnormal function of the motor analyzer (dynamic and kinesthetic dyspraxia. Visual memory disorders and modal-nonspecific memory disorders have more pronounced importance in the mental ontogenesis structure in children with convulsive paroxysms compared to children with cerebral pathology without paroxysms history

  6. Left Atrial Linear Ablation of Paroxysmal Atrial Fibrillation Guided by Three-dimensional Electroanatomical System

    DEFF Research Database (Denmark)

    Zhang, Dai-Fu; Li, Ying; Qi, Wei-Gang

    2005-01-01

    Objective To investigate the safety and efficacy of Left atrial linear ablation of paroxysmal atrial fibrillation guided by three-dimensional electroanatomical system. Methods 29 patients with paroxysmal atrial fibrillation in this study. A nonfluoroscopic mapping system was used to generate a 3D...... attacks unchanged. No pulmonary vein narrowing was observed. Conclusion Left atrial linear ablation of paroxysmal atrial fibrillation guided by three-dimensional electroanatomical system was safe and effective....

  7. Benign mixed tumor of the lacrimal sac

    Directory of Open Access Journals (Sweden)

    Jong-Suk Lee

    2015-01-01

    Full Text Available Neoplasms of the lacrimal drainage system are uncommon, but potentially life-threatening and are often difficult to diagnose. Among primary lacrimal sac tumors, benign mixed tumors are extremely rare. Histologically, benign mixed tumors have been classified as a type of benign epithelial tumor. Here we report a case of benign mixed tumor of the lacrimal sac.

  8. Paroxysmal hemicrania as the clinical presentation of giant cell arteritis

    Directory of Open Access Journals (Sweden)

    Jennifer L. Beams

    2011-11-01

    Full Text Available Head pain is the most common complaint in patients with giant cell arteritis but the headache has no distinct diagnostic features. There have been no published reports of giant cell arteritis presenting as a trigeminal autonomic cephalalgia. We describe a patient who developed a new onset headache in her fifties, which fit the diagnostic criteria for paroxysmal hemicrania and was completely responsive to corticosteroids. Removal of the steroid therapy brought a reemergence of her headaches. Giant cell arteritis should be considered in the evaluation of secondary causes of paroxysmal hemicrania; in addition giant cell arteritis needs to be ruled out in patients who are over the age of 50 years with a new onset trigeminal autonomic cephalalgia.

  9. Propranolol for Paroxysmal Sympathetic Hyperactivity with Lateralizing Hyperhidrosis after Stroke

    Directory of Open Access Journals (Sweden)

    Jason W. Siefferman

    2015-01-01

    Full Text Available Brain injury can lead to impaired cortical inhibition of the hypothalamus, resulting in increased sympathetic nervous system activation. Symptoms of paroxysmal sympathetic hyperactivity may include hyperthermia, tachycardia, tachypnea, vasodilation, and hyperhidrosis. We report the case of a 41-year-old man who suffered from a left middle cerebral artery stroke and subsequently developed central fever, contralateral temperature change, and hyperhidrosis. His symptoms abated with low-dose propranolol and then returned upon discontinuation. Restarting propranolol again stopped his symptoms. This represents the first report of propranolol being used for unilateral dysautonomia after stroke. Propranolol is a lipophilic nonselective beta-blocker which easily crosses the blood-brain barrier and may be used to treat paroxysmal sympathetic hyperactivity.

  10. Radical pancreaticoduodenectomy for benign disease.

    LENUS (Irish Health Repository)

    Kavanagh, D O

    2008-01-01

    Whipple\\'s procedure is the treatment of choice for pancreatic and periampullary malignancies. Preoperative histological confirmation of malignancy is frequently unavailable and some patients will subsequently be found to have benign disease. Here, we review our experience with Whipple\\'s procedure for patients ultimately proven to have benign disease. The medical records of all patients who underwent Whipple\\'s procedure during a 15-year period (1987-2002) were reviewed; 112 patients underwent the procedure for suspected malignancy. In eight cases, the final histology was benign (7.1%). One additional patient was known to have benign disease at resection. The mean age was 50 years (range: 30-75). The major presenting features included jaundice (five), pain (two), gastric outlet obstruction (one), and recurrent gastrointestinal haemorrhage (one). Investigations included ultrasound (eight), computerised tomography (eight), endoscopic retrograde cholangiopancreatography (seven; of these, four patients had a stent inserted and three patients had sampling for cytology), and endoscopic ultrasound (two). The pathological diagnosis included benign biliary stricture (two), chronic pancreatitis (two), choledochal cyst (one), inflammatory pseudotumour (one), cystic duodenal wall dysplasia (one), duodenal angiodysplasia (one), and granular cell neoplasm (one). There was no operative mortality. Morbidity included intra-abdominal collection (one), anastomotic leak (one), liver abscess (one), and myocardial infarction (one). All patients remain alive and well at mean follow-up of 41 months. Despite recent advances in diagnostic imaging, 8% of the patients undergoing Whipple\\'s procedure had benign disease. A range of unusual pathological entities can mimic malignancy. Accurate preoperative histological diagnosis may have allowed a less radical operation to be performed. Endoscopic ultrasound-guided fine needle aspirate (EUS-FNA) may reduce the need for Whipple\\'s operation

  11. Chronic paroxysmal hemicrania and hemicrania continua. Parenteral indomethacin: the 'indotest'.

    Science.gov (United States)

    Antonaci, F; Pareja, J A; Caminero, A B; Sjaastad, O

    1998-02-01

    The interval between indomethacin administration and clinical response may be clinically relevant in the assessment of chronic paroxysmal hemicrania and hemicrania continua and other unilateral headache disorders with which they can be confounded. Eight patients with chronic paroxysmal hemicrania (6 women and 2 men) and 12 patients with hemicrania continua (8 women and 4 men) were entered into the study. The patients were given 50 mg of indomethacin intramuscularly (i.m.) on day 1 and some of them 100 mg IM on day 2 in an open fashion. The usual attack pattern was reestablished prior to the second test. The mean interval between attacks before the two injections (51 +/- 18 minutes) in chronic paroxysmal hemicrania was significantly shorter than the mean after each of the two indomethacin injections (50 mg = 493 +/- 251 minutes; 100 mg = 668 +/- 211 minutes; P hemicrania continua, the time between 50-mg indomethacin injection and complete pain relief was 73 +/- 66 minutes. The pain-free period after indomethacin injection was around 13 hours (i.e., 13 +/- 8 hours after 50 mg and 13 +/- 10 hours after 100 mg). The use of a test dosage of 50 mg of indomethacin IM ('indotest') gives a clear-cut answer and may be a useful tool in the diagnostic arsenal in every unilateral headache for a proper clinical assessment. A diagnosis of chronic paroxysmal hemicrania or hemicrania continua is a serious matter because it may imply life-long treatment with a potentially noxious drug. It is, therefore, of the utmost importance that an 'indotest' is carried out in a standard fashion. In the future, the rules set forth in the present context should be followed, at least in scientific studies. Pain pressure thresholds at cranial and extracranial levels were not significantly modified after indomethacin injection in any of the headaches.

  12. Dopamine-secreting adrenal ganglioneuroma presenting with paroxysmal hypertension attacks.

    Science.gov (United States)

    Erem, Cihangir; Kocak, Mustafa; Cinel, Akif; Erso, Halil O; Reis, Abdulkadir

    2008-01-01

    Adrenal ganglioneuromas are rare tumors originating from the neural crest tissue of the sympathetic nervous system. The clinical presentation for most patients is asymptomatic, and most of these tumors are hormone silent. We report a case of dopamine-secreting adrenal ganglioneuroma associated with paroxysmal hypertensive attacks in an adult patient. A 46-year-old woman was admitted to our hospital with a 2-month history of right flank pain, and a 2-year history of paroxysmal hypertensive attacks associated with headaches, palpitations, nervousness, and sweating. Abdominal CT and MRI revealed a solid round tumor approximately 4 cm in diameter on the upper pole of the right kidney. Urinary levels of dopamine and homovanillic acid were slightly elevated, although urinary levels of metanephrine and normetanephrine were suppressed. The urinary levels of epinephrine, norepinephrine, and vanillylmandelic acid were within normal limits. Right adrenalectomy was performed for treatment purposes. Histological diagnosis of the tumor was a ganglioneuroma originating from the adrenal medulla. In conclusion, this is a case of dopamine-secreting adrenal ganglioneuroma associated with paroxysmal hypertensive attacks in an adult patient.

  13. Paroxysmal dystonic choreoathetosis: Tight linkage to chromosome 2q

    Energy Technology Data Exchange (ETDEWEB)

    Fink, J.K.; Rainier, S.; Wilkowski, J.; Jones, S.M. [Univ. of Michigan, Ann Arbor, MI (United States)] [and others

    1996-07-01

    Paroxysmal dystonic choreoathetosis (PDC) is characterized by attacks of involuntary movements that last up to several hours and occur at rest both spontaneously and following caffeine or alcohol consumption. We analyzed a Polish-American kindred with autosomal dominant PDC and identified tight linkage between the disorder and microsatellite markers on chromosome 2q (maximum two-point LOD score 4.77; recombination fraction 0). Our results clearly establish the existence of a locus for autosomal dominant PDC on distal chromosome 2q. The fact that three other paroxysmal neurological disorders (periodic ataxia with myokymia and hypo- and hyperkalemic periodic paralysis) are due to mutation in ion-channel genes raises the possibility that PDC is also due to an ion-channel gene mutation. It is noteworthy that a cluster of sodium-channel genes is located on distal chromosome 2q, near the PDC locus. Identifying the PDC locus on chromosome 2q will facilitate discovery whether PDC is genetically homogeneous and whether other paroxysmal movement disorders are also genetically linked to the PDC locus. 28 refs., 2 figs., 1 tab.

  14. Cholesterol and benign prostate disease.

    Science.gov (United States)

    Freeman, Michael R; Solomon, Keith R

    2011-01-01

    The origins of benign prostatic diseases, such as benign prostatic hyperplasia (BPH) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), are poorly understood. Patients suffering from benign prostatic symptoms report a substantially reduced quality of life, and the relationship between benign prostate conditions and prostate cancer is uncertain. Epidemiologic data for BPH and CP/CPPS are limited, however an apparent association between BPH symptoms and cardiovascular disease (CVD) has been consistently reported. The prostate synthesizes and stores large amounts of cholesterol and prostate tissues may be particularly sensitive to perturbations in cholesterol metabolism. Hypercholesterolemia, a major risk factor for CVD, is also a risk factor for BPH. Animal model and clinical trial findings suggest that agents that inhibit cholesterol absorption from the intestine, such as the class of compounds known as polyene macrolides, can reduce prostate gland size and improve lower urinary tract symptoms (LUTS). Observational studies indicate that cholesterol-lowering drugs reduce the risk of aggressive prostate cancer, while prostate cancer cell growth and survival pathways depend in part on cholesterol-sensitive biochemical mechanisms. Here we review the evidence that cholesterol metabolism plays a role in the incidence of benign prostate disease and we highlight possible therapeutic approaches based on this concept.

  15. Natriuretic peptides for the detection of paroxysmal atrial fibrillation

    Science.gov (United States)

    Seegers, Joachim; Zabel, Markus; Grüter, Timo; Ammermann, Antje; Weber-Krüger, Mark; Edelmann, Frank; Gelbrich, Götz; Binder, Lutz; Herrmann-Lingen, Christoph; Gröschel, Klaus; Hasenfuß, Gerd; Feltgen, Nicolas; Pieske, Burkert; Wachter, Rolf

    2015-01-01

    Background and purpose Silent atrial fibrillation (AF) and tachycardia (AT) are considered precursors of ischaemic stroke. Therefore, detection of paroxysmal atrial rhythm disorders is highly relevant, but is clinically challenging. We aimed to evaluate the diagnostic value of natriuretic peptide levels in the detection of paroxysmal AT/AF in a pilot study. Methods Natriuretic peptide levels were analysed in two independent patient cohorts (162 patients with arterial hypertension or other cardiovascular risk factors and 82 patients with retinal vessel disease). N-terminal-pro-brain natriuretic peptide (NT-proBNP) and BNP were measured before the start of a 7-day Holter monitoring period carefully screened for AT/AF. Results 244 patients were included; 16 had paroxysmal AT/AF. After excluding patients with a history of AT/AF (n=5), 14 patients had newly diagnosed AT/AF (5.8%) NT-proBNP and BNP levels were higher in patients with paroxysmal AT/AF in both cohorts: (1) 154.4 (IQR 41.7; 303.6) versus 52.8 (30.4; 178.0) pg/mL and 70.0 (31.9; 142.4) versus 43.9 (16.3; 95.2) and (2) 216.9 (201.4; 277.1) versus 90.8 (42.3–141.7) and 96.0 (54.7; 108.2) versus 29.1 (12.0; 58.1). For the detection of AT/AF episodes, NT-proBNP and BNP had an area under the curve in receiver operating characteristic analysis of 0.76 (95% CI, 0.64 to 0.88; p=0.002) and 0.75 (0.61 to 0.89; p=0.004), respectively. Conclusions NT-proBNP and BNP levels are elevated in patients with silent AT/AF as compared with sinus rhythm. Thus, screening for undiagnosed paroxysmal AF using natriuretic peptide level initiated Holter monitoring may be a useful strategy in prevention of stroke or systemic embolism. PMID:26288739

  16. RADIOFREQUENCY CURRENT CATHETER ABLATION OF THE LEFT ATRIOVENTRICULAR ACCESSORY PATHWAYS WITH PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA

    Institute of Scientific and Technical Information of China (English)

    王静毅; 郭继鸿; 吴益明; 朱继红; 王伟民; 赵红; 刘喜荣; MichaelA.Lee

    1994-01-01

    Seventy patients with left atrioventricular accessory pathways and paroxysmal supraventricular tachycardia (PSVT) underwent radiofrequency catheter ablation (RFCA).The success rate was 94.3%.Among these pa-tients,26 had manifest preexcitation syndrome,and 44 had concealed preexcitation.Eighteen patients with con-cealed preexcitation underwent coronary sinus(CS) pacinga,and delta wave appeared in 15.The keys to successful RFCA were correct positioning of the radiofrequency (RF) catheter tip,A/V amplitude ratio,AV interval(in si-nus rhythm)and VA interval(during SVT or ventricular pacing).After 1-14 months of follow-up,two pa- tients had supraventricular tachycardia(SVT)recurrence.

  17. Environmentally Benign Stab Detonators

    Energy Technology Data Exchange (ETDEWEB)

    Gash, A E

    2006-07-07

    The coupling of energetic metallic multilayers (a.k.a. flash metal) with energetic sol-gel synthesis and processing is an entirely new approach to forming energetic devices for several DoD and DOE needs. They are also practical and commercially viable manufacturing techniques. Improved occupational safety and health, performance, reliability, reproducibility, and environmentally acceptable processing can be achieved using these methodologies and materials. The development and fielding of this technology will enhance mission readiness and reduce the costs, environmental risks and the necessity of resolving environmental concerns related to maintaining military readiness while simultaneously enhancing safety and health. Without sacrificing current performance, we will formulate new impact initiated device (IID) compositions to replace materials from the current composition that pose significant environmental, health, and safety problems associated with functions such as synthesis, material receipt, storage, handling, processing into the composition, reaction products from testing, and safe disposal. To do this, we will advance the use of nanocomposite preparation via the use of multilayer flash metal and sol-gel technologies and apply it to new small IIDs. This work will also serve to demonstrate that these technologies and resultant materials are relevant and practical to a variety of energetic needs of DoD and DOE. The goal will be to produce an IID whose composition is acceptable by OSHA, EPA, the Clean Air Act, Clean Water Act, Resource Recovery Act, etc. standards, without sacrificing current performance. The development of environmentally benign stab detonators and igniters will result in the removal of hazardous and toxic components associated with their manufacturing, handling, and use. This will lead to improved worker safety during manufacturing as well as reduced exposure of Service personnel during their storage and or use in operations. The

  18. Design of environmentally benign processes

    DEFF Research Database (Denmark)

    Hostrup, Martin; Harper, Peter Mathias; Gani, Rafiqul

    1999-01-01

    This paper presents a hybrid method for design of environmentally benign processes. The hybrid method integrates mathematical modelling with heuristic approaches to solving the optimisation problems related to separation process synthesis and solvent design and selection. A structured method...... of solution, which employs thermodynamic insights to reduce the complexity and size of the mathematical problem by eliminating redundant alternatives, has been developed for the hybrid method. Separation process synthesis and design problems related to the removal of a chemical species from process streams...... mixture and the second example involves the determination of environmentally benign substitute solvents for removal of a chemical species from wastewater. (C) 1999 Elsevier Science Ltd. All rights reserved....

  19. Multicystic Benign Mesothelioma Complicating Pregnancy.

    Science.gov (United States)

    Tamhankar, V A

    2015-01-01

    Multicystic benign mesothelioma (MBM) is a rare peritoneal pathology typically affecting women in reproductive age. Though MBM is considered benign, these lesions are prone to recurrence and their growth could be modulated by the presence of oestrogen receptors. Acute presentation of MBM is still very rare in pregnancy and management options are not established. We describe a case of MBM presenting in early pregnancy with acute pain. This was successfully treated with surgical resection. Pregnancy continued uneventfully to term and no evidence of recurrent MBM was found at Caesarean section.

  20. Multicystic Benign Mesothelioma Complicating Pregnancy

    Directory of Open Access Journals (Sweden)

    V. A. Tamhankar

    2015-01-01

    Full Text Available Multicystic benign mesothelioma (MBM is a rare peritoneal pathology typically affecting women in reproductive age. Though MBM is considered benign, these lesions are prone to recurrence and their growth could be modulated by the presence of oestrogen receptors. Acute presentation of MBM is still very rare in pregnancy and management options are not established. We describe a case of MBM presenting in early pregnancy with acute pain. This was successfully treated with surgical resection. Pregnancy continued uneventfully to term and no evidence of recurrent MBM was found at Caesarean section.

  1. HEREDITARY MYOKYMIA AND PAROXYSMAL ATAXIA LINKED TO CHROMOSOME-12 IS RESPONSIVE TO ACETAZOLAMIDE

    NARCIS (Netherlands)

    LUBBERS, WJ; BRUNT, ERP; SCHEFFER, H; LITT, M; STULP, R; BROWNE, DL; VANWEERDEN, TW

    1995-01-01

    A sixth family with autosomal dominantly inherited myokymia and paroxysmal ataxia is described. The syndrome in this family is linked to the recently discovered locus for inherited myokymia and paroxysmal ataxia on the human chromosome 12p, and a missense mutation is shown in the KCNA1 gene. The att

  2. Treatment of paroxysmal supraventricular tachycardia with intravenous injection of adenosine triphosphate.

    OpenAIRE

    Saito, D.; Ueeda, M; Abe, Y.; Tani, H; Nakatsu, T.; Yoshida, H.; Haraoka, S; Nagashima, H

    1986-01-01

    Intravenous adenosine triphosphate rapidly terminated all 11 episodes of paroxysmal supraventricular tachycardia in 10 patients. Eight patients reported side effects but these resolved within 20 seconds and did not require treatment. Adenosine triphosphate is a suitable agent for the rapid termination of paroxysmal supraventricular tachycardia.

  3. Benign concentric annular macular dystrophy

    Directory of Open Access Journals (Sweden)

    Luísa Salles de Moura Mendonça

    2015-06-01

    Full Text Available The purpose of the authors is to show clinical findings of a patient with benign concentric annular macular dystrophy, which is an unusual condition, and part of the "bull’s eye" maculopathy differential diagnosis. An ophthalmologic examination with color perception, fluorescein angiography, and ocular electrophysiology was performed.

  4. Radioiodine therapy of benign thyroid disease; Radioiodbehandling af benign thyreoideasygdom

    Energy Technology Data Exchange (ETDEWEB)

    Krogh Rasmussen, Aa.; Jarloev, A.E.; Faber, J

    2000-01-01

    The aim of the study was to evaluate differences in the use of radioactive iodine in the treatment of benigh thyroid disease in Denmark. A questionnaire was distributed to all departments in Denmark which administer radioiodine in the treatment of benign thyroid disease (n=20). Radioiodine is used for patients with toxic nodular goitre and for patients with relapse of toxic diffuse goitre. Four departments did not use radioiodine for volume reduction in non-toxic goitre. Patient information's included very different recommendations regarding cautions in relation to radioiodine treatment. Radioiodine is widely used in the treatment of benign thyroid disease. We recommend a national standardization of the cautions in relation to radioiodine treatment. (au)

  5. Nonlinear Analysis of Bedload Transport Rate of Paroxysm Debris Flow

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    The evolution characteristics of bedload transport feature of paroxysm debris flow have been studied by means of both theory analysis and experimental data.The analysis based on the flume experiment data of a sand pile model as well as a large amount of field data of debris flow clearly shown that the statistical distribu- tion for the main variable of the sand pile made of non-uniform sand (according the sand pile experiment,φ≥2.55) conform to the negative power law,that means the non-uniform sand syste...

  6. Pregnancy in a patient with paroxysmal nocturnal hemoglobinuria

    Directory of Open Access Journals (Sweden)

    Anju Singh

    2014-02-01

    Full Text Available The occurrence of Paroxysmal Nocturnal Hemoglobinuria (PNH during pregnancy is very rare. It can cause significant fetomaternal morbidity and mortality due to associated complement mediated hemolysis and/or thrombosis. We report a case of PNH in a pregnant lady who presented to our antenatal clinic at 10th weeks of gestation. Her pregnancy was managed with multiple blood transfusions and steroid administration. During 3rd weeks postpartum period she developed sepsis with acute renal failure and posterior reversible encephalopathy syndrome requiring prolonged hospitalization. She was subsequently discharged from hospital in satisfactory condition. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 285-287

  7. [Use of digoxin in patients with paroxysmal supraventricular tachycardia].

    Science.gov (United States)

    Smetnev, A S; Titov, V N; Shevchenko, N M; Gurevich, E M

    1989-04-01

    The effectiveness and electrophysiologic mechanisms of antiarrhythmic effect of digoxin were examined in 27 patients with paroxysmal atrioventricular nodal reciprocal tachycardia (PAVNRT) and supraventricular tachycardia (SVT) due to latent complementary conductive pathways, i. e. latent Wolff-Parkinson-White (WPW) syndrome. To assess antiarrhythmic action of digoxin, transesophageal pacing and plasma digoxin radioimmonoassays were used. Preventive antiarrhythmic efficiency of digoxin was 53% in PAVNRT patients, and 25% in SVT patients with latent WPW syndrome. Antegrade atrioventricular conduction block seems to be the mechanism of oral digoxin preventive effect. There was no relationship between antiarrhythmic efficiency of digoxin and its plasma level.

  8. EGC diagnosis of paroxysmal supraventricular tachycardias in patients without preexcitation.

    Science.gov (United States)

    González-Torrecilla, Esteban; Arenal, Angel; Atienza, Felipe; Datino, Tomás; Atea, Leonardo F; Calvo, David; Pachón, Marta; Miracle, Angel; Fernández-Avilés, Francisco

    2011-01-01

    This review is aimed at discussing the diagnostic value of the different electrocardiographic criteria so far described in the differential diagnosis of the major forms of paroxysmal supraventricular tachycardias (PSVTs). The predictive value of different combinations of these independent electrocardiographic (ECG) signs in distinguishing atrioventricular reentrant tachycardias (AVRTs) through a concealed accessory pathway (AP) versus atrioventricular nodal reentrant tachycardias (AVNRTs) are discussed in detail. In addition, the adjunctive diagnostic value of simple, bedside clinical variables and their combinations to the ECG interpretation in differentiating both tachycardia mechanisms is also reviewed.

  9. Paroxysmal Autonomic Instability with Dystonia after Pneumococcal Meningoencephalitis

    Directory of Open Access Journals (Sweden)

    Layal Safadieh

    2012-01-01

    Full Text Available Streptococcus pneumoniae is a common cause of bacterial meningitis, frequently resulting in severe neurological impairment. A seven-month-old child presenting with Streptococcus pneumoniae meningoencephalitis developed right basal ganglia and hypothalamic infarctions. Daily episodes of agitation, hypertension, tachycardia, diaphoresis, hyperthermia, and decerebrate posturing were observed. The diagnosis of paroxysmal autonomic instability with dystonia was established. The patient responded to clonidine, baclofen, and benzodiazepines. Although this entity has been reported in association with traumatic brain injury, and as a sequel to some nervous system infections, this is the first case, to our knowledge, associated with pneumococcal meningoencephalitis.

  10. Radiofrequency ablation as initial therapy in paroxysmal atrial fibrillation

    DEFF Research Database (Denmark)

    Walfridsson, H; Walfridsson, U; Nielsen, J Cosedis

    2015-01-01

    AIMS: The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial assessed the long-term efficacy of an initial strategy of radiofrequency ablation (RFA) vs. antiarrhythmic drug therapy (AAD) as first-line treatment for patients with PAF. I......L and symptom burden in patients with PAF. Patients randomized to RFA showed greater improvement in physical scales (SF-36) and the EQ-visual analogue scale. CLINICAL TRIAL REGISTRATION: URL http://www.clinicaltrials.gov. Unique identifier: NCT00133211....

  11. Indeterminate cell histiocytosis that presented clinically as benign cephalic histiocytosis.

    Science.gov (United States)

    Haimovic, Adele; Chernoff, Karen; Hale, Christopher S; Meehan, Shane A; Schaffer, Julie V

    2014-12-16

    Indeterminate cell histiocytosis (ICH) is a rare, heterogeneous disorder that is characterized by immunophenotypic features of both Langerhans cell histiocytosis (LCH) and non-LCH. We describe a 12-month-old boy with a four-month history of asymptomatic, small, pink-tan papules on his face. Histopathologic evaluation showed a superficial, dermal infiltrate of histiocytes that was positive for S100, CD1a, CD68, and Factor XIIIa. To our knowledge, this represents the first report of the clinical presentation of benign cephalic histiocytosis with immunohistochemical findings of ICH. We review the classification of histiocytic disorders and the clinical and immunohistochemical features of both ICH and benign cephalic histiocytosis.

  12. Lack of a Benign Interpretation Bias in Social Anxiety Disorder

    Science.gov (United States)

    Amir, Nader; Prouvost, Caroline; Kuckertz, Jennie M.

    2013-01-01

    Cognitive models of social anxiety posit that recurrent interpretation of ambiguous information as threatening maintains symptoms (e.g. Clark & Wells, 1995, pp. 69–93, Social phobia: Diagnosis, assessment, and treatment. New York: Guilford Press; Rapee & Heimberg, 1997, pp. 741–756, Behavior Research and Therapy, 35). However, biased interpretation may also be represented as a failure to make a benign interpretation of the ambiguous event. Furthermore, interpretation bias can be characterized by both an online (automatic) component and an offline (effortful) component (Hirsch & Clark, 2004, pp. 799–825, Clinical Psychology Review, 24). To measure both benign and threat biases, as well as examine the effect of social anxiety on offline versus online interpretations, Beard and Amir (2009, pp. 1135–1141, Behaviour Research and Therapy, 46) developed the Word Sentence Association Paradigm (WSAP). In the current study, we administered the WSAP to a group of participants diagnosed with social anxiety disorder (SAD) as well as to a group of non-anxious control (NAC) participants. We found that participants with SAD demonstrated a lack of benign online bias, but not an online threat bias when compared to NACs. However, when examining offline biases, SAD patients endorsed social threat interpretations and rejected benign social interpretations to a greater degree than non-anxious individuals. Our results, when taken together, clearly implicate the role of reduced bias toward benign information in SAD. PMID:22545788

  13. Histiocytic sarcoma that mimics benign histiocytosis.

    Science.gov (United States)

    Boisseau-Garsaud, A M; Vergier, B; Beylot-Barry, M; Nastasel-Menini, F; Dubus, P; de Mascarel, A; Eghbali, H; Beylot, C

    1996-06-01

    A 28-year-old man presented with a histiocytic sarcoma of a very uncommon origin, as it had developed for several years like a benign cutaneous histiocytosis resembling generalized eruptive histiocytoma before becoming acute, with nodal and massive pulmonary involvement. Despite various chemotherapies, the patient died within 8 months. Skin biopsies showed histiocytic proliferation in the dermis and node biopsies showed histiocytic proliferation with a sinusoidal pattern. Immunohistochemical analysis, performed on paraffin-embedded sections, demonstrated strong labeling of tumoral cells for CD68 and moderate labeling for CD3 and CD4. CD30 labeling was negative. S-100 protein was positive on a Langerhans' cell reactive subpopulation. Electron microscopy confirmed the histiocytic nature of malignant cells and showed cytoplasmic inclusions such as regularly laminated bodies, dense bodies and pleomorphic inclusions. No Birbeck granules were seen. A gene rearrangement study of T-cell receptor gamma and immunoglobulin heavy chain genes showed a germline configuration. Histiocytic sarcoma is an extremely rare true histiocytic malignancy, the existence of which has been recently debated since it has often been mistaken in the past for large cell lymphomas. Such a deceptive onset as benign cutaneous histiocytosis has not been described in the literature to our knowledge.

  14. Benign chondroblastoma - malignant radiological appearances

    Energy Technology Data Exchange (ETDEWEB)

    Schulze, K.; Treugut, H.; Mueller, G.E.

    1980-04-01

    The very rare benign chondroblastoma occasionally invades soft tissues and may grow beyond the epiphysis into the metaphysis. In the present case such a tumour did not show the typical radiological appearances, but presented malignant features both on plain films and on the angiogram. The importance of biopsy of tumours which cannot be identified with certainty must be stressed before radical surgery is carried out.

  15. Dual chamber pacemaker in the treatment of paroxysmal atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Rađen Goran

    2005-01-01

    Full Text Available Background. Atrial fibrillation is the most frequent cardiac dysrhythmia. The aim of this study was to show the role and the efficacy of a dual chamber pacemaker with the algorithm of atrial dynamic overdrive, in the suppression of paroxysmal atrial fibrillation. Case report. A woman with a classical bradycardia-tachycardia syndrome, and frequent attacks of atrial fibrillation, underwent the implantation of a single chamber permanent pacemaker (VVI. Pacemaker successfully treated the episodes of symptomatic bradycardia, but the patient had frequent attacks of atrial fibrillation, despite the use of different antiarrhythmic drugs, which she did not tolerate well. The decision was made to reimplant a permanent dual chamber pacemaker with the algorithm of atrial dynamic overdrive. The pacemaker was programmed to the basic rate of 75/min, while rate at rest was 55/min. In addition, sotalol was administered. After three months, the patient became asymptomatic with only 4 short − term episodes of atrial fibrillation, and a high level of atrial pacing (99%. Conclusion. In selected patients with bradycardia−tachycardia syndrome, atrial-based pacing seemed to be very effective in reducing the incidence of paroxysmal atrial fibrillation.

  16. Understanding paroxysmal sympathetic hyperactivity after traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Kimberly S Meyer

    2014-01-01

    Full Text Available Background: Paroxysmal sympathetic hyperactivity (PSH is a condition occurring in a small percentage of patients with severe traumatic brain injury (TBI. It is characterized by a constellation of symptoms associated with excessive adrenergic output, including tachycardia, hypertension, tachypnea, and diaphoresis. Diagnosis is one of exclusion and, therefore, is often delayed. Treatment is aimed at minimizing triggers and pharmacologic management of symptoms. Methods: A literature review using medline and cinahl was conducted to identify articles related to PSH. Search terms included paroxysmal sympathetic hyperactivity, autonomic storming, diencephalic seizures, and sympathetic storming. Reference lists of pertinent articles were also reviewed and these additional papers were included. Results: The literature indicates that the understanding of PSH following TBI is in its infancy. The majority of information is based on small case series. The review revealed treatments that may be useful in treating PSH. Conclusions: Nurses play a critical role in the identification of at-risk patients, symptom complexes, and in the education of family. Early detection and treatment is likely to decrease overall morbidity and facilitate recovery. Further research is needed to establish screening tools and treatment algorithms for PSH.

  17. [Intravenous amiodarone in the therapy of paroxysmal supraventricular tachycardias].

    Science.gov (United States)

    Storelli, A; Andriulo, C; Chisena, A; De Giorgi, M; De Giorgio, N A; Gallone, V; Guadalupi, M; Lupis, O; Nadovezza, S; Tarentini, A

    1985-03-01

    The Authors evaluated the effectiveness and the tolerance of intravenous Amiodarone in 50 cases of recent onset paroxysmal supraventricular tachyarrhythmias. Fifty consecutive patients, aged 17 to 84 (mean 52 years), presenting with paroxysmal supraventricular tachycardia (PSVT, 33 cases) or atrial flutter (11 cases) or atrial fibrillation (6 cases), were given 300 mg of Amiodarone intravenously within 2 min, followed in 4 patients by 150 mg after 15 min. All patients were monitored for 1 hour; ECG and blood pressure were recorded at fixed times. Within 15 min sinus rhythm was restored in 88% of PSVT, in 27% of atrial flutter and in 17% of atrial fibrillation cases; the other cases of atrial flutter and fibrillation always showed a 48-81% reduction of the average heart rate within 15 min. We have evidenced neither significant modifications of blood pressure and ECG parameters (P-Q, QRS and Q-T duration) nor particular side effects, except for 2 cases in which brief hot flushes were reported. The Authors believe Amiodarone to be an effective and well tolerated drug for the above mentioned arrhythmias, particularly promptly acting in PSVT cases, in whom sinus rhythm was restored within 15 min in 88% and within 1 hour in 100% of the cases.

  18. Reducing false-positive biopsies: a pilot study to reduce benign biopsy rates for BI-RADS 4A/B assessments through testing risk stratification and new thresholds for intervention.

    Science.gov (United States)

    Flowers, Chris I; O'Donoghue, Cristina; Moore, Dan; Goss, Adeline; Kim, Danny; Kim, June-Ho; Elias, Sjoerd G; Fridland, Julia; Esserman, Laura J

    2013-06-01

    The aim of this study is to evaluate Breast Imaging Reporting and Data Systems (BI-RADS) 4A/B subcategory risk estimates for ductal carcinoma in situ (DCIS) and invasive cancer (IC), determining whether changing the proposed cutoffs to a higher biopsy threshold could safely increase cancer-to-biopsy yields while minimizing false-positive biopsies. A prospective clinical trial was performed to evaluate BI-RADS 4 lesions from women seen in clinic between January 2006 and March 2007. An experienced radiologist prospectively estimated a percent risk-estimate for DCIS and IC. Truth was determined by histopathology or 4-year follow-up negative for malignancy. Risk estimates were used to generate receiver-operating characteristic (ROC) curves. Biopsy rates, cancer-to-biopsy yields, and type of malignancies missed were then calculated across postulated risk thresholds. A total of 124 breast lesions were evaluated from 213 women. An experienced radiologist gave highly accurate risk estimates for IC, DCIS alone, or the combination with an area under ROC curve of 0.91 (95 % CI 0.84-0.99) (p biopsies avoided; cancer-to-biopsy yields of 36, 47, and 46 %; and associated chance of missing an IC of 0, 1, and 2 %, respectively. Expert radiologists estimate risk of IC and DCIS with a high degree of accuracy. Increasing the cut off point for recommending biopsy, substituting with a short-term follow-up protocol with biopsy if any change, may safely reduce the number of false-positive biopsies.

  19. [Rare case of a pregnancy in a woman with paroxysmal nocturnal hemoglobinuria. Case report].

    Science.gov (United States)

    Horányi, Dániel; Várkonyi, Andrea; Nagy, Gyula Richárd; Bodó, Imre; Masszi, Tamás

    2016-06-01

    Paroxysmal nocturnal hemoglobinuria is a rare hematological disease. It is associated with increased maternal and fetal complications to such an extent that pregnancy has been considered relatively contraindicated in woman with paroxysmal nocturnal haemoglobinuria. Recently, eculizumab, a monoclonal antibody, has been shown to decrease complications during pregnancies. The highest risk is thromboembolic complication and, therefore, anticoagulant is a standard therapy during pregnancy. In the presented case, a 29-year-old woman with a 5-year history of paroxysmal nocturnal haemoglobinuria had a pregnancy. It was her first pregnancy and was complicated by a sinus thrombosis at the 11th gestational week. After the introduction of eculizumab treatment, the remaining period of pregnancy and delivery were uncomplicated. There are only a few cases in the literature about pregnancy in woman with paroxysmal nocturnal hemoglobinuria who are treated with eculizumab. This monoclonal antibody seems to be safe and it likely prevents many of the complications otherwise observed.

  20. EFFECT OF SPIRAPRIL ON THE LENGTH OF INTERICTAL INTERVAL IN PAROXYSMAL ATRIAL FIBRILLATION

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    L. N. Chikhireva

    2015-12-01

    Full Text Available Aim. To evaluate effects of angiotensin converting enzyme inhibitor spirapril on efficacy of preventive antiarrhythmic therapy in patients with paroxysmal atrial fibrillation (AF.Material and methods. 40 patients with paroxysmal AF were involved in open-label, cross-over study with periods of antiarrhythmic drug withdrawal. During 3 months all patients received by turns two types of therapy: combination of preventive antiarrhythmic therapy with spirapril 6 mg once daily - (CT group or preventive antiarrhythmic therapy only (AT group.Results. AF-free intervals to the first and the second AF paroxysms during antiarrhythmic drug withdrawal were comparable in AT and CT groups (p=0,4 and p=0,6, respectively, logrank test.Conclusion. Spirapril added to the basic preventive antiarrhythmic therapy during 3 months had no effect on the length of interictal period in paroxysmal AF.

  1. Childhood paroxysmal nocturnal haemoglobinuria (PNH), a report of 11 cases in the Netherlands

    NARCIS (Netherlands)

    van den Heuvel-Eibrink, MM; Bredius, RGM; Winkel, MLT; Tamminga, R; de Kraker, J; Schouten-van Meeteren, AYN; Bruin, Marrie; Korthof, ET

    2005-01-01

    Paroxysmal nocturnal haemoglobinuria (PNH) is characterized by intravascular haemolysis, nocturnal haemoglobinuria, thrombotic events, serious infections and bone marrow failure. This acquired disease, caused by a deficiency of glycosylphosphatidylinositol (GPI) anchored proteins on the haematopoiet

  2. Topiramate-antagonism of L-glutamate-induced paroxysms in planarians.

    Science.gov (United States)

    Raffa, Robert B; Finno, Kristin E; Tallarida, Christopher S; Rawls, Scott M

    2010-12-15

    We recently reported that NMDA (N-methyl-D-aspartate) and AMPA (α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid) induce concentration-dependent paroxysms in planarians (Dugesia dorotocephala). Since the postulated mechanisms of action of the sulfamate-substituted monosaccharide antiepileptic drug topiramate include inhibition of glutamate-activated ion channels, we tested the hypothesis that topiramate would inhibit glutamate-induced paroxysms in our model. We demonstrate that: (1) L-glutamate (1-10 mM), but not D-glutamate, induced dose-related paroxysms, and that (2) topiramate dose-relatedly (0.3-3 mM) inhibited L-glutamate-induced paroxysms. These results provide further evidence of a topiramate-sensitive glutamate receptor-mediated activity in this model.

  3. Impaired autonomic function predicts dizziness at onset of paroxysmal atrial fibrillation

    NARCIS (Netherlands)

    van den Berg, MP; Hassink, RJ; Tuinenburg, AE; Lefrandt, JD; de Kam, PJ; Crijns, HJGM

    2001-01-01

    Background: Paroxysmal atrial fibrillation is associated with various symptoms, including dizziness, which presumably reflects hemodynamic deterioration. Given the importance of the autonomic nervous system in mitigating the hemodynamic effect of atrial fibrillation, we hypothesized that autonomic f

  4. Paroxysmal vascular events in Sturge– Weber syndrome: Role of aspirin

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    Jyoti Sanghvi

    2014-01-01

    Full Text Available Sturge-Weber syndrome (SWS is a rare, sporadically occurring neurocutaneous disorder with a frequency of approximately 1 per 50,000. The hallmark is an intracranial leptomeningeal vascular angioma in association with a port wine nevus, usually involving ophthalmic or maxillary distribution of trigeminal nerve. Other clinical findings associated with SWS are seizures, glaucoma, hemiparesis and mental retardation. The radiological hallmark is "Tram-line" or "Gyri-form" calcification. 25 to 56% of patients experience recurrent episodes of paroxysmal focal neurological deficits in form of transient hemiparesis, which may be due to vascular ischemia or postictal in origin. EEG helps to differentiate the exact etiology, as it is normal in former. Aspirin prophylaxis in those, due to ischemia decreases their recurrences and improves overall neurological prognosis. We report a 25-month-old child of SWS with recurrent episodes of transient hemiparesis and atypical midline location of facial vascular nevus.

  5. [Paroxysmal supraventricular tachycardia-mechanisms, diagnostic, and treatment].

    Science.gov (United States)

    Tanner, Hildegard

    2014-02-01

    Paroxysmal supraventricular tachycardia have their origin above the His bundle. However, this definition has a historical origin and is imprecise regarding AV-reentry tachycardia using an accessory pathways since this tachycardia use the ventricule a part of the reentry-circuit. The most common supraventricular tachycardia is the atrioventricular nodal re-entry tachycardia, which is caused by a re-entrant tachycardia that involves the AV node and the atrial tissue followed by the atrioventricular re-entry tachycardia using an accessory pathway. More prevalent are sinus tachycardia, which is often physiologic and atrial fibrillation/flutter which are covered in detail by other articles within this issue of Therapeutischen Umschau. Therefore, the main topic of this review is the discussion of the mechanisms, diagnosis and treatment of AV nodal reentry tachycardia, AV reentry tachycardia using an accessory pathway and to a less extent focal atrial tachycardia.

  6. Predictors and prognosis of paroxysmal atrial fibrillation in general practice in the UK

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    Wallander Mari-Ann

    2005-07-01

    Full Text Available Abstract Background Natural history of paroxysmal atrial fibrillation (AF is not very well documented. Clinical experience suggests that paroxysmal AF could progress to chronic AF with estimates ranging between 15 and 30% over a period of 1–3 years. We performed an epidemiologic study to elucidate the natural history of paroxysmal AF, this study estimated its incidence in a general practice setting, identified associated factors and analyzed the progression into chronic AF as well as the mortality rate. Methods Using the UK General Practice Research Database (GPRD, we identified patients aged 40–89 years with a first-recorded episode of paroxysmal AF during 1996. Risk factors were assessed using 525 incident paroxysmal AF cases confirmed by the general practitioner (GP and a random sample of controls. We follow-up paroxysmal AF patients and estimated their mortality rate and progression to chronic AF. Results The incidence of paroxysmal AF was 1.0 per 1,000 person-years. Major risk factors for paroxysmal AF were age and prior valvular heart disease, ischaemic heart disease, heart failure and hyperthyroidism. During a mean follow-up of 2.7 years, 70 of 418 paroxysmal AF patients with complete information progressed to chronic AF. Risk factors associated with progression were valvular heart disease (OR 2.7, 95% CI 1.2–6.0 and moderate to high alcohol consumption (OR 3.0, 95% CI 1.1–8.0. Paroxysmal AF patients did not carry an increased risk of mortality, compared to an age and sex matched sample of the general population. There was a suggestion of a small increased risk among patients progressing to chronic AF (RR 1.5, 96% CI 0.8–2.9. Conclusion Paroxysmal AF is a common arrhythmia in the general practice setting, increasing with age and commonly associated with other heart diseases. It sometimes is the initial presentation and then progress to chronic AF. A history of valvular heart disease and alcohol consumption are associated with

  7. Paroxysmal neuralgia in pediatric population--a diagnostic dilemma for physicians and dental practioners.

    Science.gov (United States)

    Dubey, A; Mujoo, S; Sakarde, S B; Dubey, A K

    2012-01-01

    Paroxysmal neuralgia is relatively uncommon in children. Neuropathic orofacial pain is a challenge for the clinician, as no obvious dental pathology exists either clinically or radiographically. Dentist and physician should be able to recognize the characteristics of neuropathic pain so as to correctly diagnose these conditions hence avoid unnecessary dental intervention. This article reviews the conditions with paroxysmal neuralgia in children and available treatment strategies.

  8. Benign Papules and Nodules of Oral Mucosa

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    Mehmet Salih Gürel

    2012-12-01

    Full Text Available This article reviews some of the more common benign oral papules and nodules of oral mucosa with emphasis on their etiology, epidemiology, clinical presentation, histopathology, and treatment. These lesions include mucocele, traumatic fibroma, epulis, pyogenic granuloma, oral papilloma, oral warts, lymphangioma, hemangioma, lipoma, oral nevi and some soft tissue benign tumors. These benign lesions must be separated clinically and histologically from precancerous and malign neoplastic lesions. Accurate clinico-pathological diagnosis is mandatory to insure appropriate therapy.

  9. Differentiation between Benign and Malignant Solid Thyroid Nodules Using an US Classification System

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Hun; Kim, Dong Wook; In, Hyun Sin; Park, Ji Sung; Kim, Sang Hyo; Eom, Jae Wook; Kim, Bomi [Busan Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of); Lee, Eun Joo [Dongnam Institute of Radiological and Medical Science, Busan (Korea, Republic of); Rho, Myung Ho [Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2011-10-15

    To evaluate the diagnostic accuracy of a new ultrasound (US) classification system for differentiating between benign and malignant solid thyroid nodules. In this study, we enrolled 191 consecutive patients who received real-time US and subsequent US diagnoses for solid thyroid nodules, and underwent US-guided fine-needle aspiration. Each thyroid nodule was prospectively classified into 1 of 5 diagnostic categories by real-time US: 'malignant,' 'suspicious for malignancy,' 'borderline,' 'probably benign,' and 'benign'. We evaluated the diagnostic accuracy of thyroid US and the cut-off US criteria by comparing the US diagnoses of thyroid nodules with cytopathologic results. Of the 191 solid nodules, 103 were subjected to thyroid surgery. US categories for these 191 nodules were malignant (n = 52), suspicious for malignancy (n = 16), borderline (n = 23), probably benign (n 18), and benign (n = 82). A receiver-operating characteristic curve analysis revealed that the US diagnosis for solid thyroid nodules using the 5-category US classification system was very good. The sensitivity, specificity, positive and negative predictive values, and accuracy of US diagnosis were 86%, 95%, 91%, 92%, and 92%, respectively, when benign, probably benign, and borderline categories were collectively classified as benign (negative). The diagnostic accuracy of thyroid US for solid thyroid nodules is high when the above-mentioned US classification system is applied.

  10. Elastography in Distinguishing Benign from Malignant Thyroid Nodules

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    Bulent Colakoglu

    2016-01-01

    Full Text Available Aim: The aim of this study is to test the diagnostic success of strain elastography in distinguishing benign from malignant thyroid nodules. Materials and Methods: The size, echogenicity, and halo integrity of 293 thyroid nodules and the presence of microcalcification in these nodules were evaluated on gray-scale examination. Doppler characteristics and elastography patterns were also evaluated and recorded. Nodules were classified in four categories (patterns 1-4 based on elastographic examination. Results: According to the cytopathological findings, 222 nodules were benign, and 71 nodules were malignant. The risk of a nodule to be malignant was 3.8 times increased by hypoechogenicity, 7.7 times increased by the presence of microcalcification, and 11.5 times increased by the absence of halo. On Doppler patterns, the presence of central vascularity increased the malignancy risk of a nodule by 5.8 times. According to the receiver operating characteristic analysis, patterns 3 and 4 were malignant, and patterns 1 and 2 were benign. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of elastography were 100%, 80.2%, 61.7%, 100%, and 85%, respectively. Conclusion: Strain elastography can be used as a noninvasive method in distinguishing benign from malignant thyroid nodules and in identifying the patients who would undergo surgery.

  11. Elastography in Distinguishing Benign from Malignant Thyroid Nodules

    Science.gov (United States)

    Colakoglu, Bulent; Yildirim, Duzgun; Alis, Deniz; Ucar, Gokhan; Samanci, Cesur; Ustabasioglu, Fethi Emre; Bakir, Alev; Ulusoy, Onur Levent

    2016-01-01

    Aim: The aim of this study is to test the diagnostic success of strain elastography in distinguishing benign from malignant thyroid nodules. Materials and Methods: The size, echogenicity, and halo integrity of 293 thyroid nodules and the presence of microcalcification in these nodules were evaluated on gray-scale examination. Doppler characteristics and elastography patterns were also evaluated and recorded. Nodules were classified in four categories (patterns 1–4) based on elastographic examination. Results: According to the cytopathological findings, 222 nodules were benign, and 71 nodules were malignant. The risk of a nodule to be malignant was 3.8 times increased by hypoechogenicity, 7.7 times increased by the presence of microcalcification, and 11.5 times increased by the absence of halo. On Doppler patterns, the presence of central vascularity increased the malignancy risk of a nodule by 5.8 times. According to the receiver operating characteristic analysis, patterns 3 and 4 were malignant, and patterns 1 and 2 were benign. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of elastography were 100%, 80.2%, 61.7%, 100%, and 85%, respectively. Conclusion: Strain elastography can be used as a noninvasive method in distinguishing benign from malignant thyroid nodules and in identifying the patients who would undergo surgery. PMID:28123841

  12. Benign communicating hydrocephalus in children

    Energy Technology Data Exchange (ETDEWEB)

    Kendall, B.; Holland, I.

    1981-03-01

    A review was performed of the computed tomograms (CTs) of 500 children which had been reported as showing widening of the supratentorial subarachnoid spaces with normal cerebral substance. On the basis of this a radiological diagnosis of cerebral atrophy had been made in all but five, who were said to have mengalencephaly. From these, the children with large or abnormally enlarging heads, but normal or only slightly enlarged ventricles, were selected; there were 40 such cases (8%). The clinical condition either improved or remained stable over a period of 2 years; in the majority the scan abnormality regressed (22.5%) or remained static (67.5%). In three cases there was slight progression of the CT changes before stabilisation, but only one case developed classical communicating hydrocephalus necessitating a shunt procedure. This condition is a generally benign and mild form of communicating hydrocephalus, for which an aetiological factor was apparent in about two-thirds of the cases studied.

  13. Benign fibroxanthoma of the mandible

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    L Zouloumis

    2011-01-01

    Full Text Available Histiocytomas constitute a large group of tumors, the classification of which created a lot of confusion in the past. For this reason, various attempts were carried out during the last years so that a widely accepted classification system could be defined. Fibroxanthomas, according to contemporary data, are classified into benign histiocytomas and they are mostly located at the skin of extremities. They are rarely localized in the area of the head and neck, where they are found commonly in soft tissue. Fibroxanthomas located at the bones of oral and maxillofacial region are extremely rare. The purpose of this paper is to present a case of a fibroxanthoma located at the mandible as well as to analyze the histological findings of the lesion on which the diagnosis and differential diagnosis were based.

  14. Detection of helicobacter pylori in benign laryngeal lesions by polymerase chain reaction: a cross sectional study

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    Izadi Farzad

    2012-04-01

    Full Text Available Abstract Background Although Helicobacter Pylori (HP was detected in some cases of chronic laryngitis, the results were not confirmed by polymerase chain reaction (PCR. By this time, it has not been found in laryngeal lesions by in house PCR, the most sensitive method for detecting the genome tracks. Regarding the previous results and also few numbers of studies about the presence of HP in benign laryngeal lesions, specifically by PCR, we aimed to investigate the presence of HP in benign laryngeal lesions by in-house PCR. Methods The samples were taken from 55 patients with benign laryngeal lesions and frozen in −20°C. One milliliter (ml of lysis buffer was added to 100 mg (mg of each sample and the tube was placed in 56°C overnight. Then DNA extraction was carried out. Results To find HP DNA, in-house PCR was performed that revealed 5 positive results among 55 patients with benign laryngeal lesions. Of them, 3 were polyp, 1 was nodule and 1 was papilloma. Conclusion Although the number of positive results was not a lot in this study, it was in contrast with previous studies which could not find any HP tracks in benign laryngeal lesions by other methods. More studies about the prevalence of HP in benign laryngeal lesions improve judging about the effect of this infection on benign laryngeal lesions.

  15. Prevalence of Helicobacter pylori in benign gastric ulcers in a cohort of Sri Lankan patients.

    Science.gov (United States)

    Wijetunge, S; Kotakadeniya, R; Noordeen, F; Buharideen, S M; Samarasinghe, B; Dharmapala, A; Galketiya, K B

    2015-12-01

    Helicobacter pylori prevalence is decreasing globally and prevalence of non H. pylori gastric ulcers is increasing. The following study was conducted to assess the prevalence of H. pylori in benign gastric ulcers in a sample of Sri Lankan patients. This was a cross-sectional study of 59 dyspeptic patients with benign gastric ulcers. Multiple endoscopic gastric biopsies were obtained and histology, immunohistochemistry and polymerase chain reaction were performed for H. pylori detection. An immunochromatography assay was performed to detect blood anti H. pylori antibodies. Four (6.8%) were positive for H. pylori. Therefore, it is likely that most benign gastric ulcers are of non-H. pylori aetiology.

  16. CHRONIC HEPATITIS OR «DISGUISE» PAROXYSMAL NOCTURAL HEMOGLOBINURIA?

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    D. A. Dolgopolova

    2015-01-01

    Full Text Available Objective is description of a case of diagnostics of a paroxysmal nocturnal haemoglobinuria. Subjects and methods. The male patient of 50 years asked for medical care with complaints to emergence of yellowness a skin, urine darkening, not expressed general weakness. To the patient examination was conducted: clinical and biochemical blood tests, urine, miyelogramm, definition of an index of sphericity of erythrocytes, definition of free hemoglobin of plasma of blood, urine, gemosiderinuriya, flow citometry, immunological markers of rheumatic diseases, tool inspection, etc. Results. On the basis of complaints, a clinical picture of a disease, data of objective and tool inspections the final diagnosis is made: a paroxysmal nocturnal haemoglobinuria, a classical haemolytic form (on the International classification of diseases of the 10th revision – B 59.5. The comorbid diagnoses: anemia of heavy degree; transfusion dependence; thrombosis of a subclavial vein on the right (11.2011; cholelithiasis; chronic calculous cholecystitis in remission; chronic hepatitis of the mixed genesis (alcoholic, metabolic, moderate degree of activity. By the main diagnostic method which allowed to verify the diagnosis became flow citometry. According to an flow citometry erythrocytes I Tip (normal expression of CD59 – 87,0 %, II Type (partial deficiency of CD59 – 0,3 %, III Type (full deficiency of CD59 – 12,7 %; monocytes with deficiency of FLAER/CD14 – 93,3 %; granulocytes with deficiency of FLAER/CD24 – 97,7 %. Flow citometry was revealed by availability of APG-clone among erythrocytes, granulocytes and monocytes. Judging by the huge size of a clone (on granulocytes 97,7 %, it is possible to draw a conclusion that the patient was in the highest zone of risk of APG of crises. Conclusion. Practical interest of this supervision is caused by a rarity of this hematologic disease, the analysis of modern opportunities of diagnostics and complexity of a choice of

  17. Neurofeedback therapy in patients with non pain syndromes of chronic and paroxysmal character-literature review and own experience.

    Science.gov (United States)

    Kubik, Alicja; Kaciński, Marek

    2013-01-01

    Neurofeedback has been used in treatment of many other than pain clinical syndromes. This group includes chronic as well as paroxysmal syndromes previously treated pharmacologically. However due to non satisfactory results of this treatment introduction of non-pharmacological therapy has been examined. Observations from our 9-year experience of neurofeedback therapy used in children and adult patients with epilepsy, Asperger syndrome, depression, neurosis, personality disorders, drug addiction and other (not pain) syndromes have been presented in this paper. Positive influence of neurofeedback therapy on symptoms intensity, frequency, duration and social relations of treated patients has been confirmed by our own and other authors observations. Neurofeedback therapy has been tried by patients with other difficult life problems and has been effective in some of them. The effectiveness of the therapy has been confirmed by patients, their relatives and also by neurophysiological results. Additionally, preliminary results of neurofeedback therapy used in management of computer addiction in children and adolescents have been presented herein.

  18. Dietary intakes, resting metabolic rates, and body composition in benign and malignant gastrointestinal disease.

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    Burke, M.; Bryson, E I; Kark, A E.

    1980-01-01

    Dietary protein and energy intakes were assessed in 42 patients with cancer and 24 with benign conditions of the gastrointestinal tract. The relations of dietary intake to body composition was examined. Resulting metabolic rate was measured in 51 patients. No significant differences in dietary intake or metabolic rate were found between patients with cancer and those with benign disease. There were significant positive correlations between protein and energy intakes and the ratio of total bod...

  19. Chronic paroxysmal hemicrania and hemicrania continua: lack of efficacy of sumatriptan.

    Science.gov (United States)

    Antonaci, F; Pareja, J A; Caminero, A B; Sjaastad, O

    1998-03-01

    Attacks of chronic paroxysmal hemicrania are prevented by the continuous administration of indomethacin. Sumatriptan, an agonist of 5-HT1-like receptors, has proven effective in the treatment of cluster headache attacks. There are clear clinical similarities between chronic paroxysmal hemicrania and cluster headache. A natural consequence of these considerations would be to establish whether chronic paroxysmal hemicrania also responds similarly to sumatriptan. Since hemicrania continua is another unilateral headache responsive to indomethacin, it would be meaningful to also include hemicrania continua in such a study. Sumatriptan, 6 mg subcutaneous, was tried in an open fashion in 7 patients (6 women and 1 man) with chronic paroxysmal hemicrania and 7 patients (5 women and 2 men) with hemicrania continua. In chronic paroxysmal hemicrania, the mean interval between the last three attacks prior to sumatriptan treatment (40 +/- 23 minutes) was not statistically different from the mean interval between the three attacks subsequent to sumatriptan treatment of an attack (32 +/- 20 minutes). In none of the patients did the mean duration of the "test attack" decrease as compared to the attacks antedating the test attack (25 +/- 11 minutes and 19 +/- 9 minutes, respectively) (P = 0.027, Wilcoxon). In 2 patients with chronic paroxysmal hemicrania, placebo (saline) administration did not lead to any change in the interval between attacks. There was a mild, but statistically significant reduction in visual analog scale values for headache intensity in hemicrania continua (P = 0.04, Wilcoxon). There was no clear, i.e., clinically meaningful, reduction in visual analog scale values in any particular patient with hemicrania continua. Taken together, these results seem to show that sumatriptan is of no benefit in chronic paroxysmal hemicrania, but may have a partial efficacy in hemicrania continua. However, the latter effect is clinically unimportant. This minor difference in

  20. Prolonged Paroxysmal Sympathetic Storming Associated with Spontaneous Subarachnoid Hemorrhage

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    Yan Liu

    2013-01-01

    Full Text Available Paroxysmal sympathetic storming (PSS is a rare disorder characterized by acute onset of nonstimulated tachycardia, hypertension, tachypnea, hyperthermia, external posturing, and diaphoresis. It is most frequently associated with severe traumatic brain injuries and has been reported in intracranial tumors, hydrocephalous, severe hypoxic brain injury, and intracerebral hemorrhage. Although excessive release of catecholamine and therefore increased sympathetic activities have been reported in subarachnoid hemorrhage (SAH, there is no descriptive report of PSS primarily caused by spontaneous SAH up to date. Here, we report a case of prolonged PSS in a patient with spontaneous subarachnoid hemorrhage and consequent vasospasm. The sympathetic storming started shortly after patient was rewarmed from hypothermia protocol and symptoms responded to Labetalol, but intermittent recurrence did not resolve until 3 weeks later with treatment involving Midazolam, Fentanyl, Dexmedetomidine, Propofol, Bromocriptine, and minimizing frequency of neurological and vital checks. In conclusion, prolonged sympathetic storming can also be caused by spontaneous SAH. In this case, vasospasm might be a precipitating factor. Paralytics and hypothermia could mask the manifestations of PSS. The treatment of the refractory case will need both timely adjustment of medications and minimization of exogenous stressors or stimuli.

  1. Nocturia and benign prostatic hyperplasia

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    Laketić Darko

    2008-01-01

    Full Text Available Background/Aim. Nocturia often occurs in patients with benign prostate hyperplasia (BPH. The aim of the study was to investigate the frequency of nocturia in patients with BPH. Nocturia and other factors associated with it were also investigated. Methods. Forty patients with the confirmed diagnosis of BPH were studied. Transurethral and transvesical prostatectomy were performed in all the patients. Symptoms were evaluated with the International Prostate Symptom Score before, as well as three and six months after the surgery. All the results were compared with the control group. Results. There was no statistically significant difference between the patients before and after the surgery regarding nocturia. There was, however, a statistically significant difference between the operated patients and the control group regarding nocturia, as well as a statistically significant correlation between noctruia and the age of the patients in both the investigated and the control group. A correlation also existed between nocturia and the prostatic size. Conclusion. There was no statistically significant improvement in symptoms of nocturia after the surgery. It is necessary to be very careful in decision making in patients with nonabsolute indiction for surgery and isolated bothersome symptom of nocturia. Age of a patient should also be considered in the evaluation of favorable result of the surgery because of a significant correlation between noctura and the age of a patient.

  2. Malondialdehyde in benign prostate hypertrophy: a useful marker?

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    Rosaria Alba Merendino

    2003-01-01

    Full Text Available Benign prostate hypertrophy (BPH is the most common benign tumor in men due to obstruction of the urethra and, finally, uremia. Malondialdehyde (MDA is a product derived from peroxidation of polyunsaturated fatty acids and related esters. Evaluation of MDA in serum represents a non-invasive biomarker of oxidative stress. Prostate-specific antigen (PSA is a sensitive marker for prostatic hypertrophy and cancer. We analyzed MDA serum levels to evaluate the oxidative stress in BPH. To this end, 22 BPH patients and 22 healthy donors were enrolled. Data show an increase of MDA level in BPH patients and a positive correlation between PSA and MDA levels. In conclusion, we describe a previously unknown relationship between PSA and MDA as an index of inflammation and oxidative stress in BPH.

  3. BENIGN INTRACRANIAL HYPOTENSION WITH INCIDENTAL PARASAGITTAL MENINGIOMA

    Directory of Open Access Journals (Sweden)

    Sukumar

    2015-12-01

    Full Text Available Benign intracranial hypotension, otherwise called as idiopathic intracranial hypotension is caused by CSF leaks due to disruption in spinal meninges. It is most commonly caused by disruption and leak at cervical and thoracic spine. Imaging is sometimes the most important key to the diagnosis of idiopathic intracranial hypotension, which helps in appropriate treatment of the patient. Here, we are presenting a case of benign intracranial hypotension associated with incidental parasagittal meningioma. The presence of benign intracranial hypotension was confirmed by taking MR myelogram.

  4. Quality of life in patients with paroxysmal atrial fibrillation and its predictors : importance of the autonomic nervous system

    NARCIS (Netherlands)

    van den Berg, MP; Hassink, RJ; Tuinenburg, AE; van Sonderen, EFLP; Lefrandt, JD; de Kam, PJ; van Gelder, IC; Smit, AJ; Sanderman, R; Crijns, HJGM

    2001-01-01

    Aims To determine the impact of paroxysmal atrial fibrillation on quality of life and to determine the predictors of quality of life, particularly the role of symptomatology and autonomic function. Methods and Results The study group comprised 73 patients with paroxysmal atrial fibrillation (mean ag

  5. A three-pulmonary vein isolation approach to treat paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Lexin WANG; Jing ZHOU

    2004-01-01

    Objective To investigate the safety and efficacy of a 3-pulmonary vein (PV) isolation approach in treating paroxysmal atrial fibrillation (AF). Methods Radiofrequency catheter ablation was used to eliminate PV potential in 11 patterns with frequent paroxysmal AF refractory to anti-arrhythmic agents. During sinus rhythm, PV potential was mapped in the left and right superior PVs and left inferior PV. The procedural success was defined as the elimination of PV potential in the 3 PVs. Restults PV potential was identified and abolished in a total of 24 PVs, mostly in the left and right superior PV. There was no pulmonary stenosis or other complications during or after the procedures. AF recurred in one patient after an average of 12 ± 3 month follow-up. Conclusions PV potemials were present mostly in the left or right superior PV. The 3-PVs isolation approach is safe and effective in preventing drug-resistant paroxysmal AF.

  6. Oxidative stress in benign prostate hyperplasia.

    Science.gov (United States)

    Zabaiou, N; Mabed, D; Lobaccaro, J M; Lahouel, M

    2016-02-01

    To assess the status of oxidative stress in benign prostate hyperplasia, a very common disease in older men which constitutes a public health problem in Jijel, prostate tissues were obtained by transvesical adenomectomy from 10 men with benign prostate hyperplasia. We measured the cytosolic levels of malondialdehyde (MDA) and glutathione (GSH) and cytosolic enzyme activities of superoxide dismutase, catalase, glutathione peroxidase and glutathione S-transferase. The development of benign prostate hyperplasia is accompanied by impaired oxidative status by increasing levels of MDA, depletion of GSH concentrations and a decrease in the activity of all the antioxidant enzymes studied. These results have allowed us to understand a part of the aetiology of benign prostate hyperplasia related to oxidative stress.

  7. Migraine with benign episodic unilateral mydriasis

    Directory of Open Access Journals (Sweden)

    Jabr FI

    2011-06-01

    Full Text Available Nedaa Skeik1, Fadi I Jabr21Mayo Clinic, Rochester, MN, USA; 2Horizon Medical Center, Hospital Medicine, Dickson, TN, USAAbstract: Pupil asymmetry or anisocoria can have benign or malignant causes, and be categorized as acute or chronic. It can also be a normal finding in about 20% of cases. Benign episodic unilateral mydriasis is an isolated benign cause of intermittent pupil asymmetry. The exact pathophysiology is not always understood. According to one hypothesis, it is due to discordance between the sympathetic and parasympathetic systems. It is occasionally seen in patients with migraine. Some authors consider it a limited form of ophthalmoplegic migraine. We report a case of benign episodic unilateral mydriasis diagnosed in a 30-year-old lady with a history of migraine who had extensive negative neurological evaluation.Keywords: anisocoria, migraine, unilateral episodic mydriasis

  8. Genetics Home Reference: benign familial neonatal seizures

    Science.gov (United States)

    ... Facebook Share on Twitter Your Guide to Understanding Genetic Conditions Search MENU Toggle navigation Home Page Search ... Conditions Genes Chromosomes & mtDNA Resources Help Me Understand Genetics Home Health Conditions BFNS benign familial neonatal seizures ...

  9. Benign Metastatic Leiomyoma Presenting as a Hemothorax

    Directory of Open Access Journals (Sweden)

    Anna M. Ponea

    2013-01-01

    Full Text Available Uterine leiomyomas have been reported to metastasize to various organs including the lungs, skeletal muscles, bone marrow, peritoneum, and heart. They may present with symptoms related to the metastases several years after hysterectomy. These tumors regress after menopause, and it is rare to detect active tumors in postmenopausal women. Despite their ability to metastasize, they are considered to be benign due to the lack of anaplasia. Pulmonary benign metastasizing leiomyoma is usually detected in the form of pulmonary nodules incidentally on imaging. Tissue biopsy of these nodules is required to identify them as benign metastasizing leiomyomas. Immunohistochemical analysis and molecular profiling may further help detect any malignant transformation in it. Untreated pulmonary benign metastasizing leiomyoma may result in the formation of cystic structures, destruction of lung parenchyma, and hemothorax and may cause respiratory failure. Surgical resection and hormonal therapy help prevent progression of this disease and provide an avenue for a cure.

  10. Benign metastatic leiomyoma presenting as a hemothorax.

    Science.gov (United States)

    Ponea, Anna M; Marak, Creticus P; Goraya, Harmeen; Guddati, Achuta K

    2013-01-01

    Uterine leiomyomas have been reported to metastasize to various organs including the lungs, skeletal muscles, bone marrow, peritoneum, and heart. They may present with symptoms related to the metastases several years after hysterectomy. These tumors regress after menopause, and it is rare to detect active tumors in postmenopausal women. Despite their ability to metastasize, they are considered to be benign due to the lack of anaplasia. Pulmonary benign metastasizing leiomyoma is usually detected in the form of pulmonary nodules incidentally on imaging. Tissue biopsy of these nodules is required to identify them as benign metastasizing leiomyomas. Immunohistochemical analysis and molecular profiling may further help detect any malignant transformation in it. Untreated pulmonary benign metastasizing leiomyoma may result in the formation of cystic structures, destruction of lung parenchyma, and hemothorax and may cause respiratory failure. Surgical resection and hormonal therapy help prevent progression of this disease and provide an avenue for a cure.

  11. Oromotor Dyspraxia in Benign Childhood Epilepsy

    OpenAIRE

    J Gordon Millichap

    1989-01-01

    A six year old right handed boy with prolonged intermittent drooling, oromotor dyspraxia, and benign childhood epilepsy with centrotemporal spikes is reported from the Departments of Pediatrics and Neurology, Centre Hospitalier, Universitaire Vaudois, Lausanne, Switzerland.

  12. Genetics Home Reference: benign recurrent intrahepatic cholestasis

    Science.gov (United States)

    ... All Close All Description Benign recurrent intrahepatic cholestasis (BRIC) is characterized by episodes of liver dysfunction called ... a lack of appetite. A common feature of BRIC is the reduced absorption of fat in the ...

  13. Oral benign fibrous histiocytoma: two case reports

    OpenAIRE

    Menditti, Dardo; Laino, Luigi; Mezzogiorno, Antonio; Sava, Sara; Bianchi, Alexander; Caruso, Giovanni; Di Maio, Luigi; Baldi, Alfonso

    2009-01-01

    Fibrous histiocytoma is a benign soft tissue tumour arising as a fibrous mass everywhere in the human body. The involvement of the oral cavity is rare. We report two cases of benign fibrous histiocytoma that localized in the oral cavity. The clinical and histological features of the lesion are reported. Finally, a literature revision of this pathology at the level of the oral cavity is reported.

  14. Infantile convulsions with paroxysmal dyskinesia (ICCA syndrome and copy number variation at human chromosome 16p11.

    Directory of Open Access Journals (Sweden)

    Patrice Roll

    Full Text Available BACKGROUND: Benign infantile convulsions and paroxysmal dyskinesia are episodic cerebral disorders that can share common genetic bases. They can be co-inherited as one single autosomal dominant trait (ICCA syndrome; the disease ICCA gene maps at chromosome 16p12-q12. Despite intensive and conventional mutation screening, the ICCA gene remains unknown to date. The critical area displays highly complicated genomic architecture and is the site of deletions and duplications associated with various diseases. The possibility that the ICCA syndrome is related to the existence of large-scale genomic alterations was addressed in the present study. METHODOLOGY/PRINCIPAL FINDINGS: A combination of whole genome and dedicated oligonucleotide array comparative genomic hybridization coupled with quantitative polymerase chain reaction was used. Low copy number of a region corresponding to a genomic variant (Variation_7105 located at 16p11 nearby the centromere was detected with statistical significance at much higher frequency in patients from ICCA families than in ethnically matched controls. The genomic variant showed no apparent difference in size and copy number between patients and controls, making it very unlikely that the genomic alteration detected here is ICCA-specific. Furthermore, no other genomic alteration that would directly cause the ICCA syndrome in those nine families was detected in the ICCA critical area. CONCLUSIONS/SIGNIFICANCE: Our data excluded that inherited genomic deletion or duplication events directly cause the ICCA syndrome; rather, they help narrowing down the critical ICCA region dramatically and indicate that the disease ICCA genetic defect lies very close to or within Variation_7105 and hence should now be searched in the corresponding genomic area and its surrounding regions.

  15. Benign nontraumatic osteolytic vertebral collapse simulating malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Sattari, Azadeh [Hopital Lariboisiere, Department of Musculoskeletal Radiology, Paris Cedex 10 (France); Quillard, Alain [Hopital Lariboisiere, Department of Pathology, Paris Cedex 10 (France); Laredo, Jean-Denis [Hopital Lariboisiere, Department of Musculoskeletal Radiology, Paris Cedex 10 (France); University of Pennsylvania Health System, Department of Radiology, Philadelphia, PA (United States)

    2008-03-15

    This study described the imaging features of a distinctive pattern of biopsy-proven benign non-traumatic vertebral collapse (VC) that can mimic malignancy. Among 240 patients referred with painful VC over a 10-year period, we retrospectively selected 15 cases of benign VC which simulated malignancy, due to cortical bone destruction on radiographs. The diagnosis of benign origin was documented by percutaneous biopsy and 12-months of follow-up. Radiographs, CT and MR images of the spine were reviewed. Findings suggestive of malignancy included destruction involving the anterolateral cortex, posterior cortex and pedicles of the vertebral body (46%,15% and 15% respectively) at CT, epidural soft-tissue masses on CT (23%) and MR images (21%), and diffuse low signal-intensity (SI) of the vertebral body (50%) and pedicles (79%) on T1-weighted images. Features suggestive of a benign origin included an intravertebral vacuum phenomenon on radiographs and CT (13%), fracture lines within the vertebral body (92%) or pedicles (62%) at CT and presence an intravertebral area of high SI on T2-weighted images (93%). Benign non-traumatic osteolytic VC can simulate malignancy on radiographs. The features, above mentioned on CT and MR suggestive of a benign VC, are useful in interpreting biopsy results of such lesions and avoiding unnecessary repeat biopsy. (orig.)

  16. Classification conundrums in paroxysmal dyskinesias: a new subtype or variations on classic themes?

    Science.gov (United States)

    Pourfar, Michael H; Guerrini, Renzo; Parain, Dominique; Frucht, Steven J

    2005-08-01

    Paroxysmal movement disorders are a group of heterogeneous entities that have been categorized based on their most salient features. The four classic categories of paroxysmal dyskinesias are kinesigenic, nonkinesigenic, hypnogenic, and exercise-induced. The phenotypic variability of these disorders, coupled with new insights into their possible etiologies, has made the task of classification increasingly problematic. We describe 4 cases that do not fit easily into the current classification scheme, compare them with four others recently described in the literature, and raise the question as to whether they constitute a new subtype.

  17. Paroxysmal dysarthria and ataxia in multiple sclerosis and corresponding magnetic resonance imaging findings.

    Science.gov (United States)

    Li, Yongmei; Zeng, Chun; Luo, Tianyou

    2011-02-01

    Paroxysmal dysarthria (PD) and paroxysmal dysarthria-ataxia (PDA) syndromes are uncommon symptoms of the neurological dysfunction in multiple sclerosis (MS). We describe two patients who had clinically definite MS presented with symptomatic PD and PDA syndromes, respectively, related to demyelinating lesions. In one patient, the PD symptom was the initial manifestation of an acute episode. In the other patient, the episode of dysarthria was accompanied by ataxia disorders. Both patients had midbrain lesions at or below the level of the right red nucleus on magnetic resonance imaging (MRI), confirming that this area is critically involved. Both responded well to carbamazepine (CBZ).

  18. FOCAL GENERATION OF PAROXYSMAL FAST RUNS DURING ELECTROGRAPHIC SEIZURES

    Science.gov (United States)

    Boucetta, Sofiane; Chauvette, Sylvain; Bazhenov, Maxim; Timofeev, Igor

    2008-01-01

    Purpose A cortically generated Lennox-Gastaut type seizure is associated with spike-wave/polyspike-wave discharges at 1.0–2.5 Hz and fast runs at 7–16 Hz. Here we studied the patterns of synchronization during runs of paroxysmal fast spikes. Methods Electrographic activities were recorded using multisite intracellular and field potential recordings in vivo from cats anesthetized with ketamine-xylazine. In different experiments, the recording electrodes were located either at short distances (<1 mm) or at longer distances (up to 12 mm). The main experimental findings were tested in computational models. Results In the majority of cases, the onset and the offset of fast runs occurred almost simultaneously in different recording sites. The amplitude and duration of fast runs could vary by orders of magnitude. Within the fast runs, the patterns of synchronization recorded in different electrodes were as following: (i) synchronous, in phase, (ii) synchronous, with phase shift, (iii) patchy, repeated in phase/phase shift transitions and (iv) non-synchronous, slightly different frequencies in different recording sites or absence of oscillatory activity in one of the recording sites; the synchronous patterns (in phase or with phase shifts) were most common. All these patterns could be recorded in the same pair of electrodes during different seizures and they were reproduced in a computational network model. Intrinsically-bursting (IB) neurons fired more spikes per cycle than any other neurons suggesting their leading role in the fast run generation. Conclusions Once started, the fast runs are generated locally with variable correlations between neighboring cortical foci. PMID:18616553

  19. Somatosensory disinhibition in patients with paroxysmal kinesigenic dyskinesia

    Institute of Scientific and Technical Information of China (English)

    WEI Hua; SUN Ying; CHEN Hai; WANG De-quan; LI Li-ping; DING Yan; LIU Ai-hua; LU Chang-feng; WANG Yu-ping

    2012-01-01

    Background Paroxysmal kinesigenic dyskinesia (PKD) is characterized by recurrent brief episodes of chorea and dystonia induced by sudden movement.Whether the central nervous system is hyper- or hypoexcitable in PKD remains undetermined.The aim of our study was to compare the somatosensory evoked potential (SEP) recovery cycle,a marker of somatosensory system excitability,in PKD patients and controls.Methods Twenty-four PKD patients (mean age of (20.0±5.3) years; 21 males,3 females) and 18 control age-matched subjects (mean age of (22.0±5.0) years; 17 males,1 female) were studied.The stimuli were delivered to the median nerve in the affected dominant arm in patients and in the dominant arm in controls.The change in SEP amplitude was measured after paired electrical stimulation at interstimulus intervals (ISIs) of 5,20,and 40 ms.The SEPs evoked by S2 (test stimulus) were calculated by subtracting the response to S1 (the conditioning stimulus) from the response to a pair of stimuli (S1 + S2),and their amplitudes were compared with those of the control response (S1) at each ISI.Analysis of variance (ANOVA) or equivalent was used for non-parametric data.Results In patients,the P27 amplitude after the single stimulus (S1) was significantly larger than that after the control stimulus.The (S2/S1)x100 ratio for P14 and N30 SEPs did not differ significantly between PKD patients and normal subjects at ISI of 5 ms but were significantly higher in patients at ISIs of 20 and 40 ms (P<0.05).Conclusions Somatosensory system disinhibition takes place in PKD.The finding of reduced suppression of different SEPs,each thought to have a different origin,suggests an abnormality of intracortical and subcortical inhibitory circuits.

  20. P-cadherin as myoepithelial cell marker for differential diagnosis of benign and malignant breast lesions

    Directory of Open Access Journals (Sweden)

    Yachika Bhatia

    2013-01-01

    Full Text Available Background: P-cadherin is cell-cell adhesion glycoprotein which can be used as a myoepithelial cell (MEC marker in the breast lesions. MEC layer is retained in most benign lesions and loss of this outer layer is hallmark of infiltrating carcinomas in the breast. Aim: To evaluate the expression of P-cadherin as MEC marker in the differential diagnosis of benign and malignant breast lesions. Materials and Methods: Immunohistochemical staining was done using P-cadherin-specific antibody on formalin fixed paraffin-embedded sections of 25 benign and 15 malignant breast lumps. Results: All 25 cases of benign breast lesions showed positive P-cadherin immunostaining, while only 4 out of 15 cases of infiltrating ductal carcinoma showed positive immunostaining for P-cadherin. In the case of benign lesions, staining index varied from 4 to 6 or 7 to 9, while in case of malignant lesions, 11 cases showed staining index from 1 to 3. Only 4 out of 15 malignant cases had staining index from 4 to 6. None of them showed index from 7 to 9. Conclusions: P-cadherin as a MEC marker can be used in differentiating benign and malignant breast lesions.

  1. Paroxysmal ventricular tachycardia and paroxysmal atrial fibrillation associated with subclinical hyperthyroidism, chronic renal failure and elevation of prostate-specific antigen during acute myocardial infarction.

    Science.gov (United States)

    Patanè, Salvatore; Marte, Filippo

    2010-02-04

    Subclinical hyperthyroidism is an increasingly recognized entity that is defined as a normal serum free thyroxine and free triiodothyronine levels with a thyroid-stimulating hormone level suppressed below the normal range and usually undetectable. Paroxysmal atrial fibrillation is a frequent complication of acute myocardial infarction. It has been reported that subclinical hyperthyroidism is not associated with coronary heart disease or mortality from cardiovascular causes but it is sufficient to induce arrhythmias including an increase in atrial fibrillation rate. It has also been reported that increased factor X activity in patients with subclinical hyperthyroidism represents a potential hypercoagulable state. Moreover chronic renal failure presents an increased arrhythmic risk. Apparently spurious result has been reported in a work about mean serum prostate-specific antigen (PSA) concentration during acute myocardial infarction with mean serum PSA concentration significantly lower on day 2 than either day 1 or day 3 and it has been reported that these preliminary results could reflect several factors, such as antiinfarctual treatment, reduced physical activity or an acute-phase response. We present a case of paroxysmal ventricular tachycardia and paroxysmal atrial fibrillation associated with subclinical hyperthyroidism, chronic renal failure and elevation of serum PSA concentration in a 90-year-old Italian man during acute myocardial infarction. Also this case focuses attention on the importance of a correct evaluation of subclinical hyperthyroidism and of chronic renal failure. Moreover, our report also confirms previous findings and extends the evaluation of PSA during acute myocardial infarction.

  2. Bilateral posterior semicircular canal aplasia and atypical paroxysmal positional vertigo: a case report

    OpenAIRE

    Walther, LE; Nath, V.; Krombach, GA; Di Martino, E

    2008-01-01

    Isolated congenital malformations of semicircular canals are rare abnormalities. Most inner ear abnormalities occur in syndromes and are associated with hearing loss. Unilateral or bilateral single aplasia of one semicircular canal does not usually result in vertigo, but these become clinically important if there are clinical complaints of vertigo. Computed tomography imaging and high resolution magnetic resonance imaging may reveal inner ear abnormalities. The case is presented here of a 46-...

  3. VDDR pacing after His-bundle ablation for paroxysmal atrial fibrillation : A pilot study

    NARCIS (Netherlands)

    Buys, EM; van Hemel, NM; Jessurun, ER; Bakema, L; Kingma, JH

    1998-01-01

    His-bundle ablation followed by pacemaker implantation is today a widely accepted therapeutic choice when drug refractoriness of symptomatic AF is evident. The selection of pacing mode in patients suffering from paroxysmal AF is still controversial. Preservation of AV synchrony is an attractive opti

  4. MYELODYSPLASIA FOLLOWING PAROXYSMAL-NOCTURNAL HEMOGLOBINURIA - EVIDENCE FOR THE EMERGENCE OF A SEPARATE CLONE

    NARCIS (Netherlands)

    VANKAMP, H; SMIT, JW; VANDENBERG, E; HALIE, MR; VELLENGA, E

    1994-01-01

    patient with paroxysmal nocturnal haemoglobinuria (PNH) who developed a myelodysplastic syndrome (MDS) is described. After the onset of myelodysplasia the neutrophils of the patient fully expressed GPI-linked proteins. It is concluded that the myelodysplasia does not originate from transformed PNH s

  5. Mutations in the Gene PRRT2 Cause Paroxysmal Kinesigenic Dyskinesia with Infantile Convulsions

    NARCIS (Netherlands)

    Lee, Hsien-Yang; Huang, Yong; Bruneau, Nadine; Roll, Patrice; Roberson, Elisha D. O.; Hermann, Mark; Quinn, Emily; Maas, James; Edwards, Robert; Ashizawa, Tetsuo; Baykan, Betul; Bhatia, Kailash; Bressman, Susan; Bruno, Michiko K.; Brunt, Ewout R.; Caraballo, Roberto; Echenne, Bernard; Fejerman, Natalio; Frucht, Steve; Gurnett, Christina A.; Hirsch, Edouard; Houlden, Henry; Jankovic, Joseph; Lee, Wei-Ling; Lynch, David R.; Mohammed, Shehla; Mueller, Ulrich; Nespeca, Mark P.; Renner, David; Rochette, Jacques; Rudolf, Gabrielle; Saiki, Shinji; Soong, Bing-Wen; Swoboda, Kathryn J.; Tucker, Sam; Wood, Nicholas; Hanna, Michael; Bowcock, Anne M.; Szepetowski, Pierre; Fu, Ying-Hui; Ptacek, Louis J.

    2012-01-01

    Paroxysmal kinesigenic dyskinesia with infantile convulsions (PKD/IC) is an episodic movement disorder with autosomal-dominant inheritance and high penetrance, but the causative genetic mutation is unknown. We have now identified four truncating mutations involving the gene PRRT2 in the vast majorit

  6. A high-rising epiglottis: a benign anatomical variant.

    Science.gov (United States)

    Alamri, Yassar; Stringer, Mark D

    2011-07-01

    We report an asymptomatic 10-year-old boy who was found to have a high-rising epiglottis visible in his pharynx. This benign anatomical variant is not widely recognized yet may cause anxiety to patients and their families. The prevalence of this finding is controversial, and it is uncertain whether it reflects an abnormal position, size, and/or shape of the epiglottis. It is probably more common in children, which is to be expected considering the normal descent of the larynx with postnatal growth. To date, the condition has not been associated with any significant clinical sequelae.

  7. Benign fibrous histiocytoma: A rare case involving jaw bone

    Directory of Open Access Journals (Sweden)

    Hitesh Shoor

    2015-01-01

    Full Text Available Benign fibrous histiocytoma (BFH is a soft tissue neoplasm which occurs mostly on the skin of extremities. BFH rarely occurs in bone and may affect femur, tibia, and pelvic bone. Jaw bone involvement is very unusual with only 11 cases reported till date. This report describes a case of BFH occurring in a 30-year-old female patient affecting left mandibular posterior region. Computed tomography revealed a well-defined expansile lytic lesion in the posterior mandible. Gross examination of the tumor revealed an admixture of fibroblasts and histiocytes in a fascicular and storiform pattern. Immunohistochemical staining was positive for CD68.

  8. Benign fibrous histiocytoma: A rare case involving jaw bone.

    Science.gov (United States)

    Shoor, Hitesh; Pai, Keerthilatha M; Shergill, Ankur Kaur; Kamath, Abhay Taranath

    2015-09-01

    Benign fibrous histiocytoma (BFH) is a soft tissue neoplasm which occurs mostly on the skin of extremities. BFH rarely occurs in bone and may affect femur, tibia, and pelvic bone. Jaw bone involvement is very unusual with only 11 cases reported till date. This report describes a case of BFH occurring in a 30-year-old female patient affecting left mandibular posterior region. Computed tomography revealed a well-defined expansile lytic lesion in the posterior mandible. Gross examination of the tumor revealed an admixture of fibroblasts and histiocytes in a fascicular and storiform pattern. Immunohistochemical staining was positive for CD68.

  9. Contribution of diffusion-weighted MR imaging for predicting benignity of complex adnexal masses

    Energy Technology Data Exchange (ETDEWEB)

    Thomassin-Naggara, Isabelle [Hopital Tenon, Assistance Publique Hopitaux de Pariss, Department of Radiology, Paris (France); Universite Rene Descartes, LRI-EA4062, Paris (France); Darai, Emile [Hopital Tenon, Assistance Publique Hopitaux de Pariss, Department of Gynecology-Obstetrics, Paris (France); Cuenod, Charles A.; Fournier, Laure [Universite Rene Descartes, LRI-EA4062, Paris (France); Hopital Europeen Georges Pompidou (HEGP), Assistance Publique Hopitaux de Paris, Department of Radiology, Paris (France); Toussaint, Irwin; Marsault, Claude; Bazot, Marc [Hopital Tenon, Assistance Publique Hopitaux de Pariss, Department of Radiology, Paris (France)

    2009-06-15

    The purpose of this study was to prospectively assess the contribution of diffusion-weighted MR imaging (DWI) for characterizing complex adnexal masses. Seventy-seven women (22-87 years old) with complex adnexal masses (30 benign and 47 malignant) underwent MR imaging including DWI before surgery. Conventional morphological MR imaging criteria were recorded in addition to b{sub 1,000} signal intensity and apparent diffusion coefficient (ADC) measurements of cystic and solid components. Positive likelihood ratios (PLR) were calculated for predicting benignity and malignancy. The most significant criteria for predicting benignity were low b{sub 1,000} signal intensity within the solid component (PLR = 10.9), low T2 signal intensity within the solid component (PLR = 5.7), absence of solid portion (PLR = 3.1), absence of ascites or peritoneal implants (PLR = 2.3) and absence of papillary projections (PLR = 2.3). ADC measurements did not contribute to differentiating benign from malignant adnexal masses. All masses that displayed simultaneously low signal intensity within the solid component on T2-weighted and on b{sub 1,000} diffusion-weighted images were benign. Alternatively, the presence of a solid component with intermediate T2 signal and high b{sub 1,000} signal intensity was associated with a PLR of 4.5 for a malignant adnexal tumour. DWI signal intensity is an accurate tool for predicting benignity of complex adnexal masses. (orig.)

  10. Diagnostic value of CD-10 marker in differentiating of papillary thyroid carcinoma from benign thyroid lesions

    Directory of Open Access Journals (Sweden)

    Mojgan Mokhtari

    2014-01-01

    Full Text Available Background: Using of CD10 in accordance with clinical and histological features of thyroid lesions could be used as both diagnostic and prognostic tool, which consequently influence the management and their prognosis for survival of patients with thyroid neoplasms especially papillary thyroid carcinoma (PTC. The aim of this study was to determine its expression in PTC and different benign thyroid lesions. Materials and Methods: In this descriptive-analytic, cross-sectional study, paraffin-embedded tissues of patients with definitive pathologic diagnosis of different benign thyroid lesions and PTC were retrieved. Immunostained sections of each slides was performed using immunohistochemistry methods and expression of CD10 was compared in two groups of benign thyroid lesions and PTC. Results: From selected cases 134 sections studied in two groups of PTC (n = 67 and benign thyroid lesions (n = 67. CD10 were immunohistochemically positive in 29.9% of PTC cases, but in none of the thyroid benign lesions (0% (P 0.05. Conclusion: The results of the current study indicate that due to the higher expression of CD10 in PTC than benign thyroid lesions it might be used for differentiating mentioned lesions. But for using it as a diagnostic tool further studies with larger sample size and determination of its sensitivity, specificity and cut-off point is necessary.

  11. Value of thyroid nodule ultrasonic strain elastography quantitative analysis in judging benignancy or malignancy of nodules

    Institute of Scientific and Technical Information of China (English)

    Hai-Yun Zhao; Hai-Xia Liu; Wei Tong; Jin-Zhong Huang; Chun Xiang

    2016-01-01

    Objective:To analyze the value of thyroid nodule ultrasonic strain elastography quantitative analysis in judging benignancy or malignancy of nodules.Methods: Patients diagnosed with thyroid nodule and receiving ultrasonic strain elastography quantitative analysis in our hospital were selected for study and divided into benign group and malignant group according to fine needle biopsy or the pathological results after surgical resection; mean strain values of quantitative indicators, blue region area and disorder of ultrasonic strain elastography, expression levels of malignant biological molecules in nodule tissue as well as the contents of serum tumor markers were detected.Results:Mean strain value of malignant group was lower than that of benign group, blue region area and disorder were higher than those of benign group, and standard deviation, complexity, kurtosis, skewness, contrast, equality, consistency and correlation were without significant differences; mRNA contents ofFascin-1, S100A4, STAT3, TC-1, MUC1 andMUC15 in thyroid nodules as well as serum Midkine, Galectin-3, CEACAM1 and TFF3 contents of malignant group were significantly higher than those of benign group, negatively correlated with mean strain value and positively correlated with blue region area and disorder.Conclusions:Mean strain values of quantitative indicators, blue region area and disorder of thyroid nodule ultrasonic strain elastography can judge benign or malignant nodules and assess the malignant degree.

  12. Clinical and electroencephalographic characteristics of benign occipital epilepsy of childhood in two tertiary Brazilian hospitals

    Directory of Open Access Journals (Sweden)

    Soniza Vieira Alves-Leon

    2011-08-01

    Full Text Available This study intended to investigate the clinical and electroencephalographic benign occipital epilepsy of childhood (BOEC characteristics in a population sample of patients from two tertiary Brazilian hospitals. We analyzed retrospectively 4912 electroencephalograms (EEGs records, and the included patients were submitted to a new clinical and EEG evaluation. Were included 12 (0.92% patients; 4 (33.3% with criteria for early BOEC; 6 (50% for late form and 2 (16.7% with superimposed early and late onset forms. After new investigation, 2 (16.7% had normal EEG; 4 (33.3% had paroxysms over the occipital region; 3 (25% over the temporal posterior regions and 3 (25% over the posterior regions. Sharp waves were the predominant change, occurring in 8 (66.6%; spike and slow wave complexes in 1 (8.3% and sharp and slow wave complexes in 1 (8.3%. Vomiting, headache and visual hallucinations were the most common ictal manifestations, presented in 100% of patients with superimposed forms. Vomiting were absent in the late form and headache was present in all forms of BOEC.

  13. Benign multicystic peritoneal mesothelioma: a case report

    Directory of Open Access Journals (Sweden)

    Papapaulou Leonidas

    2010-11-01

    Full Text Available Abstract Introduction We report the case of a patient with a benign multicystic peritoneal mesothelioma and describe its appearance on computed tomography scans and ultrasonography, in correlation with gross clinical and pathological findings. Case presentation A 72-year-old Caucasian woman presented to our emergency department with acute abdomen signs and symptoms. A clinical examination revealed a painful palpable mass in her left abdomen. Abdominal ultrasonography and computed tomography demonstrated the presence of a large cystic mass in her left upper abdomen, adjacent to her left hemidiaphragm. The lower border of the mass extended to the upper margin of her pelvis. A complete resection of the lesion was performed. Pathological analysis showed a benign multicystic peritoneal mesothelioma. Conclusions Benign multicystic peritoneal mesothelioma is a rare lesion with a non-specific appearance on imaging. Its diagnosis always requires pathological analysis.

  14. BENIGN BREAST DISEASE: OUR INSTITUTIONAL EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Harish Kumar

    2014-11-01

    Full Text Available BACKGROUND AND OBJECTIVES: In this modern era of change in dietary habits, life style and increased awareness about the self-breast examination, the rate of detection of breast lump is on increasing trend. Due to its enormous anatomical and physiological changes during different phases of life, breast diseases are not uncommon. The benign conditions however are also associated with morbidity and are of great concern to the patient. This study was carried out to compare the age distribution and proportion of various benign breast tumors, taking into account the various factors associated with them. A correlation of clinical and histopathological diagnosis was drawn and thus the specificity of clinical diagnosis. METHODS: Prospective review of 50 patients from General Surgery department, who are found to have benign breast tumors on clinico-pathological examination, Bowring and Lady Curzon Hospitals, attached to Bangalore Medical College & Research Institute, Bangalore selected during the period from October 2011 to April 2014 on random basis. Post-operative follow up done to note the complications both in hospital and after discharge. RESULTS: Patients predominantly presented with lump in breast were fibroadenoma and fibrocystic disease. Ductal papilloma, phyllodes tumor and lipoma were also encountered. All patients underwent FNAC. Treatment was mostly surgical in the form of excision, simple mastectomy, microdochotomy and wide local excision. All the specimens were subjected to histopathological examination. Using clinical diagnosis, FNAC and histopathology increased the accuracy of diagnosis. Cases followed up and no recurrence was found. CONCLUSIONS: Commonest benign breast tumor found was Fibroadenoma (78%. Majority of the patients were in the active reproductive age group. Fibroadenoma was more common in 2nd decade of life, whereas fibrocystic disease found in 3rd decade. Majority of benign breast lesions presented with painless lump. FNAC

  15. The study of mucin histochemistry in benign and malignant lesions of prostate

    Directory of Open Access Journals (Sweden)

    Durgaprasad N Agrawal

    2014-01-01

    Full Text Available Objective: To evaluate the usefulness of mucin stains in differentiating benign and malignant lesions of prostate. Materials and Methods: Sections were obtained from archival paraffin blocks which included randomly selected 70 cases of benign hyperplasia and 30 cases of carcinoma prostate. After confirming the diagnosis, sections were stained for Periodic Acid Schiff (PAS to study neutral mucins, Alcian blue (2.5 pH to study acidic mucins and combined Alcian blue - PAS to study the mucin character. Results: Benign hyperplasia of prostate showed positivity for neutral mucins (98.57% but not for acidic mucins, whereas prostatic carcinomas showed positivity for acidic mucins (46.66% in addition to the positivity for neutral mucins (56.66%. All the cases of low grade prostatic carcinomas showed positivity for acidic mucins but none of the high grade carcinomas showed positivity for the same. Conclusion: Positivity for acidic mucins with Alcian Blue (2.5 pH technique can be used to differentiate well differentiated adenocarcinomas of prostate from benign hyperplasia especially in those cases where prostatic lesion is a questionable malignancy either because it is so well differentiated histologically or have altered architecture so as to make it cytologically un diagnosable (P = 0.001.

  16. Radiofrequency ablation for benign thyroid nodules.

    Science.gov (United States)

    Bernardi, S; Stacul, F; Zecchin, M; Dobrinja, C; Zanconati, F; Fabris, B

    2016-09-01

    Benign thyroid nodules are an extremely common occurrence. Radiofrequency ablation (RFA) is gaining ground as an effective technique for their treatment, in case they become symptomatic. Here we review what are the current indications to RFA, its outcomes in terms of efficacy, tolerability, and cost, and also how it compares to the other conventional and experimental treatment modalities for benign thyroid nodules. Moreover, we will also address the issue of treating with this technique patients with cardiac pacemakers (PM) or implantable cardioverter-defibrillators (ICD), as it is a rather frequent occurrence that has never been addressed in detail in the literature.

  17. The decline of hysterectomy for benign disease.

    LENUS (Irish Health Repository)

    Horgan, R P

    2012-01-31

    Hysterectomy is one of the most common gynaecological surgical procedures performed but there appears to be a decline in the performance of this procedure in Ireland in recent times. We set out to establish the extent of the decline of hysterectomy and to explore possible explanations. Data for hysterectomy for benign disease from Ireland was obtained from the Hospital In-Patient Enquiry Scheme (HIPE) section of the Economic and Social Research Institute for the years 1999 to 2006. The total number of hysterectomies performed for benign disease showed a consistent decline during this time. There was a 36% reduction in the number of abdominal hysterectomy procedures performed.

  18. Benign cephalic histiocytosis: report of four cases.

    Science.gov (United States)

    de Luna, M L; Glikin, I; Golberg, J; Stringa, S; Schroh, R; Casas, J

    1989-09-01

    We cared for four patients with benign cephalic histiocytosis, a self-healing non-X, nonlipid cutaneous histiocytosis of children. The age of onset of the disease was 5 to 9 months, with papules and erythematous macules involving the head (mainly the cheeks), and posterior spread to the trunk and limbs in three patients. Microscopic examination of skin biopsies revealed a histiocytic infiltrate in the superficial dermis that was S100 protein-negative by immunoperoxidase (PAP method). One patient showed comma-shaped bodies and desmosomelike junctions on electron microscopy. No Birbeck's granules were present. Benign cephalic histiocytosis is a self-limiting condition that requires no treatment.

  19. Positive symptoms in multiple sclerosis: their treatment with sodium channel blockers, lidocaine and mexiletine.

    Science.gov (United States)

    Sakurai, M; Kanazawa, I

    1999-01-15

    Patients with multiple sclerosis (MS) often show positive symptoms of painful tonic seizure and dysesthesia as well as negative symptoms of paralysis and hypesthesia. Positive manifestation is paroxysmal and/or persistent. These are considered to be mediated by ectopic impulses generated at the site of demyelination, whereas negative symptoms are caused by conduction block. Conduction block at a demyelinated segment should reduce positive symptoms, but worsen negative ones. As reported previously, lidocaine, an Na channel blocker unmasks silent negative symptoms presumably by further reducing the action current in demyelinated portions and blocking conduction. Furthermore, because it blocks Na channels in a voltage- and frequency dependent manner, fibers that mediate positive symptoms are preferentially blocked. We administered lidocaine to 30 MS patients with positive symptoms. Lidocaine (mean plasma level, 2.4 pg/ml) almost completely abolished the paroxysmal manifestation of painful tonic seizures, neuralgic attacks, paroxysmal itching, and Lhermitte's sign. It also markedly alleviated persistent symptoms, but less so than paroxysmal symptoms. Similar effects were obtained with orally-administered mexiletine (300-400 mg/day), a derivative of lidocaine, but to a lesser extent. Na channel blockers have a dual effect on symptoms in MS, depending on whether symptoms are positive or negative. The mechanism that produces positive symptoms and the effects of the drugs on these symptoms are discussed.

  20. Emergency Treatment and Nursing of Paroxysmal Ventricular Tachycardia in Children%小儿阵发性室上性心动过速的急救与护理

    Institute of Scientific and Technical Information of China (English)

    侍海棠; 李月

    2015-01-01

    目的探讨小儿发生阵发性室上性心动过速时急救与护理措施。方法对28例阵发性室上性心动过速小儿入院后给予积极抢救、快速、准确用药,精心护理。结果28例阵发性室上性心动过速小儿全部痊愈出院,平均住院日为3d。结论及时、准确、有效地用药,积极、精心的护理,可减少阵发性室上性心动过速小儿心力衰竭等并发症的发生,促进其康复,减少住院天数。%Objective To investigate children paroxysmal supraventricular tachycardia occurs first aid and nursing.Methods 28 patients with paroxysmal supraventricular tachycardia in children admit ed to hospital after giving a positive rescue, rapid, accurate treatment, intensive care. Results 28 patients with paroxysmal supraventricular tachycardia in children al were discharged, average length of stay was three days. Conclusion Timely,accurate and ef ective medication,active,careful care,can reduce the occurrence of paroxysmal supraventricular tachycardia in children with heart failure and other complications,and to promote their recovery and reduce the length of hospital stay.

  1. Immunohistochemical Analysis of Omi/HtrA2 Expression in Prostate Cancer and Benign Prostatic Hyperplasia

    Institute of Scientific and Technical Information of China (English)

    HU Xiaoyong; CHEN Xiaochun; PING Hao; CHEN Zhaohui; ZENG Fuqing; LU Gongcheng

    2005-01-01

    To study the expression and significance of the serine protease Omi/HtrA2 in prostate cancer and benign prostatic hyperplasia. The expression of Omi/HtrA2 was assayed by means of immunohistochemical technique in 41 prostate cancer (Cap), 20 benign prostatic hyperplasia (BPH) and 10 normal prostate (NP) specimens. Omi/HtrA2 expression was positive in 30 (73.17%) prostate cancer specimens, and the positive rate of Omi/HtrA2 was lower in well differentiated than in poorly and moderately differentiated groups (P<0.05). By contrast, the cells in normal prostate and benign prostatic hyperplasia groups showed no or weak expression of Omi/HtrA2.Prostate cancer cells in vivo may need Omi/HtrA2 expression for apoptosis, and that Omi/HtrA2expression might be involved in prostate cancer development.

  2. E-cadherin and calretinin as immunocytochemical markers to differentiate malignant from benign serous effusions

    Institute of Scientific and Technical Information of China (English)

    Dong-Nan He; Hua-Sheng Zhu; Kun-He Zhang; Wen-Jian Jin; Wei-Ming Zhu; Ning Li; Jie-Shou Li

    2004-01-01

    AIM: To investigate the expressions of E-cadherin and calretinin in exfoliated cells of serous effusions and evaluate their values in distinguishing malignant effusions from benign ones.METHODS: Fresh serous effusion specimens werecentrifuged and exfoliated cells were collected. Cells were then processed with a standardized procedure, including paraformaldehyde fixation, BSA-PBS solution washing and smears preparation. E-cadherin and calretinin were detected by immunocytochemistry (ICC).RESULTS: In the exfoliated cells of serous effusions, most of carcinoma cells only expressed E-cadherin, and most of mesothelial cells only expressed calretinin, and benign cells (lymphocytes and granulocytes) did not express either of them. For E-cadherin, 85.7% (30/35) of malignant effusions and 8.1% (3/37) of benign fluids were ICC-positive (P<0.001).The sensitivity of E-cadherin ICC in the diagnosis of malignant effusions was 85.7%, specificity 91.9%, and diagnostic rate 88.9%. For calretinin, 94.6% (35/37) of benign effusions and 11.4% (4/35) of malignant effusions were ICC-positive (P<0.001). The sensitivity of calretinin ICC in the diagnosis of benign effusions was 94.6%,specificity 88.6%, and diagnostic rate 91.7%. For diagnosis of benign and malignant effusions by combining E-cadherin ICC and calretinin ICC, the specificities were up to 100%and 97.1%, respectively.CONCLUSION: E-cadherin ICC and calretinin ICC are sensitive and specific in differential diagnosis of benign and malignant serous effusion specimens and specificities are evidently improved when both markers are combined.

  3. Cd117 and Cd34 Staining Patterns in Childhood Benign Mammary Lesions

    Directory of Open Access Journals (Sweden)

    Ayper KAÇAR

    2012-01-01

    Full Text Available Objective: CD117 and CD34 are markers that have both been implied in cancer progression in adult breast lesions. This study was conducted in order to create a retrospective documentation and to analyze the expression patterns of these markers on childhood benign lesions along with a comparison with adult breast lesions’ staining patterns.Material and Method: Nine fibroadenomas, 2 tubular adenomas, 1 mammary hamartoma, 2 gynecomastias, 1 benign phyllodes tumor were retrieved from pathology archives of two reference centers between 2005-2010.Results: CD117 staining was identified in the epithelium of all cases in fibroadenoma/tubular adenoma group and focally positive in 1 mammary hamartoma, 2 gynecomastias, and 1 benign phyllodes tumor. CD117 staining was detected in the stroma of 8 cases. Three fibroadenomas, 1 mammary hamartoma, 2 gynecomastias and 1 benign phyllodes tumor lacked stromal labelling for this marker. All cases were strongly and diffusely positive for CD34 except the benign phyllodes tumor case. This case presented marked loss of stromal CD34 staining when compared to the surrounding stroma. Additionally, pseudoangiomatous stromal hyperplasia was noted in 2 gynecomastias and in the peritumoral stroma of benign phyllodes tumor case.Conclusion: Our study demonstrated that fibroadenoma was the most commonly encountered breast lesion in childhood and that adolescent fibroadenomas showed similar staining patterns for CD117 and CD34 as for adult counterparts. On the other hand, different expression patterns of CD117 and CD34 between adenoma group and the gynecomastias and benign phyllodes tumor group may implicate different mechanisms of development and tumorigenesis among these groups.

  4. Corrected QT dispersion as a predictor of the frequency of paroxysmal tachyarrhythmias in patients with Wolff–Parkinson–White syndrome

    Directory of Open Access Journals (Sweden)

    Eid M. Daoud

    2014-04-01

    Conclusion: Calculation of QTcd in patients with WPW syndrome presented with paroxysmal tachyarrhythmias is a simple noninvasive clinical test for risk stratification of those patients and hence detecting patients at higher risk for frequent and recurrent tachyarrhythmias.

  5. Failure of long-term digitalization to prevent rapid ventricular response in patients with paroxysmal atrial fibrillation.

    Science.gov (United States)

    Galun, E; Flugelman, M Y; Glickson, M; Eliakim, M

    1991-04-01

    Digitalis is frequently prescribed to patients with paroxysmal atrial fibrillation to reduce the ventricular rate during subsequent paroxysms. To verify the validity of this assumption, we determined the ventricular rate during paroxysmal atrial fibrillation in 13 patients receiving long-term digoxin therapy (mean plasma digoxin level + 1.28 +/- 0.4 ng/ml) and compared it with that of a group of 14 patients who had not taken digoxin or beta-adrenergic and calcium-blocking agents before the attack. The treated and the untreated groups were similar statistically. The mean ventricular rate of the digitalized patients was 121 +/- 15 beats per minute, while that of the patients in the control group was 118 +/- 16 beats per minute. It is concluded that long-term digoxin therapy is not effective in reducing the ventricular response in patients with paroxysmal atrial fibrillation despite adequate therapeutic levels.

  6. Urodynamic implications of benign prostatic hyperplasia

    DEFF Research Database (Denmark)

    Jensen, K M; Andersen, J T

    1990-01-01

    By the age of 60, about 70% of men have developed benign prostatic hyperplasia (BPH), and 85%-95% of these have symptomatic dysfunction of the lower urinary tract, 10%-20% undergoing prostatectomy. Although transurethral resection of the prostate is generally considered to be a safe and effective...

  7. Laparoscopic Management of Benign Ovarian Masses

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    Rachana Saha

    2013-12-01

    Full Text Available Introduction: Laparoscopic surgery is one of the most common procedures performed for benign ovarian masses. The aim of the study was to analyze all benign ovarian masses treated laparoscopically to assess safety, feasibility and outcome. Methods: A prospective study was carried out at Kathmandu Medical College Teaching Hospital, Sinamangal, Nepal. All the patients undergoing laparoscopic surgery for benign ovarian masses from 1st January 2012 to 31st December 2012 were included in the study. The pre-operative findings, intra-operative findings, operative techniques and post-operative complications were analyzed. Results: Thirty-six patients were taken for the study. Two cases were excluded since intra-operatively they were tubo-ovarian masses. The most common tumor was dermoid cyst (n=13; 38.23% and endometriotic cyst (n=14; 41.17%. Out of 34 cases, five cases of endometriotic cyst (14.70% were converted to laparotomy due to severe adhesions and four cases of endometriotic cyst underwent deroofing surgery. Two cases underwent laparoscopic assisted vaginal hysterectomy with bilateral salphingo-oopherectomy. Successful cystectomies were carried out in 22 cases. None were malignant. Major complications were not noted while minor complications like port-site infection (n=3; 8.82% and subcutaneous emphysema (n=1; 2.9% were present. Conclusions: Laproscopic management of benign ovarian masses is safe and feasible.

  8. Imaging features of benign adrenal cysts

    Energy Technology Data Exchange (ETDEWEB)

    Sanal, Hatice Tuba [Department of Radiology, Gulhane Military Medical Academy, Ankara (Turkey)]. E-mail: tubasanal@yahoo.com; Kocaoglu, Murat [Department of Radiology, Gulhane Military Medical Academy, Ankara (Turkey); Yildirim, Duzgun [Department of Radiology, Gulhane Military Medical Academy, Ankara (Turkey); Bulakbasi, Nail [Department of Radiology, Gulhane Military Medical Academy, Ankara (Turkey); Guvenc, Inanc [Department of Radiology, Gulhane Military Medical Academy, Ankara (Turkey); Tayfun, Cem [Department of Radiology, Gulhane Military Medical Academy, Ankara (Turkey); Ucoz, Taner [Department of Radiology, Gulhane Military Medical Academy, Ankara (Turkey)

    2006-12-15

    Benign adrenal gland cysts (BACs) are rare lesions with a variable histological spectrum and may mimic not only each other but also malignant ones. We aimed to review imaging features of BACs which can be helpful in distinguishing each entity and determining the subsequent appropriate management.

  9. Benign prostatic hyperplasia: symptoms and objective interpretation

    DEFF Research Database (Denmark)

    Andersen, J T

    1991-01-01

    Considerable new knowledge about benign prostatic hyperplasia has been gained over the past two decades, particularly with regard to its natural history, hydrodynamic changes in the lower urinary tract, and the symptomatic and urodynamic results of treatment. A survey of the literature has been u...

  10. Twenty-eight day Holter monitoring is poorly tolerated and insensitive for paroxysmal atrial fibrillation detection in cryptogenic stroke.

    Science.gov (United States)

    Tu, H T; Spence, S; Kalman, J M; Davis, S M

    2014-05-01

    This pilot study in a prospective cohort of 20 cryptogenic stroke patients showed that a significant proportion has paroxysmal atrial fibrillation undetected by 24-h Holter monitoring. However, longer monitoring with 28-day Holter was poorly tolerated and still insufficiently sensitive for paroxysmal atrial fibrillation detection. Further studies are urgently needed to elucidate the optimal timing, method and duration of cardiac rhythm monitoring following ischaemic stroke.

  11. Natural history of benign prostate hyperplasia

    Institute of Scientific and Technical Information of China (English)

    WU Shi-liang; LI Ning-chen; XIAO Yun-xiang; JIN Jie; QIU Shao-peng; YE Zhang-qun; KONG Chui-ze; SUN Guang; NA Yan-qun

    2006-01-01

    Background Benign prostate hyperplasia is one of the most common diseases affecting the health of the aging males. Watchful waiting is an acceptable management strategy for benign prostate hyperplasia in which the patient is monitored by the physician but receives no active intervention. The epidemiological data on this are lacking in China. Our study was designed to evaluate the changes of signs and symptoms of patients with benign prostate hyperplasia during management by watchful waiting in China.Methods One hundred and forty-five patients with benign prostate hyperplasia aged > 50 years were enrolled in management by watchful waiting. All the patients were visited every 6 months and were given an International Prostate Symptom Score and Quality of Life questionnaire to complete. They also had uroflowmetry and were assessed using ultrasonography to get the volume of prostate, transition zone and amount of residual urine. The Student's t test, the Chi-square test, and variance analysis were used in the statistical analysis.Results All patients were visited after 6 months, the mean volume of transitional zone was found to haveincreased by 1.6 ml (P<0.01), International Prostate Symptom Score was increased by 0.8 (P<0.01) and Quality of Life was increased by 0.2 (P<0.01), and there was no statistical change in other data. Among these patients,17.9% (26/145) visited again after 12 months when the data failed to show a statistically significant difference among the three groups (0, 6, and 12 months).Conclusions After one year's follow-up, the progression of benign prostate hyperplasia was slow and the clinical data did not undergo much change.

  12. Endo-biliary stents for benign disease: not always benign after all!

    Directory of Open Access Journals (Sweden)

    Jo-Etienne Abela

    2011-11-01

    Full Text Available This case report describes the presentation, management and treatment of a patient who suffered small bowel perforation due to the migration of his biliary stent which had been inserted for benign disease.

  13. When does good envy turn into bad envy? The relationship between benign and malicious envy

    NARCIS (Netherlands)

    Hellen, K.; Saaksjarvi, M.C.

    2012-01-01

    Previous research has distinguished between forms of envious reactions - malicious envy that is characterized by hostile feelings leading to negative consequences for firms and benign envy that is free of hostility and leading to positive consequences. In this paper, we focus on identifying conditio

  14. DNA Cytometry and Nuclear Morphometry in Ovarian Benign, Borderline and Malignant Tumors

    Science.gov (United States)

    el Din, Amina A. Gamal; Badawi, Manal A.; Aal, Shereen E. Abdel; Ibrahim, Nihad A.; Morsy, Fatma A.; Shaffie, Nermeen M.

    2015-01-01

    BACKDROUND: Ovarian carcinoma is a leading cause of death in gynecological malignancy. Ovarian surface epithelial serous and mucinous tumours are classified as benign, borderline, and malignant. The identification of borderline tumours most likely to act aggressively remains an important clinical issue. AIM: This work aimed to study DNA ploidy and nuclear area in ovarian serous and mucinous; benign, borderline and malignant tumours. MATERIAL AND METHODS: This study included forty ovarian (23 serous and 17 mucinous) tumours. Paraffin blocks were sectioned; stained with haematoxylin and eosin for histopathologic and morphometric studies and with blue feulgen for DNA analysis. RESULTS: All four serous and six out of nine mucinous benign tumours were diploid. All eight serous and five mucinous malignant tumours were aneuploid. Nine of eleven (81.8%) serous and all three mucinous borderline tumours were aneuploid. There were highly significant differences in mean aneuploid cells percentage between serous benign (1.5%), borderline (45.6%) and malignant (74.5%) (p = 0.0001) and between mucinous benign (13.2%) and both borderline (63.7%) and malignant (68.4%) groups (p = 0.0001). There were significant differences in nuclear area between serous benign (26.191%), borderline (45.619%) and malignant (67.634 %) and a significant positive correlation between mean percentage aneuploid value and mean nuclear area in all serous and mucinous groups. CONCLUSION: We suggest that DNA ploidy and nuclear area combined, may be adjuncts to histopathology; in ovarian serous and mucinous benign, borderline and malignant neoplasms; identifying the aggressive borderline tumours. PMID:27275284

  15. [The clinical characteristics of endogenous mental diseases with paroxysm-like disorders].

    Science.gov (United States)

    Chikovani, G O

    1997-01-01

    Paroxysmal-like disorders (PLD) were observed in 11 patients with manic-depressive psychosis and in 34 ones with shift-like progredient schizophrenia. 8 variations of the fits were described by the author earlier and included the states from vegetative fits to complex psychotic ones with manifestations of Kandinsky-Clérambault syndrome. Clinical pattern of endogenous psychoses was characterized by considerable presence of affective disorders (both hypomanic and depressive), moreover depressive disturbances were observed more frequently. Debut of PLD was mentioned either before depressions' or in their structure: The appearance of psychotic symptoms in structure of affective phases does not change the character of paroxysmal-like states. It was supposed that endogenous diseases with PLD are the special variant of psychoses.

  16. [Identification of paroxysmal, transient arrhythmias: Intermittent registration more efficient than the 24-hour Holter monitoring].

    Science.gov (United States)

    Hendrikx, Tijn; Rosenqvist, Mårten; Sandström, Herbert; Persson, Mats; Hörnsten, Rolf

    2015-01-06

    Many patients suffer from palpitations or dizziness/presyncope. These patients are often referred for Holter ECG (24 hour), although the sensitivity for detecting arrhythmias is low. A new method, short intermittent regular and symptomatic ECG registrations at home, might be a convenient and more sensitive alternative also suitable for primary health care. In this case report we present a patient who had contacted health care several times during a seven year period for paroxysmal palpitations. Routine examination with 24 hour Holter ECG and event recorder did not result in a diagnosis. Using intermittent handheld ECG registration at home, a paroxysmal supraventricular arrhythmia was diagnosed. Further investigation revealed that the patient had a concealed Wolff-Parkinson-White (WPW) syndrome.

  17. Paroxysmal nocturnal hemoglobinuria associated with venous thrombosis and papillary endothelial hyperplasia presenting as ulcerated duodenal mass.

    Science.gov (United States)

    Dunphy, C H; Sotelo-Avila, C; Luisiri, A; Chu, J Y

    1994-08-01

    Paroxysmal nocturnal hemoglobinuria is an acquired clonal expansion of bone marrow stem cells that are deficient in the decay-accelerating factor, which is a complement regulatory glycoprotein (CD55), as well as in the membrane inhibitor of reactive lysis (CD59) and the C8-binding protein. These proteins are deficient on the membranes of red blood cells, granulocytes, monocytes, and platelets. The disorder is associated with intermittent hemolytic anemia, hemoglobinuria, infection, a tendency toward bone marrow aplasia, and venous thromboses. The thromboses, on resolution, may give rise to endothelial proliferation that may cause ischemia and ulceration, or, alternatively, the thromboses may cause ulceration leading to a granulation tissue response with exaggerated endothelial proliferation. We report a second case of paroxysmal nocturnal hemoglobinuria that presented roentgenographically as an ulcerated circumferential duodenal mass secondary to venous thrombosis accompanied by florid papillary endothelial hyperplasia. We also review the literature concerning this phenomenon.

  18. Labile and Paroxysmal Hypertension: Common Clinical Dilemmas in Need of Treatment Studies.

    Science.gov (United States)

    Mann, Samuel J

    2015-11-01

    Although "labile hypertension" is regularly encountered by clinicians, there is a paucity of information available to guide therapeutic decisions. This review discusses its clinical relevance, the limitations of current knowledge, and possible directions for future research and clinical management. Results of studies that assessed measures of blood pressure variability or reactivity are reviewed. The limited information about effects of antihypertensive drugs on blood pressure variability is discussed. Two different clinical presentations are differentiated: labile hypertension and paroxysmal hypertension. Labile hypertension remains a clinical impression without defined criteria or treatment guidance. Paroxysmal hypertension, also called pseudopheochromocytoma, presents as dramatic episodes of abrupt and severe blood pressure elevation. The disorder can be disabling. Although it regularly raises suspicion of a pheochromocytoma, such a tumor is found in <2 % of patients. The cause, which involves both emotional factors and the sympathetic nervous system, and treatment approaches, are presented.

  19. Benign Multicystic Mesothelioma in the Left Round Ligament: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Bae, So Young; Yi, Boem Ha; Lee, Hae Kyung; Park, Seong Jin; Cho, Gyu Seok; Kwak, Jeong Ja [Soonchunhyang University Bucheon Hospital, Bucheon (Korea, Republic of)

    2010-02-15

    Benign multicystic mesothelioma is a rare mesothelial lesion that forms multicystic masses in the upper abdomen, pelvis, and retroperitoneum. Most cases have a benign course. We present the ultrasound and MR findings of benign multicystic mesothelioma in the left round ligament, which caused a left inguinal hernia in a 46-year-old woman.

  20. BENIGN PAROTID TUMORS : AN EXPERIENCE IN A GENERAL SURGICAL UNIT

    Directory of Open Access Journals (Sweden)

    Vijaya

    2015-04-01

    Full Text Available Parotid tumors are mostly benign, but their evaluation and treatment require a thorough knowledge of the relevant anatomy and pathology. Surgical treatment of benign tumors is aimed at complete removal of the mass with facial nerve preservation. The aim of this study was to evaluate the post - operative complications of superficial parotidectomy in benign parotid tumors.

  1. Paroxysmal dysarthria-ataxia in remitting-relapsing Bickerstaff's-like encephalitis.

    Science.gov (United States)

    Piffer, Silvio; Turri, Giulia; Acler, Michele; Richelli, Silvia; Cerini, Roberto; Fiaschi, Antonio; Monaco, Salvatore; Bonetti, Bruno

    2014-06-15

    Paroxysmal dysarthria-ataxia is a rare neurological condition due to ephaptic transmission, generally appearing in multiple sclerosis patients characterized by stereotyped attacks of slurred speech usually accompanied by ataxia, appearing many times a day. Here we describe a patient with an unusual remitting-relapsing form of Bickerstaff's-like brainstem encephalitis who manifested PDA after a relapse with the involvement of a peculiar region below the red nuclei and benefited from lamotrigine.

  2. [Anterior Mediastinal Bronchogenic Cyst Associated with paroxysmal supraventricular tachycardia ; Report of a Case].

    Science.gov (United States)

    Mega, Seiji

    2015-09-01

    We experienced a rare case of anterior mediastinal bronchogenic cyst. A 55-year-old female was admitted to our hospital because of paroxysmal supraventricular tachycardia (PSVT) and an abnormal shadow on the chest computed tomography. She had a 5.5 cm tumor at anterior mediastinum. The tumor was surgically removed completely by video assisted thoracoscopic surgery, and the diagnosis of bronchogenic cyst was established pathologically. After surgery, PSVT has disappeared.

  3. Potassium Model for Slow (2-3 Hz) In Vivo Neocortical Paroxysmal Oscillations

    Science.gov (United States)

    Bazhenov, M.; Timofeev, I.; Steriade, M.; Sejnowski, T. J.

    2010-01-01

    In slow neocortical paroxysmal oscillations, the de- and hyperpolarizing envelopes in neocortical neurons are large compared with slow sleep oscillations. Increased local synchrony of membrane potential oscillations during seizure is reflected in larger electroencephalographic oscillations and the appearance of spike- or polyspike-wave complex recruitment at 2- to 3-Hz frequencies. The oscillatory mechanisms underlying this paroxysmal activity were investigated in computational models of cortical networks. The extracellular K+ concentration ([K+]o) was continuously computed based on neuronal K+ currents and K+ pumps as well as glial buffering. An increase of [K+]o triggered a transition from normal awake-like oscillations to 2- to 3-Hz seizure-like activity. In this mode, the cells fired periodic bursts and nearby neurons oscillated highly synchronously; in some cells depolarization led to spike inactivation lasting 50–100 ms. A [K+]o increase, sufficient to produce oscillations could result from excessive firing (e.g., induced by external stimulation) or inability of K+ regulatory system (e.g., when glial buffering was blocked). A combination of currents including high-threshold Ca2+, persistent Na+ and hyperpolarization-activated depolarizing (Ih) currents was sufficient to maintain 2- to 3-Hz activity. In a network model that included lateral K+ diffusion between cells, increase of [K+]o in a small region was generally sufficient to maintain paroxysmal oscillations in the whole network. Slow changes of [K+]o modulated the frequency of bursting and, in some case, led to fast oscillations in the 10- to 15-Hz frequency range, similar to the fast runs observed during seizures in vivo. These results suggest that modifications of the intrinsic currents mediated by increase of [K+]o can explain the range of neocortical paroxysmal oscillations in vivo. PMID:15056684

  4. The feasibility of a Box isolation strategy for non-paroxysmal atrial fibrillation in elderly patients

    OpenAIRE

    Higuchi, Satoshi; Sohara, Hiroshi; Nakamura, Yoshinori; Ihara, Minoru; Yamaguchi, Yoshio; Shoda, Morio; Hagiwara, Nobuhisa; Satake, Shutaro

    2016-01-01

    Background Catheter ablation of non-paroxysmal atrial fibrillation (non-PAF) is a therapeutic challenge especially in elderly patients. This study describes the feasibility of a posterior left atrium isolation as a substrate modification in addition to pulmonary vein isolation, the so-called Box isolation, for elderly patients with non-PAF. Methods Two hundred twenty-nine consecutive patients who underwent Box isolations for drug-refractory non-PAF were divided into two groups according to th...

  5. Cerebral venous thrombosis presenting with intracerebral hemorrhage in a patient with paroxysmal nocturnal hemoglobinuria

    Directory of Open Access Journals (Sweden)

    Gentle Sunder Shrestha

    2016-01-01

    Full Text Available Cerebral venous thrombosis (CVT is an uncommon cause of stroke. Paroxysmal nocturnal hemoglobinuria (PNH is a rare type of hemolytic anemia, frequently associated with thrombophilia. PNH may rarely present with CVT. Approximately, one-third of the patients with CVT develop cerebral hemorrhage. Here, we present a rare combination of CVT presenting with intracerebral hemorrhage in a patient with PNH. High index of suspicion is needed to avoid misdiagnosis. Patient was successfully managed with anticoagulation therapy.

  6. Multiparameter FLAER-based flow cytometry for screening of paroxysmal nocturnal hemoglobinuria enhances detection rates in patients with aplastic anemia.

    Science.gov (United States)

    Sachdeva, Man Updesh Singh; Varma, Neelam; Chandra, Dinesh; Bose, Parveen; Malhotra, Pankaj; Varma, Subhash

    2015-05-01

    Flow cytometry is the gold standard methodology for screening of paroxysmal nocturnal hemoglobinuria. In the last few years, proaerolysin conjugated with fluorescein (FLAER) has become an important component of antibody panel used for the detection of paroxysmal nocturnal hemoglobinuria (PNH) clone. This study aimed to compare PNH clone detection by flow cytometry in the pre-FLAER era versus the FLAER era. This was a retrospective analysis of 4 years and included 1004 individuals screened for PNH clone, either presenting as hemolytic anemia or as aplastic anemia. In the pre-FLAER time period, the RBCs and neutrophils were screened with antibodies against CD55 and CD59. With the introduction of FLAER, neutrophils were screened with FLAER/CD24/CD15 and monocytes with FLAER/CD14/CD33 combination. A comparative analysis was done for detection of PNH clone in aplastic anemia patients versus non-aplastic anemia patients, as well as between pre-FLAER and FLAER era. Out of a total of 1004 individuals, 59 (5.8%) were detected to have PNH clone positivity. The frequency of PNH clone detected in aplastic anemia and non-aplastic anemia groups was 12.02 and 3.36%, respectively. The detection rate of PNH clone increased from 4.5% (32/711) in the pre-FLAER era to 9.2% (27/293) with the introduction of FLAER. However, this increase could be attributed to increased detection of PNH clone in the aplastic anemia group, which showed a significant increase from 8.3 to 18.2% after use of FLAER. In the non-aplastic group, PNH clone was detected with similar frequencies before and after use of FLAER (3.2 versus 3.8%, respectively). Mean PNH clone size was lower in the aplastic anemia group when compared with the non-aplastic group. RBCs always showed a lower clone size than neutrophils. PNH clone on neutrophils and monocytes was however similar. Inclusion of FLAER increases the sensitivity of the test which is especially useful in picking up small PNH clones in patients of aplastic anemia.

  7. Benign solitary solid cold thyroid nodules

    DEFF Research Database (Denmark)

    Døssing, Helle; Bennedbaek, Finn Noe; Karstrup, Steen;

    2002-01-01

    PURPOSE: To evaluate the effects of ultrasonography (US)-guided interstitial laser photocoagulation (ILP) on the volume of benign solitary solid cold thyroid nodules and any nodule-related symptoms. MATERIALS AND METHODS: ILP was performed in 16 patients with normal thyroid function and a solid...... to evaluate the size of the untreated thyroid nodule. RESULTS: In the 16 patients treated with ILP, the mean thyroid nodule volume decreased from 10 to 5.4 mL (P .... Pressure symptoms were significantly reduced (P =.0002) after 6 months. The treatment was well-tolerated in all patients. No significant change in thyroid nodule volume was seen in the control group. CONCLUSION: US-guided ILP could become a useful nonsurgical alternative in the treatment of the benign...

  8. Characteristics of benign lymphoadenosis of oral mucosa

    Institute of Scientific and Technical Information of China (English)

    Shu-Xia Li; Shi-Feng Yu; Kai-Hua Sun

    2005-01-01

    AIM: To investigate the pathological characteristics and carcinogenesis mechanism of benign lymphoadenosis of oral mucosa (BLOM).METHODS: The expressions of Ki-67, CD34 and apoptosis were evaluated by immunohistochemical SP staining in 64 paraffin-embedded tissue samples. Of them, 9 were from BLOM with dysplasia, 15 from BLOM without dysplasia,15 from oral squamous cell carcinoma (OSCC), 15 from oral precancerosis, and 10 from normal tissues. Cell proliferation, apoptosis and angiogenesis of tissue samples were also analyzed.RESULTS: The expression of Ki-67 in BLOM with dysplasia,oral precancerosis and OSCC was significantly higher than in BLOM without dysplasia and normal mucosa. The microvascular density (MVD) in BLOM with and without dysplasia, oral precancerosis, and OSCC was significantly higher than in normal mucosa. Apoptosis in BLOM and oral precancerosis was significantly higher than in OSCC and normal mucosa.CONCLUSION: Benign lymphoadenosis of oral mucosa has potentialities of cancerization.

  9. Endoscopic therapy of benign biliary strictures

    Institute of Scientific and Technical Information of China (English)

    Joel R Judah; Peter V Draganov

    2007-01-01

    Benign biliary strictures are being increasingly treated with endoscopic techniques. The benign nature of the stricture should be first confirmed in order to ensure appropriate therapy. Surgery has been the traditional treatment, but there is increasing desire for minimally invasive endoscopic therapy. At present, endoscopy has become the first line approach for the therapy of postliver transplant anastomotic strictures and distal (Bismuth Ⅰ and Ⅱ) post-operative strictures. Strictures related to chronic pancreatitis have proven more difficult to treat,and endoscopic therapy is reserved for patients who are not surgical candidates. The preferred endoscopic approach is aggressive treatment with gradual dilation of the stricture and insertion of multiple plastic stents. The use of uncovered self expandable metal stents should be discouraged due to poor long-term results. Treatment with covered metal stents or bioabsorbable stents warrants further evaluation. This area of therapeutic endoscopy provides an ongoing opportunity for fresh research and innovation.

  10. [Benign Metastasizing Leiomyoma of the Lung;Report of a Case].

    Science.gov (United States)

    Sawada, Takahiro; Yamamoto, Satoshi; Sugihara, Hajime; Iwasaki, Akinori

    2017-02-01

    A 71-year-old woman, in whom computed tomography revealed a solitary mass shadow at the base of the left lung, underwent resection of the mass. Histopathological examination showed estrogen receptor-positive leiomyoma cells growing in cords and mixed with glandular structures composed of alveolar cells. These findings led to a diagnosis of benign metastatic leiomyoma. Benign metastatic leiomyoma is a rare disease in which histologically benign uterine leiomyoma cells metastasize to different sites of the body. However, in this patient, the presence of uterine myoma was not confirmed in the past or at present. She had a history of cervical conization, which suggests that a small amount of the leiomyoma component contained in cervical tissue may have been forced into blood vessels during surgical manipulation, causing lung metastasis.

  11. [Do envious people show better performance?: Focusing on the function of benign envy as personality trait].

    Science.gov (United States)

    Sawada, Masato; Fujii, Tsutomu

    2016-06-01

    This study focused on the differences between two, subtypes of envy known as "benign envy" and "malicious envy" as personality traits, and examined the effects of these traits on academic achievement. Two hundred fifty-one university students participated in the study. Both benign envy and malicious envy were found to be independent as also found in a previous study by Lange & Crusius (2015), and a high criterion-related validity was revealed by an association with characteristic variables such as dispositional envy and self-esteem. The students with higher levels of benign envy were found to set goals higher, and as a result achieved higher levels of academic performance. In contrast, no such effect was found for malicious envy. The importance of focusing more attention on the positive aspects of the emotion of envy is discussed.

  12. Paroxysmal itch caused by gain-of-function Nav1.7 mutation.

    Science.gov (United States)

    Devigili, Grazia; Eleopra, Roberto; Pierro, Tiziana; Lombardi, Raffaella; Rinaldo, Sara; Lettieri, Christian; Faber, Catharina G; Merkies, Ingemar S J; Waxman, Stephen G; Lauria, Giuseppe

    2014-09-01

    Itch is a common experience. It can occur in the course of systemic diseases and can be a manifestation of allergies or a consequence of diseases affecting the somatosensory pathway. We describe a kindred characterized by paroxysmal itch caused by a variant in SCN9A gene encoding for the Nav1.7 sodium channel. Patients underwent clinical and somatosensory profile assessment by quantitative sensory testing, nerve conduction study, autonomic cardiovascular reflex, and sympathetic skin response examination, skin biopsy with quantification of intraepidermal nerve fiber density, and SCN9A mutational analysis. The index patient, her mother, and a sister presented with a stereotypical clinical picture characterized by paroxysmal itch attacks involving the shoulders, upper back, and upper limbs, followed by transient burning pain, and triggered by environmental warmth, hot drinks, and spicy food. Somatosensory profile assessment demonstrated a remarkably identical pattern of increased cold and pain thresholds and paradoxical heat sensation. Autonomic tests were negative, whereas skin biopsy revealed decreased intraepidermal nerve fiber density in 2 of the 3 patients. All affected members harbored the 2215A>G I739V substitution in exon 13 of SCN9A gene. Pregabalin treatment reduced itch intensity and attack frequency in all patients. The co-segregation of the I739V variant in the affected members of the family provides evidence, for the first time, that paroxysmal itch can be related to a mutation in sodium channel gene.

  13. Hemicrania continua changed to chronic paroxysmal hemicrania after treatment with cyclooxygenase-2 inhibitor.

    Science.gov (United States)

    Müller, Kai Ivar; Bekkelund, Svein Ivar

    2011-02-01

    Remission of hemicrania continua (HC) and transformation from HC to chronic paroxysmal hemicrania (CPH) are unusual. We report a patient with left-sided HC who, after a period of remission, presented as CPH. The continuous HC headache disappeared completely after initiating treatment with cyclooxygenase (COX)-2 inhibitor, but reappeared on the same side after 14 months remission with paroxysmal, frequent, intense and short-lasting headache attacks accompanied by ipsilateral cranial autonomic symptoms. This happened shortly after the treatment was discontinued because of withdrawal of the COX-2 inhibitor from the market. The response to indomethacin was prompt, and the patient became completely free from her paroxysmal headache with a dose of 50 mg 2 times daily. This case questions a possible modification effect on the course of HC by use of COX-2 inhibitor, as well as further supporting that some aspects of the pathophysiology of HC may resemble those of CPH, and may argue for common biological mechanisms in HC and CPH.

  14. Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix

    Science.gov (United States)

    Raś, Renata; Książek, Mariusz; Skręt-Magierło, Joanna; Kąziołka, Wojciech; Fudali, Ludmiła; Filipowska, Justyna; Skręt, Andrzej

    2016-01-01

    Benign metastasizing leiomyoma (BML) usually are situated in one organ, most often in lungs. BML patients typically have a history of uterine leiomyoma treated with hysterectomy, myomectomy or subtotal hysterectomy. The aim of the study was to present the case of a 53-year-old woman with triple location in the lungs, parametria and appendix. She had undergone a myomectomy 26 years earlier. In 2015, she was admitted to the surgical department because of abdominal pain, whereupon a cholecystectomy was performed. CT scans showed pelvic mass with pulmonary metastasis. Upon discharge the patient was referred to the Gynecology Clinic, where a laparotomy was performed. The intraoperative findings were: 1) uterus with multiple leiomyomas, 2) four tumors in the parametria, 3) tumor connected to the appendix. A subtotal hysterectomy, with a bilateral salpingo-oophorectomy, removal of the tumors from the parametria and appendectomy was performed. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining (strongly positive for estrogen receptors and SMA, while Ki67 was very low, below 1%). Upon postoperative recovery, the patient was referred to the Thoracic Surgery Department. During the thoracotomy, multiple nodes, surrounded by lung parenchyma, were revealed. Wedge resection was performed, for localized pulmonary lesions, and sent for pathological examination. The final pathological diagnosis was benign metastasizing leiomyomatosis. In conclusion, the triple location of BML could possibly be a result of a parallel different metastasizing mechanism, although it is impossible to exclude one mechanism, which may be the cause of the metastases in three locations. PMID:27582687

  15. Percutaneous treatment of benign bile duct strictures

    Energy Technology Data Exchange (ETDEWEB)

    Koecher, Martin [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)]. E-mail: martin.kocher@seznam.cz; Cerna, Marie [Department of Radiology, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Havlik, Roman [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Kral, Vladimir [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Gryga, Adolf [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic); Duda, Miloslav [Department of Surgery, University Hospital, I.P.Pavlova 6, 775 20 Olomouc (Czech Republic)

    2007-05-15

    Purpose: To evaluate long-term results of treatment of benign bile duct strictures. Materials and methods: From February 1994 to November 2005, 21 patients (9 men, 12 women) with median age of 50.6 years (range 27-77 years) were indicated to percutaneous treatment of benign bile duct stricture. Stricture of hepatic ducts junction resulting from thermic injury during laparoscopic cholecystectomy was indication for treatment in one patient, stricture of hepaticojejunostomy was indication for treatment in all other patients. Clinical symptoms (obstructive jaundice, anicteric cholestasis, cholangitis or biliary cirrhosis) have appeared from 3 months to 12 years after surgery. Results: Initial internal/external biliary drainage was successful in 20 patients out of 21. These 20 patients after successful initial drainage were treated by balloon dilatation and long-term internal/external drainage. Sixteen patients were symptoms free during the follow-up. The relapse of clinical symptoms has appeared in four patients 9, 12, 14 and 24 months after treatment. One year primary clinical success rate of treatment for benign bile duct stricture was 94%. Additional two patients are symptoms free after redilatation (15 and 45 months). One patient is still in treatment, one patient died during secondary treatment period without interrelation with biliary intervention. The secondary clinical success rate is 100%. Conclusion: Benign bile duct strictures of hepatic ducts junction or biliary-enteric anastomosis are difficult to treat surgically and endoscopically inaccessible. Percutaneous treatment by balloon dilatation and long-term internal/external drainage is feasible in the majority of these patients. It is minimally invasive, safe and effective.

  16. Large Penile Mass With Unusual Benign Histopathology

    Directory of Open Access Journals (Sweden)

    Nate Johnson

    2015-09-01

    Full Text Available Pseudoepitheliomatous hyperplasia is an extremely rare condition presenting as a lesion on the glans penis in older men. Physical exam without biopsy cannot differentiate malignant from nonmalignant growth. We report a case of large penile mass in an elderly male with a history of lichen sclerosis, highly suspicious for malignancy. Subsequent surgical removal and biopsy demonstrated pseudoepitheliomatous hyperplasia, an unusual benign histopathologic diagnosis with unclear prognosis. We review the literature and discuss options for treatment and surveillance.

  17. [Benign prostatic hypertrophy and prostate cancer].

    Science.gov (United States)

    Mourey, Loïc; Doumerc, Nicolas; Gaudin, Clément; Gérard, Stéphane; Balardy, Laurent

    2014-01-01

    Prostatic diseases are extremely common, especially in older men. Amongst them, benign prostatic hypertrophy may affect significantly the quality of life of patients by the symptoms it causes. It requires appropriate care. Prostate cancer is the second most common cancer in men after lung cancer and the fifth leading cause of cancer deaths in the world. It affects preferentially older men. An oncogeriatric approach is required for personalised care.

  18. Laparoscopic resection of retroperitoneal benign neurilemmoma

    Science.gov (United States)

    Park, Joon Seong; Kang, Chang Moo; Yoon, Dong Sup; Lee, Woo Jung

    2017-01-01

    Purpose The aim of this study was to verify that laparoscopic resection for treating retroperitoneal benign neurilemmoma (NL) is expected to be favorable for complete resection of tumor with technical feasibility and safety. Methods We retrospectively analyzed 47 operations for retroperitoneal neurogenic tumor at Yonsei University College of Medicine, Severance Hospital and Gangnam Severance Hospital between January 2005 and September 2015. After excluding 21 patients, the remaining 26 were divided into 2 groups: those who underwent open surgery (OS) and those who underwent laparoscopic surgery (LS). We compared clinicopathological features between the 2 groups. Results There was no significant difference in operation time, estimated blood loss, transfusion, complication, recurrence, or follow-up period between 2 groups. Postoperative hospital stay was significantly shorter in the LS group versus the OS group (OS vs. LS, 7.00 ± 3.43 days vs. 4.50 ± 2.16 days; P = 0.031). Conclusion We suggest that laparoscopic resection of retroperitoneal benign NL is feasible and safe by obtaining complete resection of the tumor. LS for treating retroperitoneal benign NL could be useful with appropriate laparoscopic technique and proper patient selection.

  19. [Acute benign cerebral angiopathy. 6 cases].

    Science.gov (United States)

    Rousseaux, P; Scherpereel, B; Bernard, M H; Guyot, J F

    1983-10-08

    The 6 cases reported here constitute, with 5 previously published cases, a special nosological entity tentatively called "acute benign cerebral angiopathy" by the authors. These 11 cases have in common certain radiological and clinical features. Arteriography shows segmental, multifocal and assymetrical stenoses involving the cerebral arteries between Willis' circle and the terminal arterioles and looking like "strings of sausages". The lesions disappear within one month and present the radiological characteristics of arteritis of medium caliber vessels. The clinical symptoms are suggestive of meningeal haemorrhage or acute cerebromeningeal oedema, with acute repetitive attacks of severe headache and agitation with obnubilation; epileptic seizures and transient neurological deficit may occur. True meningeal haemorrhage confirmed by lumbar puncture is seen in nearly one half of the cases; it seems to be due to alterations in the blood-brain barrier induced by the angiopathy. Intracerebral haematoma may develop, but the disease is usually benign and regresses spontaneously in a few days. None of the usual causes of cerebral arteritis (intra-cranial infection, collagen disease, allergic or toxic angitis) has been found. Pseudo-arteritis (notably spasm of ruptured arterial aneurysms) has been excluded. No aetiological factor common to the 11 cases reported has been elicited, although 6 of the patients had recently given birth and our 6 patients had benign virus infection before or during the clinical manifestations of the disease. In the authors' opinion, the most rewarding line of research would be the role of short acute attacks of arterial hypertension.

  20. Environmentally benign silicon solar cell manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Tsuo, Y.S. [National Renewable Energy Lab., Golden, CO (United States); Gee, J.M. [Sandia National Labs., Albuquerque, NM (United States); Menna, P. [National Agency for New Technologies Energy and Environment, Portici (Italy); Strebkov, D.S.; Pinov, A.; Zadde, V. [Intersolarcenter, Moscow (Russian Federation)

    1998-09-01

    The manufacturing of silicon devices--from polysilicon production, crystal growth, ingot slicing, wafer cleaning, device processing, to encapsulation--requires many steps that are energy intensive and use large amounts of water and toxic chemicals. In the past two years, the silicon integrated-circuit (IC) industry has initiated several programs to promote environmentally benign manufacturing, i.e., manufacturing practices that recover, recycle, and reuse materials resources with a minimal consumption of energy. Crystalline-silicon solar photovoltaic (PV) modules, which accounted for 87% of the worldwide module shipments in 1997, are large-area devices with many manufacturing steps similar to those used in the IC industry. Obviously, there are significant opportunities for the PV industry to implement more environmentally benign manufacturing approaches. Such approaches often have the potential for significant cost reduction by reducing energy use and/or the purchase volume of new chemicals and by cutting the amount of used chemicals that must be discarded. This paper will review recent accomplishments of the IC industry initiatives and discuss new processes for environmentally benign silicon solar-cell manufacturing.

  1. Quantitative evaluation of benign meningioma and hemangiopericytoma with peritumoral brain edema by 64-slice CT perfusion imaging

    Institute of Scientific and Technical Information of China (English)

    REN Guang; CHEN Shuang; WANG Yin; ZHU Rui-jiang; GENG Dao-ying; FENG Xiao-yuan

    2010-01-01

    Background Hemangiopericytomas (HPCs) have a relentless tendency for local recurrence and metastases,differentiating between benign meningiomas and HPCs before surgery is important for both treatment planning and the prognosis appraisal.The purpose of this study was to evaluate the correlations between CT perfusion parameters and microvessel density (MVD) in extra-axial tumors and the possible role of CT perfusion imaging in preoperatively differentiating benign meningiomas and HPCs.Methods Seventeen patients with benign meningiomas and peritumoral edema, 12 patients with HPCs and peritumoral edema underwent 64-slice CT perfusion imaging pre-operation.Perfusion was calculated using the Patlak method.The quantitative parameters, include cerebral blood volume (CBV), permeability surface (PS) of parenchyma, peritumoral edema among benign meningiomas and HPCs were compared respectively.CBV and PS in parenchyma, peritumoral edema of benign meningiomas and HPCs were also compared to that of the contrallateral normal white matter respectively.The correlations between CBV, PS of tumoral parenchyma and MVD were examined.Results The value of CBV and PS in parenchyma of HPCs were significantly higher than that of benign meningiomas (P<0.05), while the values of CBV and PS in peritumoral edema of benign meningiomas and HPCs were not significantly different (P >0.05).MVD in parenchyma of HPCs were significantly higher than that of benign meningiomas (P<0.05).There were positive correlations between CBV and MVD (r=0.648, P<0.05), PS and MVD (r=0.541, P<0.05) respectively.Furthermore, the value of CBV and PS in parenchyma of benign meningiomas and HPCs were significantly higher than that of contrallateral normal white matter (P<0.05), the value of CBV in peritumoral edema of benign meningiomas and HPCs were significantly lower than that of contrallateral normal white matter (P<0.05), while the value of PS in peritumoral edema of benign meningiomas and HPCs were not

  2. Cytokeratin 5/6 expression in benign and malignant breast lesions

    Directory of Open Access Journals (Sweden)

    Bhalla Amarpreet

    2010-10-01

    Full Text Available Background: Cytokeratin s (CK are used for the fingerprinting of carcinomas in general. In breast tissue, the luminal epithelial cells express CK 8/18, CK 7 and CK 19, while basal/myoepithelial cells express CK 5/6, CK 14 and CK 17. Material and Methods: Immunohistochemical staining for cytokeratin 5/6 was applied on cell block sections of 23 cases of benign and 25 cases of malignant breast lesions using avidin biotin peroxidase technique. The distribution and intensity of staining was recorded and graded semiquantitatively. Result: All benign lesions showed positive immunoreaction, with the staining index varying from 6-9, except lactating adenoma. The malignant lesions comprised three cases of ductal carcinoma in situ (DCIS and 22 cases of infiltrating ductal carcinoma, not otherwise specified, IDC (NOS. None of the DCIS cases showed a positive immunoreaction. Among the IDC (NOS lesions, six cases of grade III breast carcinoma exhibited a positive immunohistochemical reaction, the staining index of which varied from 2-6. The staining reaction in the malignant lesions was only cytoplasmic and the intensity was significantly less than that of benign lesions. Conclusion: CK 5/6 expression breast carcinoma implies a ′basal like′ molecular phenotype and is associated with poor prognosis. This antibody is also used as a component of panels to differentiate benign and malignant breast lesions.

  3. Natriuretic peptides for the detection of paroxysmal atrial fibrillation in patients with cerebral ischemia--the Find-AF study.

    Directory of Open Access Journals (Sweden)

    Rolf Wachter

    Full Text Available BACKGROUND AND PURPOSE: Diagnosis of paroxysmal atrial fibrillation (AF can be challenging, but it is highly relevant in patients presenting with sinus rhythm and acute cerebral ischemia. We aimed to evaluate prospectively whether natriuretic peptide levels and kinetics identify patients with paroxysmal AF. METHODS: Patients with acute cerebral ischemia were included into the prospective observational Find-AF study. N-terminal pro brain-type natriuretic peptide (NT-proBNP, brain-type natriuretic peptide (BNP and N-terminal pro atrial-type natriuretic peptide (NT-proANP plasma levels were measured on admission, after 6 and 24 hours. Patients free from AF at presentation received 7 day Holter monitoring. We prospectively hypothesized that patients presenting in sinus rhythm with NT-proBNP>median were more likely to have paroxysmal AF than patients with NT-proBNPmedian (239 pg/ml, 17.9% had paroxysmal AF in contrast to 7.4% with NT-proBNP<239 pg/ml (p = 0.025. The ratio of early (0 h to late (24 h plasma levels of NT-proBNP showed no difference between both groups. For the detection of paroxysmal atrial fibrillation, BNP, NT-proBNP and NT-proANP at admission had an area under the curve in ROC analysis of 0.747 (0.663-0.831, 0.638 (0.531-0.744 and 0.663 (0.566-0.761, respectively. In multivariate analysis, BNP was the only biomarker to be independently predictive for paroxysmal atrial fibrillation. CONCLUSIONS: BNP is independently predictive of paroxysmal AF detected by prolonged ECG monitoring in patients with cerebral ischemia and may be used to effectively select patients for prolonged Holter monitoring.

  4. Introducing Cichorium Pumilum as a potential therapeutical agent against drug-induced benign breast tumor in rats.

    Science.gov (United States)

    Al-Akhras, M-Ali H; Aljarrah, Khaled; Al-Khateeb, Hasan; Jaradat, Adnan; Al-Omari, Abdelkarim; Al-Nasser, Amjad; Masadeh, Majed M; Amin, Amr; Hamza, Alaaeldin; Mohammed, Karima; Al Olama, Mohammad; Daoud, Sayel

    2012-12-01

    Cichorium Pumilum (chicory) is could be a promising cancer treatment in which a photosensitizing drug concentrates in benign tumor cells and activated by quanta at certain wavelength. Such activated extracts could lead to cell death and tumor ablation. Previous studies have shown that Cichorium Pumilum (chicory) contains photosensitive compounds such as cichoriin, anthocyanins, lactucin, and Lactucopicrin. In the present study, the protective effect of sun light-activated Cichorium against the dimethylbenz[a]anthracene (DMBA) induced benign breast tumors to female Sprague-Dawley rats was investigated. Chicory's extract has significantly increase P.carbonyl (PC) and malondialdehyde (MDA) and decreases the hepatic levels of total antioxidant capacity (TAC) and superoxide dismutase (SOD) in benign breast tumors-induced group compared to control. It also significantly decrease the number of estrogen receptors ER-positive cells in tumor masses. These results suggest that chicory extracts could be used as herbal photosensitizing agent in treating benign breast tumor in rats.

  5. Rehabilitation exercise for treatment of vestibular disorder: A case study

    OpenAIRE

    Avraham Feazadeh; Eli Carmeli

    2006-01-01

    Vertigo and dizziness are common symptoms in the general population. While the clinical picture is well known and widely described, there are different interpretations of Benign Paroxysmal Positional Vertigo. The purpose of this case report was to describe the treatment of a 56 year old woman with complains of positional vertigo for 35 consecutive years. She suffered from a sudden onset of rotatory, unilateral horizontal canal type benign paroxysmal positional vertigo (BPPV). The symtoms star...

  6. Breast cancer. Part 1: Awareness and common benign diseases.

    Science.gov (United States)

    Harmer, Victoria

    Breast cancer is the most common cancer for women in the United Kingdom and topic on which there is much information. This article discusses the principles behind breast awareness and breast health, detailing common benign breast diseases that cause disproportionate anxiety. The NHS Breast Screening Programme is celebrating 20 years of screening this year, and in all randomized controlled trials of women aged 50 and over, mortality from breast cancer is reduced in those offered screening compared with unscreened controls (although the reduction is not statistically significant in all trials). Once a breast cancer is diagnosed, the different characteristics and stage of the disease can be identified through histopathology and scans. These factors will be discussed later in this article, including illustrating if a cancer is hormone sensitive or HER-2 positive, for example. These factors enable clinicians to recommend a treatment pathway suitable for each individual.

  7. Leveling up and down: the experiences of benign and malicious envy.

    Science.gov (United States)

    van de Ven, Niels; Zeelenberg, Marcel; Pieters, Rik

    2009-06-01

    Envy is the painful emotion caused by the good fortune of others. This research empirically supports the distinction between two qualitatively different types of envy, namely benign and malicious envy. It reveals that the experience of benign envy leads to a moving-up motivation aimed at improving one's own position, whereas the experience of malicious envy leads to a pulling-down motivation aimed at damaging the position of the superior other. Study 1 used guided recall of the two envy types in a culture (the Netherlands) that has separate words for benign and malicious envy. Analyses of the experiential content of these emotions found the predicted differences. Study 2 and 3 used one sample from the United States and one from Spain, respectively, where a single word exists for both envy types. A latent class analysis based on the experiential content of envy confirmed the existence of separate experiences of benign and malicious envy in both these cultures as well. The authors discuss the implications of distinguishing the two envy types for theories of cooperation, group performance, and Schadenfreude.

  8. Spatial contrast sensitivity in benign intracranial hypertension.

    Science.gov (United States)

    Bulens, C; Meerwaldt, J D; Koudstaal, P J; Van der Wildt, G J

    1988-01-01

    Spatial Contrast Sensitivity (CS) was studied in 20 patients with benign intracranial hypertension (BIH). At presentation CS loss was found in 43% of the eyes, and impairment of visual acuity attributed to BIH in only 16%. Nine patients had blurred vision or visual obscurations, all of whom had abnormal CS. The clinical application of CS measurement in BIH for monitoring the progression or regression of the disease is illustrated by serial measurements in 11 patients. Progressive visual loss in longstanding papilloedema and improvement of visual function in subsiding papilloedema can occur without any change in Snellen acuity or visual field charting. PMID:3225588

  9. Spatial contrast sensitivity in benign intracranial hypertension.

    Science.gov (United States)

    Bulens, C; Meerwaldt, J D; Koudstaal, P J; Van der Wildt, G J

    1988-10-01

    Spatial Contrast Sensitivity (CS) was studied in 20 patients with benign intracranial hypertension (BIH). At presentation CS loss was found in 43% of the eyes, and impairment of visual acuity attributed to BIH in only 16%. Nine patients had blurred vision or visual obscurations, all of whom had abnormal CS. The clinical application of CS measurement in BIH for monitoring the progression or regression of the disease is illustrated by serial measurements in 11 patients. Progressive visual loss in longstanding papilloedema and improvement of visual function in subsiding papilloedema can occur without any change in Snellen acuity or visual field charting.

  10. Benign symmetric lipomatosis of the knees

    Institute of Scientific and Technical Information of China (English)

    Zhiqiang Yin; Di Wu; Yixin Ge; Meihua Zhang; Zhigang Bi; Dan Luo

    2008-01-01

    Benign symmetric lipomatosis(BSL) is a rare disease characterized by the presence of multiple, symmetric and nonencapsulated fat masses in the face, neck and other areas. It is commonly seen in middle-aged Caucasian Mediterranean males, while its etiology is still not clear. The majority of the patients with BSL have a history of alcohol abuse and hepatopathy. BSL of the limbs is very rare. This article reports a unique case of a 60-year-old Chinese woman with involvement of the knees confirmed by the results of magnetic resonance imaging(MRI) and histopathology, which was not described previously in published literatures.

  11. Clarithromycin Culprit of Benign Intracranial Hypertension

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    Habib Rehman Khan

    2015-01-01

    Full Text Available Benign intracranial hypertension is characterized with increase in CSF opening pressure with no specific etiology. It is predominantly found in women of child bearing age and particularly in individuals with obesity. Visual disturbances or loss and associated headaches are common and can lead to blindness if left untreated. Diagnosis can be achieved once other causes of visual loss, headaches and high opening pressures are excluded. Management consists of serial optic disc assessments although no specific treatment is available despite recent trials using carbonic anhydrase inhibitors. Diet modification and weight management can help in therapy.

  12. Paroxysmal Disorders in Neuropsychiatry: Why Episodic Disorders Must be Accounted For

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    Vernon M Neppe

    2015-10-01

    Full Text Available Possibly the most under-diagnosed of all medical conditions are the episodic ones linked with the brain. These paroxysmal disorders are often ignored because when the patient presents to the mental health practitioner (MHP they appear well. Very often, they deny that anything is wrong, and yet their families cry out for the MHP to help them. But this is only one side. These patients may have one or more of several conditions and many are not even listed in diagnostic bibles such as DSM5. They require revised terminology, which is sometimes non-existent. They need to be diagnosed, yet the criteria to evaluate them are usually unknown. The broader impacts on spouses, partner and families must be understood and in return how much role those varying ethicospirituobiopsychofamilioethnicosociocultural considerations may play in alleviating or aggravating these conditions. Episodic phenomena are difficult to evaluate, and the need for appropriate management after the initial and continued evaluations make them a challenge. Additionally, the absence of proper diagnostic listings makes even potential insurance remuneration more difficult. The author places these conditions in a varied basket of diagnoses and syndromes, called “paroxysmal disorders”. Clearly, the organic elements must be particularly carefully treated, and the underlying psychological conditions handled potentially in a therapeutic relationship or at least with appropriate support. The author has been fortunate enough to be involved in pioneering the discipline of neuropsychiatry and behavioral neurology having established the first division of neuropsychiatry in the USA in 1986 and having led the first USA and International Delegation in Neuropsychiatry and Psychopharmacology. This has necessitated developing a string of diagnostic questionnaires and standardized follow up historical questions. These various historical measures are administered in a standard way—the Inventory of

  13. Expression and Clinical Significance of Vascular Endothelial Growth Factor in Benign and Malignant Tissues of Breast

    Institute of Scientific and Technical Information of China (English)

    XU Wei-gu; LIU Yang; WANG Gang; SONG Ji-ning; YANG Xiao-qing; WANG Wen-ya

    2008-01-01

    Objective:To detect the expression of vascular endothelial growth factor(VEGF)and microvessel density(MVD)count in breast benign affection,breast atypical hyperplasia and breast carcinoma in situ,and to clarify the relationship between VEGF expression,MVD and the clinicopathological features of these diseases. Methods:The expression of VEGF and MVD count in 115 cases breast benign diseases(including 40 breast fibroid tumor,40 breast cystic hyperplasia and 35 intraductal papilloma,19 breast atypical hyperplasias and 32 breast carcinomas in situ were examined by immunohistochemistry staining(SP-method). Results:The positive rate of VEGF in breast benign diseases,breast atypical hyperplasia and breast carcinoma in situ were 21.74%(25/115)、31.58.%(6/19)and 53.13%(17/32)respectively.It was the lowest in breast benign affection group,and was the highest breast carcinoma in situ group.The expression of VEGF increased gradually in the three groups(P<0.05).The MVD count of the three groups were 14.41±2.59,18.89±4.47 and 21.13±4.12 respectively,It was the lowest in breast benign affection group,and was the highest breast carcinoma in situ group.The MVD count of the three groups increased gradually(P<0.05).In VEGF positive group,MVD count was 19.41±4.78;In VEGF negative group,MVD count was 14.91±3.15.The MVD count was higher in VEGF positive group than that in VEGF negative group(P<0.05). Conclusion:The results of this study suggested that VEGF could promote microvessel growth in breast tumors.The occurrence and progression of breast cancer might be related with the expression of VEGF.

  14. Canalith Repositioning Procedure

    Science.gov (United States)

    ... repositioning procedure can help relieve benign paroxysmal positional vertigo (BPPV), a condition in which you have brief, ... dizziness that occur when you move your head. Vertigo usually comes from a problem with the part ...

  15. Benign cementoblastoma (true cementoma in a cat

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    Lenin A Villamizar-Martinez

    2016-01-01

    Full Text Available Case summary A 10-year-old castrated male domestic shorthair cat was presented for assessment of a gingival mass surrounding the left maxillary third and fourth premolar teeth. The mass was surgically removed by means of a marginal rim excision, and the tissue was submitted for histological assessment. It was identified as a benign cementoblastoma (true cementoma. There was proliferation of mineralized eosinophilic material with multiple irregularly placed lacunae and reversal lines, reminiscent of cementum. The cat recovered uneventfully from the anesthesia, and there was no evidence of tumor recurrence 6 months after surgery. Relevance and novel information Cementoblastomas (true cementomas in domestic animals are rare, with just a few reports in ruminants, monogastric herbivores and rodents. Cementoblastoma is considered a benign tumor that arises from the tooth root. The slow, expansive and constant growth that characterizes these masses may be accompanied by signs of oral discomfort and dysphagia. This case report is intended to increase knowledge regarding this tumor in cats and also highlights the importance of complete excision of the neoplasm. To our knowledge, there are no previous reports in the literature of cementoblastoma in the cat.

  16. Recurrence of atrial fibrillation within three months after pulmonary vein isolation for patients with paroxysmal atrial fibrillation: Analysis using external loop recorder with auto-trigger function

    Science.gov (United States)

    Kawasaki, Shiro; Tanno, Kaoru; Ochi, Akinori; Inokuchi, Koichiro; Chiba, Yuta; Onishi, Yoshimi; Onuma, Yoshimasa; Munetsugu, Yumi; Kikuchi, Miwa; Ito, Hiroyuki; Onuki, Tatsuya; Miyoshi, Fumito; Minoura, Yoshino; Watanabe, Norikazu; Adachi, Taro; Asano, Taku; Kobayashi, Youichi

    2014-01-01

    Background Pulmonary vein isolation (PVI) via catheter ablation has been shown to be a highly effective treatment option for patients with symptomatic paroxysmal atrial fibrillation (AF). The recurrence of AF within 3 months after PVI is not considered to be the result of ablation procedure failure, because early recurrence of AF is not always associated with late recurrence. We examined the usefulness of an external loop recorder with an auto-trigger function (ELR-AUTO) for the detection of atrial fibrillation following PVI to characterize early recurrence and to determine the implications of AF occurrence within 3 months after PVI. Methods Fifty-three consecutive symptomatic patients with paroxysmal AF (age 61.6±12.6 years, 77% male) who underwent PVI and were fitted with ELR-AUTO for 7±2.0 days within 3 months after PVI were enrolled in this study. Results Of the 33 (62.2%) patients who did not have AF recurrence within 3 months after PVI, only 1 patient experienced AF recurrence at 12 months. Seven (35%) of the 20 patients who experienced AF within 3 months of PVI experienced symptomatic AF recurrence at 12 months. The sensitivity, specificity, positive predictive value, and negative predictive value of early AF recurrence for late recurrence were 87.5%, 71.1%, 35.0%, and 96.9%, respectively. Conclusions AF recurrence measured by ELR-AUTO within 3 months after PVI can predict the late recurrence of AF. Freedom from AF in the first 3 months following ablation significantly predicts long-term AF freedom. ELR-AUTO is useful for the detection of symptomatic and asymptomatic AF. PMID:26336538

  17. Progress in the research of genetics and clinical manifestation of paroxysmal kinesigenic dyskinesia

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    HUANG Xiao-jun

    2013-05-01

    Full Text Available Paroxysmal kinesigenic dyskinesia (PKD is a disorder characterized by recurrent and brief attacks that are induced by sudden voluntary movement with highly clinical and genetic heterogeneity. Familial PKD are mostly autosomal dominant inherited and proline-rich transmembrare protein 2 (PRRT2 gene has been identified as the causative gene for PKD. So far 56 mutations have been documented and most of them are nonsense ones. No obvious genotype-phenotype correlation has been observed and the function of PRRT2 is still unclear, but the interaction between PRRT2 and synaptosomal-associated protein 25 (SNAP25 will shed the light on the research of PKD mechanism.

  18. Paroxysmal atrioventricular nodal reentrant tachycardias: epidemiology, clinical picture, diagnostics, treatment (review

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    Morozov I.A.

    2012-03-01

    Full Text Available Nowadays paroxysmal AV nodal reentrant tachycardia (AVNRT is one of the most widespread arrhythmias. In most cases AVRNT is a recurrent process, and it worsens the life quality of such patients, reduces their workability and increases the incidence of applying for medical help. Thus AVNRT today is of special attention among investigators. The interest of clinicians to the problem of cardiac arrhythmias is associated with permanent dissatisfaction with the results of antiarrhythmic therapy and also with the rapid development of the surgical methods of treatment, i.e. the use of radio frequency catheter ablation.

  19. [Myocardial damage and paroxysmal ventricular tachycardia in a dog after Albuterol intoxication].

    Science.gov (United States)

    Matos, J; Jenni, S; Fischer, N; Bienz, H; Glaus, T

    2012-07-01

    Intoxication with the beta2-agonist Albuterol may lead to immediate signs of beta-adrenergic stimulation like excitation, tachypnea and tachycardia. Furthermore, it typically causes severe hypokalemia, which then leads to muscle weakness and which predisposes to ventricular arrhythmias. We describe a dog where albuterol intoxication caused runs of fast paroxysmal ventricular tachycardia that persisted after normalization of the hypokalemia. Based on a markedly elevated serum troponin I level acute myocardial damage was identified as cause of the tachyarrhythmia. Repeated Troponin I measurements and Holter-ECGs were the means to document complete cure.

  20. Coincidence of paroxysmal supraventricular tachycardia and panic disorder: two case reports

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    Breithardt Günter

    2010-04-01

    Full Text Available Abstract Panic disorder (PD is characterised by sudden attacks of intense fear with somatic symptoms including palpitations and tachycardia. Reciprocally, palpitations caused by paroxysmal supraventricular tachycardia (PSVT are commonly associated with anxiety and may therefore be misdiagnosed as PD. As demonstrated by two case reports, PSVT and PD can occur comorbidly in a chronological sequence, with PSVT possibly precipitating and maintaining PD via interoceptive processes or, alternatively, with PD increasing the risk for PSVT by elevating stress levels. As both PSVT and PD require different treatments, potentially helpful differential clinical diagnostic criteria are proposed.