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Sample records for benign positional vertigo

  1. 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. ...

  2. 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 ...

  3. Benign Paroxysmal Positional Vertigo (BPPV)

    Science.gov (United States)

    ... 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, ...

  4. Benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    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.

  5. Horizontal Canal Benign Positional Vertigo

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    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.

  6. Benign paroxysmal positional vertigo following septorhinoplasty.

    Science.gov (United States)

    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.

  7. 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

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

    Science.gov (United States)

    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.

  9. Benign paroxysmal positional vertigo recurrence and persistence

    OpenAIRE

    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...

  10. 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.

  11. Benign Paroxysmal Positional Vertigo: An Integrated Perspective

    Directory of Open Access Journals (Sweden)

    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.

  12. 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

  13. 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.

  14. 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....

  15. Benign paroxysmal positional vertigo in an airline pilot.

    Science.gov (United States)

    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.

  16. 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.

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

    OpenAIRE

    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-...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  1. 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.

  2. 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.

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

    Science.gov (United States)

    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.

  4. A Geriatric Perspective on Benign Paroxysmal Positional Vertigo.

    Science.gov (United States)

    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.

  5. DIAGNOSIS AND MANAGEMENT BENIGN PAROXYSMAL POSITIONAL VERTIGO (BPPV

    Directory of Open Access Journals (Sweden)

    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;}

  6. 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.

  7. 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.

  8. 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.

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

    Science.gov (United States)

    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.

  10. 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.

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

    Science.gov (United States)

    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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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...

  17. 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...

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

    Science.gov (United States)

    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.

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

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    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.

  20. 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

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

    Science.gov (United States)

    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.

  2. 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.

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

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    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.

  4. 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.

  5. 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.

  6. 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.

  7. [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.

  8. 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.

  9. [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.

  10. 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.

  11. 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.

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

    Science.gov (United States)

    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.

  13. 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

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

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    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.

  15. 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...

  16. 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...

  17. 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.

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

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    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

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

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    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

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

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    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...

  1. 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.

  2. 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

  3. 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

  4. 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.

  5. 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.

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

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    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.

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

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    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

  8. 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.

  9. 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

  10. 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.

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

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    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

  12. 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).

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. 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...

  6. 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...

  7. 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.

  8. 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.

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

    Science.gov (United States)

    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.

  10. 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.

  11. 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.

  12. 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.

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

    Science.gov (United States)

    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.

  14. 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.

  15. 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.

  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 simultaneously affecting several canals: a 46-patient series.

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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

  19. 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.

  20. 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.

  1. 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/).

  2. [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.

  3. 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

  4. 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

  5. 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

  6. 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.

  7. 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.

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

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    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.

  9. 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.

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

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    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. 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.

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

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    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.

  13. 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

  14. 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

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

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    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.

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

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    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.

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

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    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.

  18. 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.

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

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    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.

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

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    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.

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

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    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.

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

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    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.

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

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    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.

  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

    Institute of Scientific and Technical Information of China (English)

    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. 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.

  7. 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.

  8. 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。

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. 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...

  17. 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。

  18. 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

  19. 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.

  20. 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

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

    Directory of Open Access Journals (Sweden)

    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

  2. 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.

  3. 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

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    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.

  4. 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

  5. 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.

  6. 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 .

  7. 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.

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  10. 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

  11. 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.

  12. 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

  13. 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。

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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.

  2. 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.

  3. 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。

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

    Directory of Open Access Journals (Sweden)

    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

  5. 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.

  6. 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。

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

    Directory of Open Access Journals (Sweden)

    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

  8. 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

  9. 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.

  10. 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....

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

    Directory of Open Access Journals (Sweden)

    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

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  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. 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

  19. 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

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. VESTIBULAR VERTIGO

    Directory of Open Access Journals (Sweden)

    M V Zamergrad

    2009-01-01

    Full Text Available The authors consider the cardinal causes of vestibular vertigo, a benign paroxysmal positional vertigo, Meniere's disease, vestibular neuroni-tis, vestibular migraine, cerebrovascular diseases. It gives brief data on the etiology, pathogenesis, clinical manifestations, and treatment of these diseases. The diagnosis of the latter is largely based on a patientKhs complaints and medical history data and frequently requires no additional instrumental study. The currently available treatments for various diseases manifesting as vestibular vertigo are analyzed. Vestibular exercises and rehabilitation maneuvers that are effective in benign positional vertigo are noted to play an important role. In addition, methods for drug stimulation of vestibular compensation in central and peripheral vestibulopathies are described.

  18. 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...

  19. 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.

  20. 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.

  1. 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.

  2. 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。

  3. 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

  4. VESTIBULAR VERTIGO

    OpenAIRE

    M V Zamergrad

    2009-01-01

    The authors consider the cardinal causes of vestibular vertigo, a benign paroxysmal positional vertigo, Meniere's disease, vestibular neuroni-tis, vestibular migraine, cerebrovascular diseases. It gives brief data on the etiology, pathogenesis, clinical manifestations, and treatment of these diseases. The diagnosis of the latter is largely based on a patientKhs complaints and medical history data and frequently requires no additional instrumental study. The currently available treatments for ...

  5. 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

  6. 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%

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. 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

  12. 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

  13. 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)

  14. Evidence-Based Practice: Management of Vertigo

    OpenAIRE

    Nguyen-Huynh, Anh T.

    2012-01-01

    The article focuses on the evidence basis for the management of benign paroxysmal positional vertigo (BPPV), the most common diagnosis of vertigo in both primary care and subspecialty settings. Like all articles in this compilation of evidence-based practice, an overview is presented along with evidence based clinical assessment, diagnosis, and management. Summaries of differential diagnosis of vertigo and outcomes are presented.

  15. 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

  16. Vertigo

    Index Scriptorium Estoniae

    2007-01-01

    Tallinnas Rävala pst. 4 asuva restorani Vertigo sisekujundus. Sisearhitektid Janno Roos ja Andres Labi (Ruumilabor OÜ). Sisearhitektidest, nende koos teostatud projektid. Kaks plaani, 8 värv. sisevaadet, fotod sisearhitektidest

  17. 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

  18. 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.

  19. 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

  20. 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

  1. 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

  2. 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。

  3. 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,

  4. 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.

  5. 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.

  6. 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。

  7. 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

  8. 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.

  9. 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,

  10. 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.

  11. 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.

  12. [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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Persistent Positional Vertigo in a Patient with Sudden Sensorineural Hearing Loss: A Case Report.

    Science.gov (United States)

    Kim, Yong Won; Shin, Jung Eun; Lee, Yong-Sik; Kim, Chang-Hee

    2015-09-01

    Because inner ear organs are interconnected through the endolymph and surrounding endolymphatic membrane, the patients with sudden sensorineural hearing loss (SSNHL) often complain of vertigo. In this study, we report a patient with SSNHL accompanied by persistent positional vertigo, and serial findings of head-roll tests are described. At acute stage, head-roll test showed persistent geotropic direction-changing positional nystagmus (DCPN), which led to a diagnosis of SSNHL and ipsilateral light cupula. Although vertigo symptom gradually improved, positional vertigo lasted for more than 3 weeks. At this chronic stage, persistent apogeotropic DCPN was observed in a head roll test, which led to a diagnosis of the heavy cupula. Although the mechanism for the conversion of nystagmus direction from geotropic to apogeotropic persistent DCPN is unclear, the change of specific gravity of the endolymph might be one of the plausible hypothetical explanations.

  19. 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

  20. 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.

  1. Pharmacological treatment of vertigo.

    Science.gov (United States)

    Hain, Timothy C; Uddin, Mohammed

    2003-01-01

    This review discusses the physiology and pharmacological treatment of vertigo and related disorders. Classes of medications useful in the treatment of vertigo include anticholinergics, antihistamines, benzodiazepines, calcium channel antagonists and dopamine receptor antagonists. These medications often have multiple actions. They may modify the intensity of symptoms (e.g. vestibular suppressants) or they may affect the underlying disease process (e.g. calcium channel antagonists in the case of vestibular migraine). Most of these agents, particularly those that are sedating, also have a potential to modulate the rate of compensation for vestibular damage. This consideration has become more relevant in recent years, as vestibular rehabilitation physical therapy is now often recommended in an attempt to promote compensation. Accordingly, therapy of vertigo is optimised when the prescriber has detailed knowledge of the pharmacology of medications being administered as well as the precise actions being sought. There are four broad causes of vertigo, for which specific regimens of drug therapy can be tailored. Otological vertigo includes disorders of the inner ear such as Ménière's disease, vestibular neuritis, benign paroxysmal positional vertigo (BPPV) and bilateral vestibular paresis. In both Ménière's disease and vestibular neuritis, vestibular suppressants such as anticholinergics and benzodiazepines are used. In Ménière's disease, salt restriction and diuretics are used in an attempt to prevent flare-ups. In vestibular neuritis, only brief use of vestibular suppressants is now recommended. Drug treatments are not presently recommended for BPPV and bilateral vestibular paresis, but physical therapy treatment can be very useful in both. Central vertigo includes entities such as vertigo associated with migraine and certain strokes. Prophylactic agents (L-channel calcium channel antagonists, tricyclic antidepressants, beta-blockers) are the mainstay of treatment

  2. [Peripheral, central and functional vertigo syndromes].

    Science.gov (United States)

    Strupp, M; Dieterich, M; Zwergal, A; Brandt, T

    2015-12-01

    Depending on the temporal course, three forms of vertigo syndrome can be differentiated: 1) vertigo attacks, e.g. benign paroxysmal positional vertigo (BPPV), Menière's disease and vestibular migraine, 2) acute spontaneous vertigo lasting for days, e.g. acute unilateral vestibulopathy, brainstem or cerebellar infarction and 3) symptoms lasting for months or years, e.g. bilateral vestibulopathy and functional vertigo. The specific therapy of the various syndromes is based on three principles: 1) physical treatment with liberatory maneuvers for BPPV and balance training for vestibular deficits, 2) pharmacotherapy, e.g. for acute unilateral vestibulopathy (corticosteroids) and Menière's disease (transtympanic administration of gentamicin or steroids and high-dose betahistine therapy); placebo-controlled pharmacotherapy studies are currently being carried out for acute unilateral vestibulopathy, vestibular paroxysmia, prophylaxis of BPPV, vestibular migraine, episodic ataxia type 2 and cerebellar ataxia; 3) psychotherapy for functional dizziness.

  3. 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...

  4. 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

  5. Characteristics of six otologic diseases involving vertigo.

    Science.gov (United States)

    Kentala, E

    1996-11-01

    To characterize otologic causes for vertigo, data on 564 patients with the six most common diseases involving vertigo were retrieved from the database of a computer-aided diagnostic system for neurotologic diseases. The diseases were Meniere's disease, vestibular schwannoma, benign paroxysmal positional vertigo, vestibular neuritis, sudden deafness, and traumatic vertigo. The prevalence of tinnitus in the study population was 76%. The most severe forms of vertigo and nausea were found in vestibular neuritis, whereas the most severe case of tinnitus appeared in Meniere's disease. Of the patients with vestibular schwannoma, 49% had had vertigo. A linear discrimination analysis using case history classified 90% of the patients into correct groups. The key questions discriminating between the diseases concerned the frequency and duration of vertigo attacks, the duration of hearing loss and vertigo, and the occurrence of head injury. Making a correct diagnosis during the first office visit can be difficult, especially for sudden deafness, vestibular schwannoma, and Meniere's disease. Neurotologic and audiometric information was of minor value in distinguishing between these six diseases. Vestibular schwannoma had significantly greater asymmetry in electronystagmography and smaller gains in smooth pursuit in comparison with the other disease. Factorial analysis did not aid the clustering of these diseases.

  6. 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

  7. 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。

  8. Posttraumatic vertigo and dizziness.

    Science.gov (United States)

    Fife, Terry D; Giza, Christopher

    2013-07-01

    Dizziness and vertigo are common symptoms following minor head trauma. Although these symptoms resolve within a few weeks in many patients, in some the symptoms may last much longer and impede ability to return to work and full functioning. Causes of persisting or recurrent dizziness may include benign paroxysmal positional vertigo, so-called labyrinthine concussion, unilateral vestibular nerve injury or damage to the utricle or saccule, perilymphatic fistula, or less commonly traumatic endolymphatic hydrops. Some dizziness after head trauma is due to nonlabyrinthine causes that may be related to structural or microstructural central nervous system injury or to more complicated interactions between migraine, generalized anxiety, and issues related to patients self-perception, predisposing psychological states, and environmental and stress-related factors. In this article, the authors review both the inner ear causes of dizziness after concussion and also the current understanding of chronic postconcussive dizziness when no peripheral vestibular cause can be identified.

  9. Major diseases manifesting by vestibular vertigo: Treatment and rehabilitation

    OpenAIRE

    2015-01-01

    Betahistine hydrochloride is the drug of choice for the treatment of vestibular vertigo in the presence of benign paroxysmal positional vertigo, Meniere's disease, and vestibular neuronitis. Effective combination therapy regimens that contain, along with drugs from other pharmacological groups, betahistine hydrochloride that improves blood circulation in the vestibular structures, accelerates vestibular compensation, and prevents recurrent dizzy spells, have been elaborated to treat central v...

  10. The epidemiology of dizziness and vertigo.

    Science.gov (United States)

    Neuhauser, H K

    2016-01-01

    This chapter gives an overview of the epidemiology of dizziness, vertigo, and imbalance, and of specific vestibular disorders. In the last decade, population-based epidemiologic studies have complemented previous publications from specialized settings and provided evidence for the high burden of dizziness and vertigo in the community. Dizziness (including vertigo) affects about 15% to over 20% of adults yearly in large population-based studies. Vestibular vertigo accounts for about a quarter of dizziness complaints and has a 12-month prevalence of 5% and an annual incidence of 1.4%. Its prevalence rises with age and is about two to three times higher in women than in men. Imbalance has been increasingly studied as a highly prevalent complaint particularly affecting healthy aging. Studies have documented the high prevalence of benign paroxysmal positional vertigo (BPPV) and vestibular migraine (VM), as well as of comorbid anxiety at the population level. BPPV and VM are largely underdiagnosed, while Menière's disease, which is about 10 times less frequent than BPPV, appears to be overdiagnosed. Risk factor research is only at its beginning, but has provided some interesting observations, such as the consistent association of vertigo and migraine, which has greatly contributed to the recognition of VM as a distinct vestibular syndrome.

  11. Causes and time-course of vertigo in an ear, nose, and throat clinic.

    Science.gov (United States)

    Isaradisaikul, Suwicha; Navacharoen, Niramon; Hanprasertpong, Charuk; Kangsanarak, Jaran; Panyathong, Rapeepun

    2010-12-01

    The purpose of this study is to review etiologies and identify the time-course of vertigo presenting in an ear, nose, and throat clinic, and serve as a reference guide for other clinics. The study includes retrospective chart review in a tertiary care, university hospital. The patient data with reported ICD-10 codes as causes of vertigo between April 2005 and December 2007 were extracted from the database. At each visit, the main diagnosis as to etiology, characteristics of the vertigo, its time-course, and patient demographic data were recorded. Of 547 cases, 17 diagnoses were made in 73.9%. Diagnostic categories included peripheral vertigo 72.9%, central vertigo 0.8%, psychogenic cause 0.2%, and unknown 26.1%. Common causes of vertigo were benign paroxysmal positional vertigo (BPPV) 52.5%, Meniere's disease 14.6%, and sudden idiopathic hearing loss 2.9%. Less common diagnoses were benign paroxysmal vertigo of childhood 0.7%, labyrinthitis 0.7%, and vestibular schwannoma 0.3%. Rare conditions were delayed endolymphatic hydrops, Ramsey Hunt syndrome, otosyphilis, vestibular neuritis, temporal bone fracture, post-concussion syndrome, cerebellar infarction, epilepsy, cervical vertigo, Streptococcus suis meningitis, and psychogenic vertigo. Ninety-nine cases who reported remission of vertigo during the study period had median onset of the remission at 4 weeks. In the ear, nose, and throat clinic at Chiang Mai University, a tertiary university hospital, peripheral vestibular disorders were the main etiology of vertigo. The three most common causes were BPPV, Meniere's disease, and sudden idiopathic hearing loss. Half of the cases who returned for follow up had remitted symptoms within 4 weeks.

  12. Action of Tuina on Retro-positioning of Skull Spatial Offset in Patients with Cervical Vertigo

    Institute of Scientific and Technical Information of China (English)

    吴嘉荣; 房敏; 胡军; 沈国权; 姜淑云

    2008-01-01

    目的:从颈部本体觉角度探讨颈性眩晕的发病机制,为手法治疗颈性眩晕提供临床依据.方法:符合颈椎病诊断标准的颈性眩晕患者121例.旋颈试验阴性,经颅多普勒检查证实无明显血管因素的颈性眩晕患者70例,设为观察组;旋颈试验阳性,经颅多普勒检查证实椎基底动脉痉挛或供血不足的颈性眩晕患者51例,设为对照组.两组患者均行相同的推拿治疗,每天治疗1次,5天为1个疗程,1个疗程后统计结果.结果:两组患者头颅三轴向空间偏移度较治疗前均有明显减少,差异有统计学意义(P<0.01);治疗后两组患者头颅三轴向空间偏移度的比较,差异无统计学意义(P>0.05),尚不能认为两组患者经手法治疗1个疗程后的疗效有所差异.结论:推拿手法治疗可以改善患者头颅的空间偏移回复能力.%Objective:To investigate the onset mechanism of cervical vertigo from the proprioceptive sensation and provide clinical basis for its treatment.Methods:Among the 121 cases that conformed to the diagnostic criteria of cervical vertigo,70 cases who presented with negative neck-rotation test and cervical vertigo without obvious vascular factors by transcranial Doppler(TCD)were assigned to the observation group,while 51 cases who presented with positive neck-rotation test and cervical vertigo due to spasm of vertebral basal artery or insufficient blood supply by TCD were assigned to the control group.The cases in the two groups were treated once every day,5 days make up one treatment course and the resuIts were statistically analyrzed after one treatment course.Results:The skull triaxial spatial offset of the cases in the two groups were significantly reduced after the treatment (P<<0.01).However, there was no statistically significant difference between the skull triaxial spatial offset between the two groups (p>0.05).It is not conclusive that the therapeutic effect in the two groups was significantly

  13. A specialized approach to diagnosing and treating vertigo

    Directory of Open Access Journals (Sweden)

    L. M. Antonenko

    2016-01-01

    Full Text Available Vertigo is one of the most common reasons for visits to physicians of different specialties. Thorough collection of history data and neurovestibular examination by a set of simple clinical tests are of great importance for the diagnosis of diseases of the vestibular system. The paper gives an update on the principles of diagnosis of different forms of vertigo, diagnostic errors, and treatment of major diseases manifesting by vertigo. The authors present their own data concerning the diagnosis and treatment of the most common vestibular disorders, such as benign paroxysmal positional vertigo, Meniere's disease, vestibular neuronitis, and postural phobic instability. They also describe a clinical case of a female patient with vestibular neuronitis, in whom a specialized examination (neurovestibular examination, videonystagmography, and caloric testing could identify right labyrinthine hypofunction that could not be detected prior to the examination in the clinic.

  14. 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

  15. Vestibular autorotation test in patients with positional vertigo%前庭自旋转试验在位置性眩晕患者中的检测

    Institute of Scientific and Technical Information of China (English)

    蒋子栋; 温彦华

    2011-01-01

    Objective To evaluate the value of vestibular autorotation test (VAT) in differentiating central and peripheral etiologies in patients with positional vertigo. Methods Clinical data of 140 patients with positional vertigo without hearing loss, tinnitus and vestibular hypofunction were reviewed, including history, physical exam, videonystagmogra-phy (VNC), VAT, brain MRI, positional tests and physical manipulation. Results The 138 patients with BPPV all had normal brain MRI and horizontal gain on VAT. Their positional down beating nystagmus (pDBN) disappeared after physical manipulation. In the 2 patients with Arnold-Chiari malformation, diagnosed by abnormal brain MRI, there was increased horizontal gain on VAT, and pDBN persisted after physical manipulation. Conclusion VAT may be of adjuvant value in diagnosis and etiology differentiation in BPPV.%目的 通过对位置性眩晕患者进行前庭自旋转试验(Vestibular autorotation test,VAT)检查,探讨VAT用于鉴别中枢性和外周性位置性眩晕的作用.方法 回顾性分析140例位置性眩晕患者的临床资料,均无耳聋、耳鸣或前庭功能低下.患者资料包括病史,专科检查,视频眼震电图(videonystagmography,VNG),VAT,头颅磁共振(MRI),位置试验,手法复位治疗.结果 138例良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV),VAT参数水平增益正常,部分患者的垂直向下的眼震(positional down beating nystagmus,pDBN)通过手法复位消失,经MRI排除其他疾病.2例颅底凹陷综合征(Arnold-Chiari malformation,ACM)通过头颅MRI得到确诊,其VAT水平增益增高,手法复位后pDBN不消失.结论 VAT可用以辅助BPPV的鉴别诊断.

  16. [Nystagmus the diagnosis of vertigo and dizziness].

    Science.gov (United States)

    Johkura, Ken

    2013-09-01

    Vertigo or dizziness is primarily caused by peripheral vestibular disorders, such as benign paroxysmal positional vertigo (BPPV) and vestibular neuritis. BPPV can be diagnosed from associated positional torsional or direction-changing horizontal nystagmus and can be treated with canalith repositioning procedures. In contrast, vestibular neuritis and other acute peripheral vestibulopathies can be diagnosed from associated unidirectional horizontal nystagmus. Evaluation of nystagmus is essential for the diagnosis of peripheral vestibular disorders. Vertigo/dizziness caused by disorders in the brainstem or upper cerebellum is usually associated with other neurological signs or symptoms, such as motor palsy, sensory deficit, dysarthria, ocular motor palsy, and limb ataxia. In contrast, vertigo/dizziness caused by disorders in the lower cerebellum is not associated with these signs or symptoms; however, truncal ataxia becomes apparent in a standing position. Small lesions in the lower cerebellum can rarely cause unidirectional horizontal nystagmus directed toward the side of the lesions or direction-changing apogeotropic positional nystagmus; both types of nystagmus are enhanced when a patient lies on the non-affected side. This positional enhancement suggests that the same pathogenetic mechanism is involved in both types of nystagmus. The cerebellar lesions may disinhibit both semicircular-ocular and otolith-ocular reflexes. Semicircular-ocular reflex-dominant disinhibitions may result in the ipsilateral horizontal nystagmus, whereas otolith-ocular reflex-dominant disinhibitions may result in the direction-changing apogeotropic positional nystagmus.

  17. [Clinical evaluation of vertigo in menopausal women].

    Science.gov (United States)

    Owada, Satoko; Yamamoto, Masahiko; Suzuki, Mitsuya; Yoshida, Tomoe; Nomura, Toshiyuki

    2012-05-01

    Vertigo is one of the usual menopausal symptoms. We have often examined some women under the complaint of vertigo related with the menopause. We diagnosed each disease based on neuro-otological examinations and investigated the characteristics of menopausal-associated vertigo. We studied 413 women aged 40-59 years old who complained of vertigo. There were 73 women with menopause symptoms (14 women introduced from the gynecologist in our medical center, 18 women had undergone treatment at another female clinic, and 41 women visited an otorhinolaryngologist first) compared with 340 women without menopause symptoms. In the menopause group, 41 (56.2%) cases were diagnosed as having benign paroxysmal positional vertigo (BPPV), 13 (17.8%) cases had Meniere's disease, sudden deafness with vertigo accounted 2 cases, one was an acoustic tumor, and so on. The percentage of patients with BPPV was almost same ratio between the menopause group (56.2%) and the non-menopause group (52.9%). The percentage of patients with Meniere's disease was higher markedly in the menopausal group (17.8%). than the non-menopause group (9.7%). Menopausal symptoms are caused not only by hot flashes related to a lack of estrogen but also by psychological factors. The onset of Meniere's disease can also be influenced by psychological factors. As for the diagnosis of Meniere's disease, we supposed the reason for the higher percentage in the menopausal group was its relationship with psychological factors. We could diagnose and treat some menopausal women with vertigo. We believe that joint consultation with a gynecologist and otorhinolaryngologist would be necessary to ensure an optimum quality of life for such patients.

  18. 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-...

  19. Anxiety and Depression Among Patients With Different Types of Vestibular Peripheral Vertigo

    Science.gov (United States)

    Yuan, Qing; Yu, Lisheng; Shi, Dongmei; Ke, Xingxing; Zhang, Hua

    2015-01-01

    Abstract Numerous studies have been published on comorbid anxiety and depression in patients with vertigo. However, very few studies have separately described and analyzed anxiety or depression in patients with different types of vestibular peripheral vertigo. The present study investigated anxiety and depression among patients with 4 different types of peripheral vertigo. A total of 129 patients with 4 types of peripheral vertigo, namely, benign paroxysmal positional vertigo (BPPV, n = 49), migrainous vertigo (MV, n = 37), Menière disease (MD, n = 28), and vestibular neuritis (VN, n = 15), were included in the present study. Otological and neurootological examinations were carefully performed, and self-rating anxiety scale and self-rating depression scale were used to evaluate anxiety and depression. Patients were divided into 2 groups, according to the vestibular function: normal and abnormal vestibular function. There was no significant difference in the risk of anxiety/depression between these 2 groups. However, for patients with the 4 different vertigo types, the prevalence of anxiety (MV = 45.9%, MD = 50%) and depression (MV = 27%, MD = 28.6%) was significantly higher in the patients with MV or MD than those with BPPV or VN (P BPPV or VN. This may be due to the different mechanisms involved in these 4 types of vertigo, as well as differences in the prevention and self-control of the patients against the vertigo. PMID:25654382

  20. [Vertigo and dizziness. Diagnostic algorithm from the perspective of emergency medicine].

    Science.gov (United States)

    Dodt, C; Zelihic, E

    2013-02-01

    Vertigo and dizziness are common symptoms in the acute care setting and have a wide diagnostic range. The most deleterious diagnosis is vertebrobasilar disease with brain infarction in the posterior fossa. Therefore, every patient with acute vestibular syndrome needs to be evaluated by a structured interview and a systematic physical examination for red flag symptoms which indicate vertebrobasilar infarction. Routinely, the physical examination should cover the head impulse (Halmagyi) test, test for nystagmus as well as the test of skew and in cases of benign paroxysmal positional vertigo, by the Dix-Hallpike maneuver. The suspicion of a central cause of vertigo is ideally confirmed by a magnetic resonance imaging (MRI) scan. Most patients with a peripheral cause of vertigo can be discharged under symptomatic therapy with the advice to consult an ear nose and throat physician while patients with a central cause of vertigo are admitted for further neurological treatment.

  1. Chiropractic of Recumbent Position Treating Cervical Vertigo%卧位整脊治疗颈性眩晕

    Institute of Scientific and Technical Information of China (English)

    刘立志

    2014-01-01

    Objective:To observe the curative effects in chiropractic of recumbent position treating cervical vertigo. Methods:64 cases of cervical ver-tigo were randomly divided into treatment group and control group, each of 32 cases, respectively with supine chiropractic and routine manipulation therapy, the effects were assessed after a course. Results:The total effective rate of treatment group was 93.75%, significantly higher than that of con-trol group by 75%(P<0.05). Conclusion:Chiropractic of recumbent position treating cervical vertigo is of favorable effects.%目的:观察卧位整脊治疗颈性眩晕的疗效。方法:64例颈性眩晕患者随机分为治疗组和对照组各32例,分别采用卧位整脊治疗和常规推拿治疗,1个疗程后评定疗效。结果:治疗组总有效率为93.75%,显著高于对照组的75%(P<0.05)。结论:卧位整脊治疗颈性眩晕效果良好。

  2. Vertigo during the Epley maneuver and success rate in patients with BPPV.

    Science.gov (United States)

    Fyrmpas, Georgios; Barkoulas, Eustathios; Haidich, Anna Bettina; Tsalighopoulos, Miltiadis

    2013-09-01

    To investigate whether reported vertigo during the Epley maneuver predicts therapeutic success in patients with benign paroxysmal positioning vertigo of the posterior semicircular canal (pc-BPPV). Fifty consecutive adult patients with pc-BPPV, based on a positive Dix-Hallpike test (DHT), were treated with the Epley maneuver and retested after 2 days. Patients were asked to report the presence of vertigo upon assuming each of the four positions of the maneuver. Thirty seven patients (74 %) were treated successfully in one session. Twenty out of 23 patients who reported vertigo at turning the head to the opposite side (2nd position) had a negative DHT on follow-up. These patients had a higher chance of a successful outcome compared to patients who did not report vertigo in the 2nd position (Odds ratio 5.3, 95 % CI: 1.3-22.2, p = 0.022). Report of vertigo at the other positions was not associated with the outcome. Report of vertigo at the second position of a single modified Epley maneuver is associated with therapeutic success.

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

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    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.

  4. [Vertigo and dizziness: the neurologist's perspective].

    Science.gov (United States)

    Strupp, M

    2013-01-01

    The spectrum of diagnoses of patients with dizziness as the leading symptom who consult a neurologist does not differ greatly from the spectrum of those who consult ear nose and throat (ENT) specialists or general practitioners (GP). The most frequent forms are benign paroxysmal positioning vertigo (BPPV), phobic postural vertigo, central vertigo disorders, Menière's disease, vestibular neuritis and bilateral vestibulopathy. However, the first and most important question that is posed to neurologists is whether it is a central or peripheral syndrome. In more than 90 % of cases this differentiation is possible by taking the patient history (asking about the type of vertigo, the duration, triggers and accompanying symptoms) and conducting a physical examination of the patient. In the case of acute vertigo disorders in particular, a five-step procedure has proved to be helpful: the cover test to look for skew deviation as the central sign and component of the ocular tilt reaction, an examination with and without Frenzel's goggles to differentiate between peripheral vestibular spontaneous nystagmus and central fixation nystagmus, an examination of smooth pursuit and gaze-holding function and finally the head-impulse test to look for a deficit in the vestibulo-ocular reflex (VOR). Considerable advances have been made in the treatment of vertigo disorders in the last 10 years, e.g., cortisone for the treatment of acute vestibular neuritis, betahistine as a high-dosage, long-term treatment for Menière's disease, carbamazepine to treat vestibular paroxysmia and aminopyridine for downbeat nystagmus and episodic ataxia type 2.

  5. The burden and impact of vertigo: findings from the REVERT patient registry

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    Heike eBenecke

    2013-10-01

    Full Text Available Objective: Despite the high prevalence of vertigo globally and an acknowledged, but underreported, effect on an individual’s wellbeing, few studies have evaluated the burden on healthcare systems and society. This study was aimed to quantitatively determine the impact of vertigo on healthcare resource use and work productivity. Methods: The economic burden of vertigo was assessed through a multi-country, non-interventional, observational registry of vertigo patients: the Registry to Evaluate the Burden of Disease in Vertigo (REVERT. Patients included were those with a new diagnosis of Meniere’s disease (MD, benign paroxysmal positional vertigo (BPPV, other vertigo of peripheral vestibular origin or peripheral vestibular vertigo of unknown origin. Results: A total of 4,294 patients at 618 centers in 13 countries were included during the registry. Of the 4,105 patients analyzed, only half were in employment. Among this working patient population, 69.8% had reduced their workload, 63.3% had lost working days and 4.6% had changed and 5.7% had quit their jobs, due to vertigo symptoms. Use of healthcare services among patients was high. In the 3 months preceding Visit 1, patients used emergency services 0.4 ± 0.9 times, primary care consultations 1.6 ± 1.8 times and specialist consultations 1.4 ± 2.0 times (all mean ± SD. A mean of 2.0 ± 5.4 days/patient was also spent in hospital due to vertigo.Conclusions: In addition to the negative impact on the patient from a humanistic perspective, vertigo has considerable impact on work productivity and healthcare resource use.

  6. Vertigo and dizziness in the elderly

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    Lara eFernandez

    2015-06-01

    Full Text Available The prevalence of vertigo and dizziness in people aged more than 60 years reaches 30%, and due to aging of world population, the number of patients is rapidly increasing. The presence of dizziness in the elderly is a strong predictor of falls, which is the leading cause of accidental death in people older than 65 years. Balance disorders in the elderly constitute a major public health problem, and require an adequate diagnosis and management by trained physicians. In the elderly, common causes of vertigo may manifest differently, as patients tend to report less rotatory vertigo and more nonspecific dizziness and instability than younger patients, making diagnosis more complex. In this mini review, age-related degenerative processes that affect balance are presented. Diagnostic and therapeutic approaches oriented to the specific impaired system, including visual, proprioceptive, and vestibular pathways are proposed. In addition, presbystasis -the loss of vestibular and balance functions associated with aging-, benign paroxysmal positional vertigo, and stroke (in acute syndromes should always be considered.

  7. Vertigo-associated disorders

    Science.gov (United States)

    Peripheral vertigo; Central vertigo; Dizziness ... There are two types of vertigo, peripheral and central vertigo. Peripheral vertigo is due to a problem in the part of the inner ear that controls balance. ...

  8. [Surgery for vertigo].

    Science.gov (United States)

    Lacombe, H

    2009-04-01

    Spontaneous recovery or central compensation makes surgical procedures rare in patients with vertigo. Surgery for vertigo proposed after pharmacological or physical therapy fails to eliminate Ménière's disease and some very rare cases of paroxystic positional vertigo. The main target in treating Ménière's disease is to promote vestibular compensation, which is possible only with a nonprogressive and stable deficit leading to readjustment of vestibular reflexes. Surgical procedures can be classified as nondestructive (endolymphatic sac decompression, vestibular nerve decompression, patching of perilymphatic fistulas), selectively destructive (middle fossa or retrosigmoid vestibular neurotomy, lateral semi-circular plugging) and destructive (labyrinthectomy). Surgical indications essentially concern incapacitating vertigo and depend mainly on hearing status. In Ménière's disease, vestibular neurotomy can be regarded as the gold standard considering its good results on vertiginous episodes; however, scoring with functional and quality-of-life scales bring out residual deficiency in some cases.

  9. Vertigo and dizziness in childhood - update on diagnosis and treatment.

    Science.gov (United States)

    Jahn, K; Langhagen, T; Schroeder, A S; Heinen, F

    2011-08-01

    Vertigo and balance disorders are not uncommon in children. The prevalence of vestibular vertigo in 10-year-Dolds is estimated to be 5.7%. The most common cause is vestibular migraine which accounts for almost 40% of the diagnoses. In adolescents, the incidence of somatoform vertigo syndromes increases. Vestibular function can be reliably evaluated at the bedside by the head-impulse test for vestibulo-ocular reflex function, ocular motor testing of the central vestibular system, and balance tests for vestibulo-spinal function. Vestibular migraine is treated by behavioural and drug therapies. Somatoform vertigo improves if information about the disorder and behavioual advice are provided. Sometimes psychotherapy is useful; drug therapy is recommended in severe cases. Other common vestibular disorders in children include benign positioning nystagmus and labyrinthitis. In summary, the underlying causes of vertigo and dizziness in children can be diagnosed on the basis of patient history and clinical bedside testing. Reponses to caloric irrigation of the ears, rotational chair testing, posturography, and video-oculography can be used to ascertain the diagnosis. Brain imaging is indicated in patients presenting with subacute central vestibular signs. The majority of syndromes have a favourable prognosis and can be successfully treated.

  10. Major diseases manifesting by vestibular vertigo: Treatment and rehabilitation

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    V. A. Parfenov

    2015-01-01

    Full Text Available Betahistine hydrochloride is the drug of choice for the treatment of vestibular vertigo in the presence of benign paroxysmal positional vertigo, Meniere's disease, and vestibular neuronitis. Effective combination therapy regimens that contain, along with drugs from other pharmacological groups, betahistine hydrochloride that improves blood circulation in the vestibular structures, accelerates vestibular compensation, and prevents recurrent dizzy spells, have been elaborated to treat central vestibular vertigo in migraine-associated dizziness and in acute cerebrovascular accident. Of great importance is a combination of drug therapy and the current rehabilitation methods for vestibular diseases, which contribute to prompter and complete recovery of vestibular function. Biofeedback instrumental rehabilitation techniques using a stabilographic platformare highly effective. Successful treatment depends on the correctness of the established diagnosis. The diagnosis of peripheral and central vestibular vertigo frequently poses challenges. The essential reason for this is physicians’ unawareness about outpatient methods for the diagnosis of major vestibular diseases when the patient is at a doctor. It is important to follow a vestibular system study protocol since the use and correct assessment of diagnostic tests in most cases make it possible to estimate the degree of vestibular analyzer injury and to make an accurate diagnosis. The paper describes the diseases that are the most common causes of vestibular vertigo. The most effective methods for their treatment and current rehabilitation methods are discussed.

  11. Ischemic syndromes causing dizziness and vertigo.

    Science.gov (United States)

    Choi, K-D; Lee, H; Kim, J-S

    2016-01-01

    Dizziness/vertigo and imbalance are the most common symptoms of vertebrobasilar ischemia. Even though dizziness/vertigo usually accompanies other neurologic symptoms and signs in cerebrovascular disorders, a diagnosis of isolated vascular vertigo is increasing markedly by virtue of recent developments in clinical neurotology and neuroimaging. It is important to differentiate isolated vertigo of a vascular cause from more benign disorders involving the inner ear, since therapeutic strategies and prognosis differ between these two conditions. Over the last decade, we have achieved a marked development in the understanding and diagnosis of vascular dizziness/vertigo. Introduction of diffusion-weighted magnetic resonance imaging (MRI) has greatly enhanced detection of infarctions in patients with vascular dizziness/vertigo, especially in the posterior-circulation territories. However, well-organized bedside neurotologic evaluation is even more sensitive than MRI in detecting acute infarction as a cause of spontaneous prolonged vertigo. Furthermore, detailed evaluation of strategic infarctions has elucidated the function of various vestibular structures of the brainstem and cerebellum. In contrast, diagnosis of isolated labyrinthine infarction still remains a challenge. This diagnostic difficulty also applies to isolated transient dizziness/vertigo of vascular origin. Regarding the common nonlacunar mechanisms in the acute vestibular syndrome from small infarctions, individual strategies may be indicated to prevent recurrences of stroke in patients with vascular vertigo.

  12. Clinical Management of a Patient with Chronic Recurrent Vertigo Following a Mild Traumatic Brain Injury

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    Eric G. Johnson

    2009-01-01

    Full Text Available Vertigo, was provoked and right torsional up-beat nystagmus was observed in a 47-year-old patient when she was placed into the right Hallpike-Dix test position using infrared goggle technology. The clinical diagnosis was benign paroxysmal positional vertigo (BPPV, specifically right posterior canalithiasis, resulting from a mild traumatic brain injury (TBI suffered approximately six-months earlier. Previous medical consultations did not include vestibular system examination, and Meclizine was prescribed to suppress her chief complaint of vertigo. Ultimately, the patient was successfully managed by performing two canalith repositioning maneuvers during a single clinical session. The patient reported 100% resolution of symptoms upon reexamination the following day, and the Hallpike-Dix test was negative. Continued symptom resolution was subjectively reported 10 days postintervention via telephone consultation. This case report supports previous publications concerning the presence of BPPV following TBI and the need for inclusion of vestibular system examination during medical consultation.

  13. Vertigo Imaging; Clinical Radiology'

    Directory of Open Access Journals (Sweden)

    Jalal Jalal Shokouhi

    2009-01-01

    ;' and anxiety in psychiatry. "n- Clinical differentiating of peripheral and central vestibular lesion should be done by separating harmonic and disharmonic vestibular syndrome. "n- Examination of the patient with vertigo '' laboratory and imaging'' "n•Electronystagmography "n•Video-oculography "n•Audiometry "n•BAEP "n•CT "n•MRI "n - Common cause of vertigo '' all by image '' "nPeripheral: Physiological '' motion sickness'', benign paroxysmal positional vertigo , vestibular neuronitis , labyrinthitis , meniere disease , perilymph fistula. "nCentral: Brain stem TIA/infarct , post. fossa tumors , M.sclerosis, syringobulbia ,Arnold -chiari , temporal lobe epilepsy and basilar migraine. "nOthers: Cardiac , GI , psycogenic , mediacations , anemia and  hypotension , toxin and drugs: "n''aminoglycoside antibiotics,anticonvulsants,salycilates , alcohol , sedatives , antihistamins , antidepressants '' , cervical spondylosis , sensory deprivation ''neuropathy , visual impairment '',anemia , hypoglycemia , orthostatic hypotension and hyperventilation.  

  14. Clinical and demographic features of vertigo: findings from the REVERT registry

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    Sam eAgus

    2013-05-01

    Full Text Available IntroductionDespite being a common disease, data on vertigo management in a real-world setting are scarce. AimsTo provide information on the vertigo and its management in a real-world setting.Materials and MethodsData were collected from 4,294 patients with vertigo in 13 countries over 28 months via a multi-national, non-interventional observational study (the so-called REVERT registry. Data included medical history and details of anti-vertigo therapy. ‘Clinical global impression’ (CGI of severity (CGI-S was assessed at baseline (V1 and then at 6 months follow-up (V2 along with CGI change (CGI-C. All variables were analysed descriptively. ResultsThe majority of patients were female, >40 years of age, and almost half had co-morbid cardiovascular disease. Diagnoses were split into 4 categories: 37.2% ‘other vertigo of peripheral vestibular origin’, 26.9% benign paroxysmal positional vertigo (BPPV, 20.5% ‘peripheral vestibular vertigo of unknown origin’ and 15.4% Menière’s disease (MD. Betahistine was the most commonly prescribed therapy prior to and after enrolment, and was followed by piracetam, ginkgo biloba and diuretics. MD had the highest proportion of betahistine treated patients. Almost half of patients were ‘moderately ill’ at V1 based on CGI-S. At V2, patient distribution moved towards ‘less severe illness’ (91.0% improved.The greatest improvements were in the more severely ill, and those with BPPV or ‘other vertigo of peripheral origin’. ConclusionsThere was a reduction in illness severity over the course of the study, some of which is likely to be due to pharmacological intervention. Further studies are needed to confirm these results.

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

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    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.

  16. 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.

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

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    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.

  18. Drug treatment of vertigo in neurological disorders

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    Ivana I Berisavac

    2015-01-01

    Full Text Available Vertigo is a common symptom in everyday clinical practice. The treatment depends on the specific etiology. Vertigo may be secondary to inner ear pathology, or any existing brainstem or cerebellar lesion but may also be psychogenic. Central vertigo is a consequence of a central nervous system lesion. It is often associated with a focal neurological deficit. Peripheral vertigo is secondary to dysfunction of the peripheral vestibular system and is usually characterized by an acute vertigo with loss of balance, sensation of spinning in the space or around self, and is exaggerated with changes of the head and body position; no other neurological deficit is present. Some medications may also cause vertigo. Depending on the cause of the vertigo, drugs with different mechanisms of action, physical therapy, psychotherapy, as well as surgery may be used to combat this disabling malady. Symptomatic treatment has a particularly important role, regardless of the etiology of vertigo. We reviewed the current medications recommended for patients with vertigo, their mechanisms of action and their most frequent side effects.

  19. Drug treatment of vertigo in neurological disorders.

    Science.gov (United States)

    Berisavac, Ivana I; Pavlović, Aleksandra M; Trajković, Jasna J Zidverc; Šternić, Nadežda M Čovičković; Bumbaširević, Ljiljana G Beslać

    2015-01-01

    Vertigo is a common symptom in everyday clinical practice. The treatment depends on the specific etiology. Vertigo may be secondary to inner ear pathology, or any existing brainstem or cerebellar lesion but may also be psychogenic. Central vertigo is a consequence of a central nervous system lesion. It is often associated with a focal neurological deficit. Peripheral vertigo is secondary to dysfunction of the peripheral vestibular system and is usually characterized by an acute vertigo with loss of balance, sensation of spinning in the space or around self, and is exaggerated with changes of the head and body position; no other neurological deficit is present. Some medications may also cause vertigo. Depending on the cause of the vertigo, drugs with different mechanisms of action, physical therapy, psychotherapy, as well as surgery may be used to combat this disabling malady. Symptomatic treatment has a particularly important role, regardless of the etiology of vertigo. We reviewed the current medications recommended for patients with vertigo, their mechanisms of action and their most frequent side effects.

  20. Vertigo and dizziness in children.

    Science.gov (United States)

    Jahn, K

    2016-01-01

    Vertigo and dizziness of at least moderate severity occur in >5% of school-aged children and cause considerable restrictions in participation in school and leisure activity. More than 50% of dizzy children also have headache. Vestibular migraine and benign paroxysmal vertigo as a migraine precursor are the most common diagnoses in dizziness clinics for children and adolescents. They account for 30-60% of diagnoses. Other common causes are somatoform, orthostatic, or posttraumatic dizziness. All other disorders that are known to cause vertigo and dizziness in adults also occur in children, but incidence rates are usually lower. The vestibular and balance systems are largely developed after 1 year of age. Therefore, clinical and laboratory testing is reliable. Brain magnetic resonance imaging to exclude severe conditions, such as a brainstem tumor, is necessary only if clinical - in particular, ocular motor - testing is abnormal. Most conditions causing vertigo and dizziness in childhood and adolescence are treatable. Nonpharmacologic prophylaxis should always be recommended in vestibular migraine. Behavioral support is useful in somatization. Evidence for the effectiveness of drug therapy is largely based on experience in adult populations. High-quality controlled studies in childhood cohorts are sparse. It is important to make a correct diagnosis early on, as counseling and appropriate treatment may avoid chronic illness.

  1. The treatment of acute vertigo.

    Science.gov (United States)

    Cesarani, A; Alpini, D; Monti, B; Raponi, G

    2004-03-01

    Vertigo and dizziness are very common symptoms in the general population. The aim of this paper is to describe the physical and pharmacological treatment of symptoms characterized by sudden onset of rotatory vertigo. Acute vertigo can be subdivided into two main groups: (1) spontaneous vertigo and (2) provoked vertigo, usually by postural changes, generally called paroxysmal positional vertigo (PPV). Sudden onset of acute vertigo is usually due to acute spontaneous unilateral vestibular failure. It can be also fluctuant as, e.g., in recurrent attacks of Ménière's disease. Pharmacotherapy of acute spontaneous vertigo includes Levo-sulpiride i.v., 50 mg in 250 physiologic solution, once or twice a day, methoclopramide i.m., 10 mg once or twice a day, or triethilperazine rectally, once or twice a day, to reduce neurovegetative symptoms; diazepam i.m., 10 mg once or twice a day, to decrease internuclear inhibition, sulfate magnesium i.v., two ampoules in 500 cc physiological solution, twice a day, or piracetam i.v., one ampoule in 500 cc physiological solution, twice a day, to decrease vestibular damage. At the onset of the acute symptoms, patients must lie on their healthy side with the head and trunk raised 20 degrees. The room must be quiet but not darkened. If the patient is able to swallow without vomiting, it is important to reduce nystagmus and stabilize the visual field with gabapentine, per os, 300 mg twice or three times a day. The first step of the physical therapy of acute vertigo is vestibular electrical stimulation, that is to say, a superficial paravertebral electrical stimulation of neck muscles, aimed to reduce antigravitary failure and to increase proprioceptive cervical sensory substitution. PPV is a common complaint and represents one of the most common entities in peripheral vestibular pathology. While the clinical picture is well known and widely described, the etiopathogenesis of PPV is still a matter of debate. Despite the different

  2. Cervicogenic vertigo: etiology, diagnosis and treatment

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    Elham Tavanai

    2013-07-01

    Full Text Available Background and Aim: Cervicogenic dizziness is induced by a specific neck position and the earth’s gravity has no effect on provoking of it. The precise incidence of cervicogenic dizziness is not certain but, 20-58% of patients following sudden head injuries experience its symptoms . In this article, the etiology, diagnosis and treatment of cervicogenic vertigo is discussed. Methods: At first, articles of cervicogenic dizziness from electronic databases of Google scholar , PubMed, Scopus, Ovid and CINAHL were searched from 1987 up to 2012. Then, the articles in them vertigo, disequilibrium or nystagmus were consistent with neck disorders were searched. Conclusion: Articles with title of cervicogenic vertigo (cervical vertigo were limited. Clinical researches about cervicogenic vertigo up to now implicate on several points; all signify that we cannot diagnose it certainly and there is not any specific single test for that. Recently, smooth pursuit neck torsion test (SPNTT has introduced for diagnosis of cervicogenic vertigo that is not valid yet. There is no protocol for diagnosis of cervicogenic vertigo and diagnosis is often based on limited clinical experiences of clinicians. Physiotherapy, medication and manual therapies are options for treatment but there is no distinct and effective treatment for it and in just one article, a combination of treatments for cervicogenic vertigo as a protocol has recommended.

  3. 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.

  4. Acute Diagnosis and Management of Stroke Presenting Dizziness or Vertigo.

    Science.gov (United States)

    Lee, Seung-Han; Kim, Ji-Soo

    2015-08-01

    Stroke involving the brainstem and cerebellum frequently presents acute vestibular syndrome. Although vascular vertigo is known to usually accompany other neurologic symptoms and signs, isolated vertigo from small infarcts involving the cerebellum or brainstem has been increasingly recognized. Bedside neuro-otologic examination can reliably differentiate acute vestibular syndrome due to stroke from more benign inner ear disease. Sometimes acute isolated audiovestibular loss may herald impending infarction in the territory of the anterior inferior cerebellar artery. Accurate identification of isolated vascular vertigo is very important because misdiagnosis of acute stroke may result in significant morbidity and mortality.

  5. Particle sedimentation in curved tubes: A 3D simulation and optimization for treatment of vestibular vertigo

    Science.gov (United States)

    White, Brian; Squires, Todd M.; Hain, Timothy C.; Stone, Howard A.

    2003-11-01

    Benign paroxysmal positional vertigo (BPPV) is a mechanical disorder of the vestibular system where micron-size crystals abnormally drift into the semicircular canals of the inner ear that sense angular motion of the head. Sedimentation of these crystals causes sensation of motion after true head motion has stopped: vertigo results. The usual clinical treatment is through a series of head maneuvers designed to move the particles into a less sensitive region of the canal system. We present a three-dimensional model to simulate treatment of BPPV by determining the complete hydrodynamic motion of the particles through the course of a therapeutic maneuver while using a realistic representation of the actual geometry. Analyses of clinical maneuvers show the parameter range for which they are effective, and indicate inefficiencies in current practice. In addition, an optimization process determines the most effective head maneuver, which significantly differs from those currently in practice.

  6. Causes of vertigo

    Directory of Open Access Journals (Sweden)

    Violetta Aleksandrovna Tolmacheva

    2010-01-01

    Full Text Available Vertigo is the second common complaint next to headache, which makes a patient seek medical care. Neurological, auricular, cardiac, mental, and other diseases may be a cause of dizziness. Since vertigo is interdisciplinary in nature, there are frequently problems of establishing its origin. Vertigo is commonly associated with vascular pathology of the head and neck, which results in the hyperdiagnosis of cerebrovascular diseases. At the same time, little attention is given to the patient's psychoemotional sphere and ENT pathology. Large-scale studies have demonstrated that vertigo most frequently results from psychogenic causes and vestibular apparatus diseases.

  7. [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.

  8. 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.

  9. Vertigem no idoso: relato de caso Vertigo in elderly: a case report

    Directory of Open Access Journals (Sweden)

    Marcelle Alpino Levandowski

    2008-12-01

    Full Text Available TEMA: investigar a vertigem em paciente idosa com vários comprometimentos sistêmicos e avaliar a efetividade terapêutica para o tratamento da vertigem Posicional Paroxística Benigna (VPPB. PROCEDIMENTOS: estudo de caso longitudinal de paciente do sexo feminino com vertigem submetido à terapia fonoaudiológica com exercícios de habituação vestibular. RESULTADOS: no período de seis meses, observou-se melhora no quadro vertiginoso da paciente. CONCLUSÃO: a reabilitação vestibular com exercícios de habituação vestibular mostrou eficácia no tratamento da VPPB da paciente.BACKGROUND: to investigate the vertigo in elderly woman with several systemic commitments and evaluate treatment effectiveness for Benign Paroxysmal Positional Vertigo (BPPV. PROCEDURES: longitudinal clinical study of a female patient with vertigo submitted to speech and hearing therapy with vestibular habituation exercises. RESULTS: after six months the patient had clinical improvement. CONCLUSION: vestibular rehabilitation with vestibular habituation exercises showed effectiveness in the treatment of this patient with BPPV.

  10. Health services utilization of patients with vertigo in primary care: a retrospective cohort study.

    Science.gov (United States)

    Grill, Eva; Strupp, Michael; Müller, Martin; Jahn, Klaus

    2014-08-01

    Vertigo and dizziness count among the most frequent symptoms in outpatient practices. Although most vestibular disorders are manageable, they are often under- and misdiagnosed in primary care. This may result in prolonged absence from work, increased resource use and, potentially, in chronification. Reliable information on health services utilization of patients with vertigo in primary care is scarce. Retrospective cohort study in patients referred to a tertiary care balance clinic. Included patients had a confirmed diagnosis of benign paroxysmal positional vertigo (BPPV), Menière's disease (MD), vestibular paroxysmia (VP), bilateral vestibulopathy (BVP), vestibular migraine (VM), or psychogenic vertigo (PSY). All previous diagnostic and therapeutic measures prior to the first visit to the clinic were recorded. 2,374 patients were included (19.7 % BPPV, 12.7 % MD, 5.8 % VP, 7.2 % BVP, 14.1 % VM, 40.6 % PSY), 61.3 % with more than two consultations. Most frequent diagnostic measures were magnetic resonance imaging (MRI, 76.2 %, 71 % in BPPV) and electrocardiography (53.5 %). Most frequent therapies were medication (61.0 %) and physical therapy (41.3 %). 37.3 % had received homoeopathic medication (39 % in BPPV), and 25.9 % were treated with betahistine (20 % in BPPV). Patients had undergone on average 3.2 (median 3.0, maximum 6) diagnostic measures, had received 1.8 (median 2.0, maximum 8) therapies and 1.8 (median 1.0, maximum 17) different drugs. Diagnostic subgroups differed significantly regarding number of diagnostic measures, therapies and drugs. The results emphasize the need for establishing systematic training to improve oto-neurological skills in primary care services not specialized on the treatment of dizzy patients.

  11. Migrainous vertigo and basilar migraine(Analyze the clinical symptoms of 9 migraine patients with vertigo)%偏头痛性眩晕与基底型偏头痛(附9例临床分析)

    Institute of Scientific and Technical Information of China (English)

    马维娅; 单希征; 孙勍; 李娜; 戴静; 彭新

    2012-01-01

    Objective By analysing the results of clinical and laboratory examinations in 9 migraine patients with vertigo or dizziness, we aimed to recognize the relationship between migraine and vertigo, and to improve the diagnosis and treatments of the patients. Methods Nine migraine patients with vertigo/dizziness were selected from our hospital. Besides the detailed questionnaire on the medical history, clinical and laboratory examinations, including neurological examination, vestibule functioning, hearing tests and head CT/MR1, were adopted in each patient, so as to exclude the cases caused by central and vestibule related vertigo. Results Among the 9 migraine patients with vertigo /dizziness, there were 2 cases of hasilar migraine, 3 cases of migraine without aura, and 6 cases of migrainous vertigo (MV, in which 2 migraine patients changed to MV). In the 6 MV patients, vertigo or dizziness occurred several seconds to one hour prior to the headache in 3 cases, post headache in 1 case and simultaneously with headache in 1 case. There was one migraine case, whose headache never occurred together with vertigo, called migraine equivalent. Conclusions MV is a special type of migraine syndrome associated with vertigo or dizziness due to basilar migraine. The diagnosis needs to be distinguished clearly from Meniere' s disease, benign paroxysmal positional vertigo, posterior circulation ischemia (PCI), etc.%目的 分析9例偏头痛伴眩晕/头晕患者的临床及实验室检查结果,探讨头痛与眩晕/头晕的关系,以利正确诊治.方法 作者医院收治的偏头痛伴眩晕/头晕患者9例,对所有患者均详细收集病史,并进行神经系统查体以及前庭功能、听力检查和头颅CT/MRI等实验室检查,以除外中枢性和耳源性眩晕.结果 9例偏头痛伴眩晕/头晕患者中,基底型偏头痛2例,无先兆偏头痛3例,偏头痛性眩晕( migrainous vertigo,MV)6例(其中2例为无先兆偏头痛发作数年后和50

  12. 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...

  13. 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 .

  14. 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...

  15. 学龄前儿童眩晕的病因分析及诊断方法的合理选择%Preschool children' s vertigo: an investigation of etiologies and choice of appropriate diagnostic techniques

    Institute of Scientific and Technical Information of China (English)

    曾祥丽; 李鹏; 李永奇; 岑锦添; 黎志成

    2011-01-01

    Objective To identify common etiologies, clinical characteristics and appropriate diagnostic techniques in preschool children with vertigo. Methods The authors retrospectively analyzed the clinical characteristics, process of diagnosis and treatment in 12 vertigo-suffering children aging from 14 months to 6.5 years, and their parents' attitude toward the diagnostic techniques. Results (l) Etiologies of vertigo in the 12 children included secretory otitis media (SOM, n=3), benign paroxysmal vertigo (BPV, n=3), inner ear malformation (n=3), benign paroxysmal positional vertigo (BPPV, n=2) and Meniere' s disease (MD, n=l). (2) The younger the child, the fewer typical complaints of vertigo, instead of recurrent falls, difficulties in walking, poor balance and clumsiness, fear or panic. The youngest child that complained of vertigo was 5.5 years old. None of the children were able to describe the details of their vertigo episodes. (3) Among all the diagnostic techniques, vertigo questionnaire was the most acceptable to parents, and vestibular tests were the least. Conclusion Common etiologies of preschool children vertigo include SOM, BPV and inner ear malformation, Sufferers younger than 5 years seldom complain of vertigo. Vertigo questionnaires are powerful tools for clinicians in detecting vertigo and a thorough understanding of the history and symptoms helps the clinician in selecting appropriate diagnostic techniques.%目的 探讨学龄前儿童眩晕的常见病因、临床表现特点及合理的诊断方法.方法 回顾性分析12例学龄前儿童眩晕的临床表现特点、诊疗经过、结果及家长对各项诊断方法的接受程度.结果 (1) 12例患儿的诊断结果为:分泌性中耳炎3/12,儿童良性发作性眩晕3/12,内耳畸形3/12,良性阵发性位置性眩晕2/12,梅尼埃病1/12.(2)患儿年龄越小,典型的眩晕主诉越少,多表现为摔倒、行走不稳、行动笨拙、恐惧和害怕,能主诉眩晕的患儿最小年龄5.5

  16. VERTIGO IN INTERNAL MEDICINE PRACTICE

    Directory of Open Access Journals (Sweden)

    O. M. Drapkina

    2015-12-01

    Full Text Available Vertigo is observed in 30% of people above 65 y.o. and in 50% of peoples above 80 y.o. This disorder significantly affects patient quality of life and can be a reason of incidences, trauma and even disability. Vertigo is classified as systemic or non-systemic. It can be consequence of different disturbances. Physician of any clinical specialty can face with this problem. Identification of the vertigo cause is a quite difficult problem, but success of treatment depends on it. First of all treatment strategy should be directed to elimination of the vertigo cause.

  17. Betahistine dihydrochloride in the treatment of peripheral vestibular vertigo.

    Science.gov (United States)

    Mira, Eugenio; Guidetti, G; Ghilardi, L; Fattori, B; Malannino, N; Maiolino, L; Mora, R; Ottoboni, S; Pagnini, P; Leprini, M; Pallestrini, E; Passali, D; Nuti, D; Russolo, M; Tirelli, G; Simoncelli, C; Brizi, S; Vicini, C; Frasconi, P

    2003-02-01

    The present study compares the efficacy and safety of betahistine dihydrochloride to that of a placebo in recurrent vertigo resulting from Meniere's disease (MD) or in paroxysmal positional vertigo (PPV) of probable vascular origin. The design was double-blind, multicentre and parallel-group randomised. Eleven Italian centres enrolled 144 patients: 75 of the patients were treated with betahistine (41 MD/34 PPV) and 69 with placebos (40 MD/29 PPV). The betahistine dosage was 16 mg twice per day for 3 months. Compared to the placebo, betahistine had a significant effect on the frequency, intensity and duration of vertigo attacks. Associated symptoms and the quality of life also were significantly improved by betahistine. Both the physician's judgement and the patient's opinion on the efficacy and acceptability of the treatment were in agreement as to the superiority of betahistine. The effective and safe profile of betahistine in the treatment of vertigo due to peripheral vestibular disorders was confirmed.

  18. 神经内科门诊685例老年眩晕患者的病因分析%Cause analysis of 685 cases of elderly vertigo in neurology clinic of outpatient department

    Institute of Scientific and Technical Information of China (English)

    刘坤梅; 莫燕; 佘晓秋

    2013-01-01

      目的:分析神经内科门诊以眩晕为主诉的老年患者的常见病因及临床特征。方法:685例老年眩晕患者均为同一时期神经科门诊患者,根据临床特点结合辅助检查,包括头部CT、脑血管超声、颈动脉超声检查、Dix-Hallpike试验、焦虑抑郁量表检测。分析确定眩晕病因。结果:685例老年眩晕患者病因及构成:后循环缺血性眩晕304例(44.4%),精神因素诱发眩晕187例(27.3%),不明原因的前庭周围性眩晕92例(13.4%),良性位置性眩晕81例(11.8%),其他原因占21例(3.1%)。结论:老年眩晕患者中,后循环缺血性眩晕为眩晕的常见病因,医师对有脑血管病危险因素的眩晕患者进行血管病因筛查尤为重要。%Objective: To study the common causes and clinical features of elderly patients with vertigo. Methods: The causes of vertigo were analyzed in 685 elderly neurological outpatients from Apr.2011 to Apr.2012 based on clinical features and laboratory examinationts including head CT, cerebral vascular ultrasound, carotid ultrasound, Dix-Hallpike test, anxiety and depression scale detection. Results: Among 685 cases of elderly patients with vertigo, 304 cases (44.4%) were the posterior circulation ischemic rertigo, 187 cases (27.3%) had mental factors that induced vertigo,92 cases(13.4%) had unexplained peniferal vestibular vertigo, 81 cases(11.8%) had benign positional vertigo, and 21 casese (3.1%)had other causes.Conclusion:Posterior circulation is chemia vertigo is the common cause of vertigo in elderly patients. In vertigo patients with cerebro-vascular disease risk factors,the vascular causes should be screened.

  19. 与眩晕相关的临床误诊分析%Misdiagnosis Related to Vertigo

    Institute of Scientific and Technical Information of China (English)

    耿利娇; 常俊锴; 陈勇; 贺维亚

    2013-01-01

    Objective To analyze the clinical data of misdiagnosis related to Vertigo as to improve the areness level of clinical doctors and the rate of correct diagnosis of Vertigo. Methods Twelve misdiagnosed patients were screened out from Huaihe hospital to analyze the reason of misdiagnosis of Vertigo with references at home and abroad . Results Vertigo can easily be misdiagnosed as transient ischemic attack of vertebrobasilar system. It was the finally diagnosis that six cases of benign paroxysmal positional vertigo, 1case of Meniere's disease , 1 case of vestibular neuronitis ,2 cases of epilepsy, 1 case of migraine. Conclusion Not deta iled history collection ,clinical way of thinking, limited laboratory examinations and other factors relevant to the misdiagnosis of vertigo.%  目的分析眩晕误诊患者的相关临床资料,以期提高临床医师对眩晕的认识水平,提高眩晕的诊断正确率。方法利用河南大学淮河医院2010年至今收治的12例眩晕误诊患者,参考国内外文献以系统回顾的方法分析该病的误诊原因。结果眩晕容易误诊为椎基底动脉系统短暂性脑缺血发作,12例眩晕患者最后确诊为良性发作性位置性眩晕6例、梅尼埃病1例、前庭神经元炎1例、癫痫2例、偏头痛1例。结论病史采集不详细、临床思维局限、辅助检查受限等因素与眩晕的误诊有关。

  20. Seasonality of dizziness and vertigo in a tropical region.

    Science.gov (United States)

    Pereira, Alcione Botelho; Almeida, Leonardo Alves Ferreira; Pereira, Nayara Gorette; Menezes, Patrícia Andrade Freitas de; Felipe, Lilian; Volpe, Fernando Madalena

    2015-06-01

    Vertigo and dizziness are among the most common medical complaints in the emergency room, and are associated with a considerable personal and health care burden. Scarce and conflicting reports indicate those symptoms may present a seasonal distribution. This study aimed at investigating the existence of a seasonal distribution of vertigo/dizziness in a tropical region, and the correlations of these findings with climatic variables. The charts of all patients consecutively admitted between 2009 and 2012 in the emergency room of a Brazilian general hospital were reviewed. A total of 4920 cases containing these terms were sorted from a sample of 276,076 emergency records. Seasonality was assessed using Cosinor Analysis. Pearson's correlations were performed between the incidence of consultations, considering separately dizziness and vertigo and each of the predictor climatic variables of that index month. Significant seasonal patterns were observed for dizziness and vertigo in the emergency room. Vertigo was more frequent in late winter-spring, negatively correlating to humidity (r = -0.374; p = 0.013) and rainfall (r = -0.334; p = 0.020). Dizziness peaked on summer months, and positively correlated to average temperatures (r = 0.520; p dizziness and vertigo indicate possible distinct underlying mechanisms of how seasons may influence the occurrence of those symptoms.

  1. Referral and final diagnoses of patients assessed in an academic vertigo center

    Directory of Open Access Journals (Sweden)

    Rebekka eGeser

    2012-11-01

    Full Text Available OBJECTIVE: To identify under-diagnosed neuro-otological disorders and to evaluate whether under-diagnosing depends on the age of the patient.MATERIAL AND METHODS: Retrospective analysis of medical charts from 951 consecutive patients (685 under and 266 above the age of 65 years who entered diagnostic procedures at the Interdisciplinary Center for Vertigo and Balance Disorders, University Hospital Zurich, Switzerland. Final diagnoses were compared to referral diagnoses.RESULTS: Relative to referral diagnoses, the proportion of patients finally diagnosed with benign paroxysmal positional vertigo (BPPV almost doubled both in younger (< 65 year from 12.7% to 25.1% and older patients (from 20.7% to 37.6%. Striking relative increases were found for the diagnoses multisensory dizziness in older patients (from 20.7% to 37.6% and vestibular migraine in younger patients (1.8% to 20.2%. In both age groups, the proportion of patients with undetermined diagnoses was reduced by about 60% (younger: 69.8% to 9.8%; older: 69.2% to 12.4% by the diagnostic procedures in the vertigo center. These changes were all significant (p < 0.05 in McNemar tests with continuity correction (2x2 tables: focused diagnosis vs. other diagnoses, referral vs. final.CONCLUSION: Significant changes of diagnoses can be expected by a specialized neuro-otological work-up. In particular, BPPV, multisensory dizziness, and vestibular migraine are under-diagnosed by referring physicians. This finding calls for better education of primary care takers in the field of neuro-otology.

  2. A mathematical model for top-shelf vertigo: the role of sedimenting otoconia in BPPV

    CERN Document Server

    Squires, T M; Hain, T C; Stone, H A; Stone, Howard A.

    2003-01-01

    Benign Paroxysmal Positional Vertigo (BPPV) is a mechanical disorder of the vestibular system, in which calcite particles called otoconia interfere with the mechanical functioning of the fluid-filled semicircular canals normally used to sense rotation. Using hydrodynamic models, we examine the two mechanisms proposed by the medical community for BPPV: cupulolithiasis, in which otoconia attach directly to the cupula (a sensory membrane), and canalithiasis, in which otoconia settle through the canals and exert a fluid pressure across the cupula. Extending known hydrodynamic calculations and making reasonable geometric and physical approximations, we derive an expression for the transcupular pressure $\\Delta P_c$ exerted by a settling solid particle in canalithiasis. By tracking settling otoconia in a model two-dimensional geometry, the cupular displacement and associated eye response (nystagmus) can be calculated quantitatively. Several important features emerge: 1) A pressure amplification occurs as otoconia e...

  3. Drug treatment of vertigo in neurological disorders

    OpenAIRE

    Ivana I Berisavac; Pavlović, Aleksandra M.; Jasna J. Zidverc Trajković; Čovičković Šternić, Nadežda M; Ljiljana G. Beslać Bumbaširević

    2015-01-01

    Vertigo is a common symptom in everyday clinical practice. The treatment depends on the specific etiology. Vertigo may be secondary to inner ear pathology, or any existing brainstem or cerebellar lesion but may also be psychogenic. Central vertigo is a consequence of a central nervous system lesion. It is often associated with a focal neurological deficit. Peripheral vertigo is secondary to dysfunction of the peripheral vestibular system and is usually characterized by an acute vertigo with l...

  4. [Differential diagnosis "vertigo and dizziness"].

    Science.gov (United States)

    Plontke, S K; Walther, L E

    2014-08-01

    Vertigo and dizziness are symptoms of interdisciplinary dimension. However, the differentiation and classification of vertigo syndromes also require experience and multidisciplinary knowledge. Since the clinical syndrome is subjective, a detailed analysis of the complaints underlying is required. International disease definitions are an indispensable tool in the differential diagnosis of vertigo syndromes today. With simple diagnostic tools eye movement disorders and nystagmus can be examined and assigned to specific vestibular disorders today. Screening tests (e.g. head impulse test) are now an important instrument in the investigation of patients with vertigo syndromes in case of emergency. With objective diagnostic methods (caloric irrigation, video head impulse test, vestibular evoked myogenic potentials) the degree of functional impairment of the five vestibular receptors can be assessed quantitatively. Furthermore, in vestibulopathies, a receptor and side-specific diagnostic assessment can be performed even with regard to dynamic aspects.

  5. 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 ...

  6. Patients' psychological well-being and resilient coping protect from secondary somatoform vertigo and dizziness (SVD) 1 year after vestibular disease.

    Science.gov (United States)

    Tschan, Regine; Best, Christoph; Beutel, Manfred E; Knebel, Achim; Wiltink, Jörg; Dieterich, Marianne; Eckhardt-Henn, Annegret

    2011-01-01

    Secondary somatoform dizziness and vertigo (SVD) is an underdiagnosed and handicapping psychosomatic disorder, leading to extensive utilization of health care and maladaptive coping. Few long-term follow-up studies have focused on the assessment of risk factors and little is known about protective factors. The aim of this 1-year follow-up study was to identify neurootological patients at risk for the development of secondary SVD with respect to individual psychopathological disposition, subjective well-being and resilient coping. In a prospective interdisciplinary study, we assessed mental disorders in n=59 patients with peripheral and central vestibular disorders (n=15 benign paroxysmal positional vertigo, n=15 vestibular neuritis, n=8 Menière's disease, n=24 vestibular migraine) at baseline (T0) and 1 year after admission (T1). Psychosomatic examinations included the structured clinical interview for DSM-IV, the Vertigo Symptom Scale (VSS), and a psychometric test battery measuring resilience (RS), sense of coherence (SOC), and satisfaction with life (SWLS). Subjective well-being significantly predicted the development of secondary SVD: Patients with higher scores of RS, SOC, and SWLS at T0 were less likely to acquire secondary SVD at T1. Lifetime mental disorders correlated with a reduced subjective well-being at T0. Patients with mental comorbidity at T0 were generally more at risk for developing secondary SVD at T1. Patients' dispositional psychopathology and subjective well-being play a major predictive role for the long-term prognosis of dizziness and vertigo. To prevent secondary SVD, patients should be screened for risk and preventive factors, and offered psychotherapeutic treatment in case of insufficient coping capacity.

  7. [Some characteristics of vertigo in vestibular neuronitis].

    Science.gov (United States)

    Skliut, I A; Likhachev, S A; Rybina, O V

    2004-01-01

    The authors present a detailed clinical analysis of objective neurological symptoms and vertigo in patients with vestibular neuronitis. Diagnostic criteria are specified allowing differentiation between vertigo and dizziness, pathognomonic signs of vestibular neuronitis are outlined. Peripheral location of the pathological process in vestibular neuronitis is suggested. How rotating vertigo is forming in patients with vestibular neuronitis is hypothesized.

  8. Visual vertigo analogue scale: an assessment questionnaire for visual vertigo.

    Science.gov (United States)

    Dannenbaum, Elizabeth; Chilingaryan, Gevorg; Fung, Joyce

    2011-01-01

    A common symptom for people with vestibulopathy is dizziness induced by dynamic visual input, known as visual vertigo (VV). The goal of this study is to present a novel method to assess VV, using a nine-item analog scale. The subjects rated the intensity of their dizziness on each item of the Visual Vertigo Analogue Scale (VVAS), which represented a daily situation typically inducing VV. The questionnaire was completed by participants with vestibulopathy (n=102) and by subjects receiving out-patient orthopaedic physiotherapy (n=102). The dizziness handicap inventory (DHI) was also completed by the vestibulopathic group. The Cronbach's Alpha index indicated the VVAS is internally consistent and reliable (Cronbach's Alpha=0.94). The study also found that the VVAS severity scores from vestibular and a non-vestibular population were significantly different (Wilcoxon-Mann Whitney test p scale may be useful in providing a quantitative evaluation scale of visual vertigo.

  9. Initial evaluation of vertigo

    Directory of Open Access Journals (Sweden)

    Lemajić-Komazec Slobodanka

    2006-01-01

    Full Text Available Dizziness is one of the most common reasons patients visit their physicians. Balance control depends on receiving afferent sensory information from several sensory systems: vestibular, optical and proprioceptive. Bioelectric signals, generated by body movements in the semicircular canals and in the otolithic apparatus, are transported via the vestibular nerve to the vestibular nucleus. All four vestibular nuclei, located bilaterally in medial longitudinal fasciculus, are linked with central nervous system structures. These central nervous system structures are involved in maintaining visual stability, spatial orientation and balance control. Nystagmus is a result of afferent signals balance disorders. Nystagmus due to peripheral lesions is conjugate nystagmus, because there is a bilateral central connection. Lesions above the vestibular nuclei induce deficits in synchronization and conjugation of eye movements, thus the nystagmus is dissociated. This paper shows that in peripheral vestibular disorders spontaneous nystagmus is rhythmic, associated, horizontal-rotatory or horizontal, with subjective sensation of dizziness which decreases with time and harmonic signs whose direction coincides with the slow phase of nystagmus and it is associated with mild disorders during pendular stimulation with statistically significant vestibular hypofunction. Spontaneous nystagmus in central vestibular lesions is severe, dissociated, horizontal, rotatory or vertical, without changes related to optical suppression; if vestibular symptoms are present, they are non-harmonic. In central disorders, findings after thermal stimulation are either normal or pathological, with dysrhythmias and inhibition in pendular stimulation. This paper deals with differential diagnosis of vertigo based on anamnesis and clinical examination, as well as objective diagnostic tests. .

  10. Clinical characteristics of cervicogenic-related dizziness and vertigo.

    Science.gov (United States)

    Yacovino, Dario A; Hain, Timothy C

    2013-07-01

    Cervical vertigo has long been a controversial entity and its very existence as a medical entity has advocates and opponents. Supporters of cervical vertigo claim that its actual prevalence is underestimated due to the overestimation of other diagnostic categories in clinics. Furthermore, different pathophysiological mechanisms have been attributed to cervical vertigo. Here the authors discuss the clinical characteristics of rotational vertebral artery vertigo, postwhiplash vertigo, proprioceptive cervical vertigo, and cervicogenic vertigo of old age. A clinical entity named subclinical vertebrobasilar insufficiency appears in the context of cervical osteoarticular changes. Migraine-associated vertigo may explain why some patients suffering from cervical pain have vertigo while others do not.

  11. Betahistine for symptoms of vertigo

    NARCIS (Netherlands)

    Murdin, Louisa; Hussain, Kiran; Schilder, Anne G M

    2016-01-01

    BACKGROUND: Vertigo is a symptom in which individuals experience a false sensation of movement. This type of dizziness is thought to originate in the inner ear labyrinth or its neural connections. It is a commonly experienced symptom and can cause significant problems with carrying out normal activi

  12. Analysis on Clinical Misdiagnosis of Vertigo%眩晕临床误诊分析

    Institute of Scientific and Technical Information of China (English)

    查达珍; 郑志雄; 郑建明

    2013-01-01

    Objective To analyze the clinical characteristics and the causes of misdiagnosis of vertigo to improve the diagnosis rate. Methods The clinical data of 235 vertigo cases of our hospital from January 2009 to June 2012 were analyzed retrospectively. Misdiagnosed cases were selected to analyze misdiagnosis. The contents included: the consequences of misdiagnosis and diagnose, the clinical manifestation of misdiagnosed cases, imaging, otology and electrophysiology test, cerebrospinal fluid test, hospitals and departments of misdiagnosed cases. Results 93 cases of vertigo were misdiagnosed, and the misdiagnosis rate was 39. 6%. The patients were misdiagnosed as 39 cases of vertebrobasilar insufficiency, 13 cases of Meniere's disease, 11 cases of cervical vertebra disease, 8 cases of cerebral infarction, 8 cases of posterior circulation ischemia, 4 cases of craniocerebral injury syndrome, 4 cases of vestibular neuronitis, 3 cases of migrainous vertigo and 3 cases of hysteria. According to diagnostic criteria, the misdiagnosed cases were: 53 cases of benign paroxysmal positional vertigo, 10 cases of Meniere's disease, 7 cases of vestibular neuronitis, 5 cases of delayed endolymphatic hydrops, 4 cases of cerebellar infarction, 3 cases of brain stem infarction , 3 cases of migrainous vertigo, 2 cases of multiple sclerosis, 2 cases of acoustic neuromas, 2 cases of sudden sensorineural hearing loss, one case of drug induced vertigo and one case of labyrinthine concussion. Conclusion The misdiagnosis rate of vertigo is high due to various causes. The improvement of doctor's recognition of vertigo and related diseases and detailed enquiry of disease history as well as careful body examination and otologic and imaging examination can effectively reduce misdiagnosis rate.%目的 分析眩晕误诊病例的临床特点及误诊原因,总结减少误诊的措施,提高诊断率.方法 回顾性分析2009年1月-2012年6月我院神经内科门诊及住院诊治的235例眩晕患

  13. [Peripheral vertigo versus central vertigo. Application of the HINTS protocol].

    Science.gov (United States)

    Batuecas-Caletrío, Ángel; Yáñez-González, Raquel; Sánchez-Blanco, Carmen; González-Sánchez, Enrique; Benito, José; Gómez, José Carlos; Santa Cruz-Ruiz, Santiago

    2014-10-16

    Introduccion. Uno de los dilemas mas importantes concernientes al vertigo en urgencias es su diagnostico diferencial. Existen signos de alarma de gran sensibilidad en la exploracion que pueden ponernos en la pista de encontrarnos ante un vertigo central. Objetivo. Determinar la eficacia de la aplicacion del protocolo HINTS en el diagnostico del accidente cerebrovascular que simula un vertigo periferico. Pacientes y metodos. Estudio observacional descriptivo sobre pacientes ingresados con diagnostico de sindrome vestibular agudo en urgencias. Todos los pacientes fueron objeto de un seguimiento diario hasta la mejoria de sus sintomas con informacion del nistagmo, la maniobra de impulso oculocefalico y el test de skew. Se comparan los resultados del estudio de resonancia magnetica con la alteracion en alguno de esos tres signos a lo largo del ingreso del enfermo. Resultados. Se reunio a 91 pacientes, con una edad media de 55,8 años. Se objetivo un accidente cerebrovascular en ocho de ellos. De estos (edad media: 71 años), en siete existia una alteracion en alguno de los signos HINTS y en uno el estudio fue normal (sensibilidad: 0,88; especificidad: 0,96). Todos ellos tenian algun factor de riesgo vascular. Conclusiones. Una exploracion adecuada y dirigida ante un paciente que acude a urgencias con un sindrome vestibular agudo resulta de vital importancia para establecer el diagnostico diferencial entre la patologia periferica y la central, ya que algunos accidentes cerebrovasculares se pueden presentar bajo la apariencia de un vertigo agudo. Aplicar un protocolo como HINTS permite sospechar la patologia central con una gran sensibilidad y especificidad.

  14. Vestibular neuronitis: a review of a common cause of vertigo in general practice.

    OpenAIRE

    Cooper, C W

    1993-01-01

    Vestibular neuronitis is an interesting condition characterized by the acute onset of vertigo, nausea and vomiting, in the absence of hearing loss or tinnitus. There is often evidence of a recent or concurrent upper respiratory tract infection. The disease follows a benign course of between two days and six weeks. It often occurs in epidemics. Following the acute attack, mild transitory episodes of dizziness may recur over a period of 12 to 18 months. Clinical and histopathological evidence s...

  15. Vertigo in Elderly – Common but Complicated

    Directory of Open Access Journals (Sweden)

    N. S Neki

    2017-01-01

    Full Text Available Dizziness and its subtype vertigo are common complaints occurring in all age groups after teenage but, it become a major health problem in elderly because of the frequency with which it affects the elder population and leads to direct and indirect consequences. Causes of vertigo in the elderly are not totally different from young population but to some extent they are different too. In elderly, the causation of dizziness and vertigo is interplay multiple factors, so its diagnosis and management differs from other age groups. This review is aimed at highlighting the special aspects of dizziness and vertigo in the elderly.

  16. Vertigo and Dizziness in Neuropsychiatry

    OpenAIRE

    佐久川, 肇; SAKUGAWA, Hajime; 琉球大学医学部附属病院精神科神経科

    1981-01-01

    In order to clarify the clinical features of Vertigo and Dizziness in Neuropsychiatry, two hundred and seven cases which demonstrated these symptoms were statistically investigated. The diseases were classified according to International Classification of Diseases ( WHO, 1977). The most prevalent diseases were neurotic disorders and they occurred 45.9% Anxiety neurosis was most frequent among the neurotic disorders. The majority of the cases of neurotic disorders showed dizziness. It is well ...

  17. Analysis of clinical features of concomitant vertigo in idiopathic sudden deafness%伴有眩晕的突发性聋眩晕的临床特点分析

    Institute of Scientific and Technical Information of China (English)

    吴子明; 张素珍; 刘兴健; 兰兰; 杨伟炎; 韩东一

    2010-01-01

    Objective To analyze the clinical characteristics of concomitant vertigo in patients with sudden deafness (SD). Methods Ninety-six cases of SD were reviewed retrospectively from January 2005to July 2009. SD and benign paroxysmal positional vertigo (BPPV) were diagnosed according to the guides of China Medical Association. The characteristics of vestibular function and the order of the onset of cochlear and vestibular symptoms were analyzed. Results Of all 96 cases, 23 (24.0%) cases presented with BPPV;58(60.4% ) cases took the form of unilateral vestibular hypofunction and 15( 15.6% ) cases had normal vestibular function. Time interval between cochlear and vestibular symptoms was as follows: 46 patients could tell the exact time of onset of cochlear and vestibular symptoms, of which 6( 13.0% ) cases occurred simultaneously; 4 (8. 7% ) cases presented vertigo within 1 hour after onset of cochlear symptomar hypofunction; 21 (45.7%)cases showed time interval between 1 hour and 24 hours; and 13 (28.3%) cases presented vertigo at several days( less than 10 days) after cochlear symptoms. And only in 2 (4.3%) cases did vertigo occur before cochlear symptoms. Conclusions Concomitant vertigo in idiopathic SD took the forms of normal or abnormal vestibular function, some of which were BPPV. Occurrence of vertigo was after cochlear symptoms.%目的 分析突发性聋伴发的眩晕的临床特点.方法 回顾性分析2005年1月至2009年7月就诊于解放军总医院眩晕中心的伴发作性眩晕的突发性聋患者96例的临床资料,突发性聋及良性阵发性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的诊断根据中华医学会颁布的指南.分析其前庭功能特点及前庭与耳蜗症状出现的时间关系.结果 96例患者中BPPV23例(24.O%);余73例患者中一侧前庭功能低下者58例(60.4%),前庭功能正常者15例(15.6%).96例患者中46例患者可以提供准确的耳蜗症状与眩晕出现的时间:其中6例(13.0%)耳

  18. Long-term outcome of vertigo and dizziness associated disorders following treatment in specialized tertiary care: the Dizziness and Vertigo Registry (DiVeR) Study.

    Science.gov (United States)

    Obermann, Mark; Bock, Eva; Sabev, Nikolay; Lehmann, Nils; Weber, Ralph; Gerwig, Marcus; Frings, Markus; Arweiler-Harbeck, Diana; Lang, Stephan; Diener, Hans-Christoph

    2015-09-01

    To investigate the long-term outcome of interdisciplinary treatment in a tertiary care neuro-otology institution after 2 years as part of the Dizziness and Vertigo Registry study. Risk factors associated with unfavourable outcome were assessed. 3113 consecutive patients with disorders of vertigo and dizziness were recruited prospectively between March 2010 and February 2012. Patients were clinically assessed and treated according to their diagnosis. Standardized instruments were used at baseline and at 2-year follow-up [Dizziness Handicap Inventory (DHI), Quality of Life Questionnaire, General Depression Scale, Stait-Trait Anxiety Index], as well as a custom health-related questionnaire. The primary outcome variable of this observational study was the change in DHI after 2 years. Patients suffered from phobic postural vertigo (23%), benign peripheral paroxysmal vertigo (14.4%), unilateral vestibulopathy (10.5%), central vestibular disorders (8%), Menière's disease (9.8%), vestibular migraine (6.9%), bilateral vestibulopathy (5.5%), and vestibular paroxysmia (3.1%). Mean disease duration was 4.6 ± 6.3 years. 1272 patients were available for follow-up, 1159 completed the DHI score. 72.1% of patients improved in DHI score from baseline to 2 years follow-up. Mean reduction in DHI score was 14 points (p = 0.02). Long-term outcome following diagnosis and treatment in a specialized tertiary care centre is good and persistent after 2 years. Risk factors for an unfavourable outcome were advanced age, severe disability, constant vertigo or dizziness, and concomitant back pain, while depression and anxiety did not contribute to this risk considerably.

  19. Period Prevalence of Dizziness and Vertigo in Adolescents

    OpenAIRE

    Thyra Langhagen; Lucia Albers; Florian Heinen; Andreas Straube; Filipp Filippopulos; Landgraf, Mirjam N; Lucia Gerstl; Klaus Jahn; Rüdiger von Kries

    2015-01-01

    Objectives To assess the period prevalence and severity of dizziness and vertigo in adolescents. Methods In 1661 students in 8th-10th grade in twelve grammar schools in Munich, Germany information on vertigo/dizziness was assessed by a questionnaire in the class room setting. Three month prevalence of dizziness/vertigo was estimated; symptoms were categorized as orthostatic dizziness, spinning vertigo, swaying vertigo or unspecified dizziness. Duration of symptoms and impact on daily life act...

  20. Medial Cranial Fossa Meningioma Diagnosed as Mixed Anxiety Disorder with Dissociative Symptoms and Vertigo

    Directory of Open Access Journals (Sweden)

    Emin Mehmet Ceylan

    2016-01-01

    Full Text Available Meningiomas are mostly benign tumors of the meninges that may stay clinically silent or present first with psychiatric symptoms only. We present a case of medial cranial fossa meningioma that was first diagnosed as mixed anxiety disorder with dissociative symptoms and vertigo. In light of the intact neurological and vestibular system examination, our patient’s vertigo and depersonalization were firstly addressed as psychosomatic symptoms of the psychiatric syndrome. Despite decreased anxiety and improved mood, dissociative symptoms and vertigo were resistant to treatment which prompted further research yielding a left hemisphere localized meningioma. Resection of meningioma resulted in full remission of the patient proving it to be responsible for the etiology of the psychiatric syndrome and vertigo. We suggest that brain imaging should be performed for patients with late-onset (>50 years psychiatric symptoms and those with treatment resistance. It is important to keep in mind always that medically unexplained symptoms may become explicable with detailed assessment and regular follow-up of the patient.

  1. Why do subjective vertigo and dizziness persist over one year after a vestibular vertigo syndrome?

    Science.gov (United States)

    Best, Christoph; Eckhardt-Henn, Annegret; Tschan, Regine; Dieterich, Marianne

    2009-05-01

    The overlap and interlinkage of dizzy symptoms in patients with psychiatric and vestibular vertigo/dizziness disorders is the subject of an ongoing debate. In a one-year follow up in 68 patients with vestibular vertigo syndromes, the persistency of vertigo and dizziness symptoms was examined and correlated with vestibular parameters and results from a psychiatric evaluation. Patients with vestibular migraine showed poorest improvement of vertigo and dizziness symptoms over time. In addition, patients who developed anxiety or depressive disorder after the onset of the vestibular disorder showed poor improvement and high persistency of symptoms.

  2. Differential diagnosis and treatment of vestibular vertigo

    Directory of Open Access Journals (Sweden)

    Vladimir Anatolyevich Parfenov

    2010-01-01

    Full Text Available Vertigo is a common complaint that leads patients to visit physicians of various specialties. Diseases resulting in vestibular vertigo are very diverse and may be caused by lesion of both the central parts of the vestibular system and the peripheral vestibular apparatus. In many cases, its diagnosis can be made from complaints and a history of disease and special bedside tests requiring no sophisticated equipment. Management of vestibular vertigo should aim at treating the underlying disease; vestibular dilators as symptomatic therapy can be effective for several days. Vestibular exercises the efficiency of which can be enhanced by betahistine and other drugs accelerating vestibular compensation should be further needed. Data on the efficacy of betaver (betahistine in patients with vestibular vertigo are given.

  3. Vertigo in patients with cervical spine dysfunction

    OpenAIRE

    Galm, R.; Rittmeister, M.; Schmitt, E.

    1998-01-01

    To our knowledge, quantitative studies on the significance of disorders of the upper cervical spine as a cause of vertigo or impaired hearing do not exist. We examined the cervical spines of 67 patients who presented with symptoms of dizziness. Prior to the orthopaedic examination, causes of vertigo relating to the field of ENT and neurology had been ruled out. Fifty patients of the above-mentioned group were studied. They followed the outlined treatment protocol with physical therapy and wer...

  4. 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。

  5. 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。

  6. 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.

  7. Abnormal insulin levels and vertigo.

    Science.gov (United States)

    Proctor, C A

    1981-10-01

    Fifty patients with unexplained vertigo (36) or lightheadedness (14) are evaluated, all of whom had abnormal ENGs and normal audiograms. Five hour insulin glucose tolerance tests were performance on all patients, with insulin levels being obtained fasting and at one-half, one, two, and three hours. The results of this investigation were remarkable. Borderline or abnormal insulin levels were discovered in 82% of patients; 90% were found to have either an abnormal glucose tolerance test or at least borderline insulin levels. The response to treatment in these dizzy patients was also startling, with appropriate low carbohydrate diets improving the patient's symptoms in 90% of cases. It is, therefore, apparent that the earliest identification of carbohydrate imbalance with an insulin glucose tolerance test is extremely important in the work-up of the dizzy patients.

  8. Period Prevalence of Dizziness and Vertigo in Adolescents.

    Directory of Open Access Journals (Sweden)

    Thyra Langhagen

    Full Text Available To assess the period prevalence and severity of dizziness and vertigo in adolescents.In 1661 students in 8th-10th grade in twelve grammar schools in Munich, Germany information on vertigo/dizziness was assessed by a questionnaire in the class room setting. Three month prevalence of dizziness/vertigo was estimated; symptoms were categorized as orthostatic dizziness, spinning vertigo, swaying vertigo or unspecified dizziness. Duration of symptoms and impact on daily life activities were assessed.72.0% (95%-CI = [69.8-74.2]; N = 1196 of the students (mean age 14.5±1.1 reported to suffer from at least one episode of dizziness or vertigo in the last three months. Most adolescents ticked to have symptoms of orthostatic dizziness (52.0%, 95%-CI = [49.5-54.4], N = 863. The period prevalence for the other types of vertigo were spinning vertigo: 11.6%, 95%-CI = [10.1-13.3], N = 193; swaying vertigo: 12.2%, 95%-CI = [10.6-13.8], N = 202; and unspecified dizziness: 15.2%, 95%-CI = [13.5-17.1], N = 253. About 50% of students with spinning vertigo and swaying vertigo also report to have orthostatic dizziness. Most vertigo/dizziness types were confined to less than one minute on average. The proportion of students with any dizziness/vertigo accounting for failure attending school, leisure activities or obliging them to stay in bed were more pronounced for spinning or swaying vertigo.Dizziness and vertigo in grammar school students appear to be as common as in adults. In face of the high period prevalence and clinical relevance of dizziness/vertigo in adolescents there is a need for prevention strategies. Risk factors for dizziness/vertigo need to be assessed to allow for conception of an intervention programme.

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

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    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.

  10. PERIPHERAL VERTIGO – A STUDY OF 100 CASES: OUR EXPERIENCE

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    Asha Annie

    2014-07-01

    Full Text Available Vertigo is one of the most common symptoms forcing patients to visit their physician and for referral to an Otolaryngologist. The aim of this study was to analyze the causes of peripheral vertigo, age: sex ratio and the management protocols. 100 patients with peripheral vertigo during the period from January 2013 to April 2014 were evaluated and the results were tabulated.

  11. 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).

  12. Vertigo and dizziness from environmental motion: visual vertigo, motion sickness, and drivers' disorientation.

    Science.gov (United States)

    Bronstein, Adolfo M; Golding, John F; Gresty, Michael A

    2013-07-01

    The normal vestibular system may be adversely affected by environmental challenges which have characteristics that are unfamiliar or ambiguous in the patterns of sensory stimulation they provide. A disordered vestibular system lends susceptibility even to quotidian environmental experiences as the sufferer becomes dependent on potentially misleading, nonvestibular sensory stimuli. In both cases, the sequelae may be vertigo, incoordination, imbalance, and unpleasant autonomic responses. Common environmental motion conditions include visual vertigo, motion sickness, and motorists' disorientation. The core therapy for visual vertigo, motion sickness, and drivers' disorientation is progressive desensitization within a cognitive framework of reassurance and explanation, plus anxiolytic tactics and autogenic control of autonomic symptoms.

  13. Vertigo as a Predominant Manifestation of Neurosarcoidosis

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    Tasnim F. Imran

    2015-01-01

    Full Text Available Sarcoidosis is a granulomatous disease of unknown etiology that affects multiple organ systems. Neurological manifestations of sarcoidosis are less common and can include cranial neuropathies and intracranial lesions. We report the case of a 21-year-old man who presented with vertigo and uveitis. Extensive workup including brain imaging revealed enhancing focal lesions. A lacrimal gland biopsy confirmed the diagnosis of sarcoidosis. The patient was initially treated with prednisone, which did not adequately control his symptoms, and then was switched to methotrexate with moderate symptomatic improvement. Our patient had an atypical presentation with vertigo as the predominant manifestation of sarcoidosis. Patients with neurosarcoidosis typically present with systemic involvement of sarcoidosis followed by neurologic involvement. Vertigo is rarely reported as an initial manifestation. This case highlights the importance of consideration of neurosarcoidosis as an entity even in patients that may not have a typical presentation or systemic involvement of disease.

  14. Basic problems in the diagnosis and treatment of vestibular vertigo

    Directory of Open Access Journals (Sweden)

    Maksim Valeryevich Zamergrad

    2010-01-01

    Full Text Available The paper describes the basic problems in the diagnosis and treatment of diseases accompanied by vertigo. In particular, it discusses the specific features of vertigo terminology, the overestimation of the value of cerebrovascular diseases and degenerative cervical spine changes in the development of vertigo and the underestimation of a role of peripheral vestibular diseases and psychogenic disorders in the genesis of different forms of vertigo. Emphasis is placed on the importance of vestibular exercises in the complex treatment of diseases manifesting themselves as vertigo. In addition, the possibilities of drug-induced stimulation of vestibular compensation are discussed.

  15. Abnormality in cerebellar blood flow in solo vertigo patients

    Energy Technology Data Exchange (ETDEWEB)

    Nagahori, Takeshi [Shakaihoken Takaoka Hospital, Toyama (Japan); Nishijima, Michiharu; Endo, Shunro; Takaku, Akira

    1997-03-01

    Little is known about the blood flow of the vertebrobasilar system as a cause of vertigo and dizziness. We used Xe-CT to study cerebellar blood flow in 53 patients who ranged in age from 35 to 85 years. The patients were divided into two groups. One of them was the vertigo group that comprised 28 patients with rotatory sensation, and the other, the non-vertigo group of 25 patients with a sensation other than rotation. At the stage of severe symptoms, there was decreased cerebellar blood flow in all patients of both, the vertigo and the non-vertigo groups, and a decrease in the bilateral cerebellar hemisphere was observed in five patients and in a unilateral hemisphere in three patients of the vertigo group. By comparison, in the non-vertigo group, unilateral decrease of cerebellar blood flow was observed in only one patient, and a bilateral decrease in five. At the stage of severe symptoms, the mean regional cerebellar blood flow was 40.5{+-}8.0 ml/100 g/min (n=16 sides) in the vertigo group and 45.3{+-}9.5 ml/100 g/min (n=12 sides) in the non-vertigo group. At the stage of moderate symptoms, blood flow image was normal in four of 14 vertigo patients and in seven of 12 non-vertigo patients. The mean regional blood flow was 47.8{+-}8.6 ml/100 g/min (n=28 sides) in the vertigo group and 47.1{+-}5.1 ml/100 g/min (n=24 sides) in the non-vertigo group. At the asymptomatic stage, a high proportion of normal blood flow images (nine of 16 vertigo patients and 10 of 10 non-vertigo patients) was observed. The mean regional cerebellar blood flow was 51.6{+-}10.7 ml/100 g/min (n=32 sides) in the vertigo group and 52.8{+-}8.5 ml/100 g/min (n=20 sides) in the non-vertigo group. This study demonstrates that a unilateral or bilateral decrease in blood flow of the vertebrobasilar system may cause vertigo and dizziness. It also shows that Xe-CT of the cerebellum may be a valuable examination modality for the diagnosis and treatment of vertigo and dizziness. (author)

  16. Cervical vertigo%颈性眩晕

    Institute of Scientific and Technical Information of China (English)

    何及; 樊东升; 孙宇

    2011-01-01

    Cervical vertigo refers to a syndrome with a chief complaint of vertigo arising from cervical verteprae discomfort. In general, cervical vertigo is correlated with but not always caused by cervical spondylopathy,which mainly includes vertebral arterial and sympathetic cervical spondylosis. The vertebral artery insufficiency caused by compression from lateral displacement of the intervertebral dise is very rare, while the sympathetic cervical spondylosis caused by the vertebral instability is much more common. Rigorous criteria have been developed for diagnosis of the latter. Conservative therapy is mainly recommended for treatment of cervical vertigo.%颈性眩晕通常与颈椎病有关,但不一定完全由颈椎病所致.与颈性眩晕有关的主要是椎动脉型和交感型颈椎病.由椎间盘侧突压迫导致的椎动脉供血不足非常罕见,由椎体不稳引起的交感型颈椎病较多,但后者也有其严格的诊断标准.治疗以保守治疗为主.

  17. Dizziness, vertigo, and presyncope: what's the difference?

    Science.gov (United States)

    Saccomano, Scott J

    2012-12-10

    Dizziness is a general term used to express subjective patient complaints related to changes in sensation, movement, perception, or consciousness. There are four types of dizziness: vertigo, disequilibrium, presyncope/syncope, and dizziness as a result of psychological disturbances. Differentiating the type of dizziness will assist in the course of the evaluation.

  18. A specialized approach to diagnosing and treating vertigo

    OpenAIRE

    2016-01-01

    Vertigo is one of the most common reasons for visits to physicians of different specialties. Thorough collection of history data and neurovestibular examination by a set of simple clinical tests are of great importance for the diagnosis of diseases of the vestibular system. The paper gives an update on the principles of diagnosis of different forms of vertigo, diagnostic errors, and treatment of major diseases manifesting by vertigo. The authors present their own data concerning the diagnosis...

  19. Vertigo in neurological practice (common problems of diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Olga Vladimirovna Kosivtsova

    2012-01-01

    Full Text Available Most patients with vertigo seek neurological advice. In spite of the availability of current examination techniques, a differential diagnosis of vertigo is not frequently made. The paper discusses the terminology and classification of vertigo and clinical methods for diagnosing central and peripheral vestibulopathies. It considers the common problems of management of patients with diseases of the central and peripheral vestibular systems, the use of piracetam and other drugs to stimulate rehabilitation.

  20. Vertigo in downhill mountain biking and road cycling.

    Science.gov (United States)

    Lion, Alexis; Vibert, Dominique; Bosser, Gilles; Gauchard, Gérome C; Perrin, Philippe P

    2016-01-01

    Vertigo has been described after the practice of mountain bike. This study aimed to investigate the prevalence of vertigo following competitions or training sessions of downhill mountain biking (DMB) or road cycling (RC). One hundred and two DMB riders, 79 road cyclists and 73 control participants filled in a survey intended to evaluate the prevalence of vertigo in daily living activities and following competitions or training sessions. Vertigo causal factors (crashes, head trauma, fatigue, characteristics of the path/road ridden) were recorded. DMB riders and road cyclists did not report more vertigo during daily living activities than controls. But DMB riders older than 30 had more risk to report vertigo than age-matched road cyclists (OR: 5.06, 95% CI: 1.23-20.62). Road cyclists aged between 20 and 29 were 2.59-fold (95% CI: 1.06-6.27) more likely to report vertigo than controls. After competitions and training sessions, DMB riders were 2.33-fold (95% CI: 1.22-4.41) more likely to report vertigo than road cyclists. Vertigo causal factors were crash with head trauma in DMB riders and fatigue in road cyclists. Vertigo during daily living activities may be of concern for cyclists, particularly older DMB riders. The accumulation of impacts (crashes, vibrations) during the career of a DMB rider may generate micro-traumatisms of the central nervous system and/or peripheral vestibular structures, particularly the otolith organs. In RC, the pathophysiological mechanisms generating vertigo might be effort-related disturbance of homeostasis. To avoid injuries, DMB riders should be aware that vertigo may occur at the end of training sessions or competitions.

  1. 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, ...

  2. The Neural Correlates of Chronic Symptoms of Vertigo Proneness in Humans.

    Directory of Open Access Journals (Sweden)

    Ola Alsalman

    Full Text Available Vestibular signals are of significant importance for variable functions including gaze stabilization, spatial perception, navigation, cognition, and bodily self-consciousness. The vestibular network governs functions that might be impaired in patients affected with vestibular dysfunction. It is currently unclear how different brain regions/networks process vestibular information and integrate the information into a unified spatial percept related to somatosensory awareness and whether people with recurrent balance complaints have a neural signature as a trait affecting their development of chronic symptoms of vertigo. Pivotal evidence points to a vestibular-related brain network in humans that is widely distributed in nature. By using resting state source localized electroencephalography in non-vertiginous state, electrophysiological changes in activity and functional connectivity of 23 patients with balance complaints where chronic symptoms of vertigo and dizziness are among the most common reported complaints are analyzed and compared to healthy subjects. The analyses showed increased alpha2 activity within the posterior cingulate cortex and the precuneues/cuneus and reduced beta3 and gamma activity within the pregenual and subgenual anterior cingulate cortex for the subjects with balance complaints. These electrophysiological variations were correlated with reported chronic symptoms of vertigo intensity. A region of interest analysis found reduced functional connectivity for gamma activity within the vestibular cortex, precuneus, frontal eye field, intra-parietal sulcus, orbitofrontal cortex, and the dorsal anterior cingulate cortex. In addition, there was a positive correlation between chronic symptoms of vertigo intensity and increased alpha-gamma nesting in the left frontal eye field. When compared to healthy subjects, there is evidence of electrophysiological changes in the brain of patients with balance complaints even outside chronic

  3. [Hyperinsulinemia in vertigo, tinnitus and hearing loss].

    Science.gov (United States)

    Doroszewska, Grazyna; Kaźmierczak, Henryk

    2002-01-01

    48 patients (25 woman, mean age 42 +/- 9.9 years and 23 men, mean age 46.6 +/- 8.3 years) suffering from vertigo, tinnitus and hearing loss of unknown origin were included into this study. The occurrence and coexistence of symptoms was measured. Insulin levels were measured fasting and at the second hour of OGTT. Results were compared with the control group of 31 healthy persons (16 women, mean age 41.3 +/- 5.6 years and 15 men, mean age 47.6 +/- 9.4 years). The character of vertigo, localization of hearing loss and electronystagmographic findings showed the pathology of the inner ear. The occurrence of hyperinsulinemia was significantly more common in the patients group--43.8%, comparing to the control group--22.6%. Also the insulin levels in the second hour of OGTT, were statistically significantly higher in patients that in the control group.

  4. Vértigo en el niño Vertigo in children

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    Ricardo Erazo Torricelli

    2007-01-01

    Full Text Available El vértigo en el niño es una patología poco frecuente, pero además ha sido subvalorada y poco citada en la literatura hasta la década de los 80. Definido como la sensación de movimiento del propio cuerpo o del ambiente circundante, es un síntoma que se origina por múltiples causas. En este artículo se describen los diferentes cuadros de vértigo en el niño y las características clínicas que permiten su identificación. Especial importancia tiene una historia clínica detallada y un examen otológico y neurológico completos para efectuar el diagnóstico. Destacan la otitis media y las variantes migrañosas, en especial el vértigo paroxístico benigno, como las causas más frecuentes de vértigo en la infancia. El adecuado enfrentamiento del niño con vértigo, que parte por la sospecha clínica en un paciente que puede no dar las claves anamnésticas por su corta edad, es fundamental para establecer el diagnóstico correcto y efectuar los tratamientos adecuados según la causa de vértigo en cada caso.Vertigo is uncommon in children, but it is usually underecognized and it has not been well referenced in the medical literature until the 1980s. It is defined as a subjective sensation of movement of the body or the surrounding, and it is a symptom that may have multiple causes. This paper reviews the different types of vertigo in children, emphasizing their clinical features that may be useful in establishing the diagnosis. Of particular relevance is an accurate clinical history and a complete otologic and neurologic examination. More common causes of pediatric vertigo are otitis media and migraine variants, particularly benign paroxysmal vertigo. An appropriate approach to the child with vertigo begins with the clinical suspicion, based on a detailed clinical history and examination, and specific tests. Diagnosis should be followed by adequate symptomatic treatment and management of the underlying specific causes.

  5. Probable Correlation between Temporomandibular Dysfunction and Vertigo in the Elderly

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    Marchiori, Luciana Lozza de Moraes

    2014-01-01

    Full Text Available Introduction Temporomandibular disorder (TMD covers a variety of clinical problems, and some epidemiologic studies have tried to indicate mechanisms of interaction and association between vertigo and TMD, but this topic still is controversial. Objective To assess the presence of vertigo in elderly patients associated with TMD. Methods A cross-sectional study was conducted with the inclusion of elderly individuals who lived independently. TMD was assessed by dental evaluation and vertigo was verified by medical history. Statistical analysis was performed using the chi-square and relative risk. Results There was a significant association (p = 0.0256 between the TMD and vertigo (odds ratio = 2.3793. Conclusion These results highlighted the importance of identifying risk factors for vertigo that can be modified through specific interventions, which is essential to prevent future episodes, as well as managing the process of rehabilitation of elderly patients in general.

  6. [Thinking about vertigo effectiveness evaluation methods in clinical research of Chinese medicine].

    Science.gov (United States)

    Liu, Hong-mei; Li, Tao

    2014-10-01

    Vertigo is a kind of patients' subjective feelings. The severity of vertigo is closely related to many factors. But we are short of a well accepted quantitative evaluation method capable of accurately and comprehensively evaluating vertigo in clinics. Reducing the onset of vertigo, enhancing the re- covery of equilibrium function, and improving the quality of life of vertigo patients should be taken as the focus of evaluating therapeutic effects. As for establishing a Chinese medical effectiveness evaluation system for vertigo, we believe we should distinguish different "diseases". We could roughly identify it as systemic vertigo and non-systemic vertigo. For systemic vertigo, the efficacy of vertigo could be comprehensively evaluated by UCLA vertigo questionnaire or dizziness handicap inventory combined with equilibrium function testing indices. But for non-systemic vertigo, the efficacy of vertigo could be comprehensively evaluated by taking UCLA vertigo questionnaire or dizziness handicap inventory as main efficacy indices. Secondly, we should analyze different reasons for vertigo, choose symptoms and signs in line with vertigo features as well as with Chinese medical theories, and formulate corresponding syndrome effectiveness standards according to different diseases. We should not simply take syndrome diagnosis standards as efficacy evaluation standards.

  7. Pesquisa do nistagmo/vertigem de posição e avaliação eletronistagmográfica em um grupo de indivíduos portadores de diabetes Mellitus tipo I Search of the nystagmus/ positional vertigo and electronystagmographic evaluation in a group of diabetics Mellitus type I

    Directory of Open Access Journals (Sweden)

    Lílian P. Scherer

    2002-05-01

    search the nystagmus/ positional vertigo and electronystagmographic evaluation, and to identify possible alterations. Study design: Prospective clinical. Material and method: 12 Diabetics Type I, insulin dependents, between 12 and 27 years old, and members of Associação Riograndense de Apoio aos Diabéticos (ARAD. To observe the vestibular reactions, we did a specific interview, otoscopy, tympanometric, search of the Nystagmus/ Positional Vertigo and Electronystagmographic Evaluation in the selected sample. Results: We verified Periferic Irritable Vestibular Syndrome in 75% of the altered results. 62,5% in this group didn't present otoneurologyc symptom. Conclusions: We note that the effect of Diabetes Type I in the vestibular function may be taken into consideration like any other usual complications, since the same may occur in asymptomatic patients, and also because with the early etiologic diagnostic it is possible to help in the prevention of this disease's complications.

  8. Vertigo with a Vestibular Dysfunction in Children During Respiratory Tract Infections.

    Science.gov (United States)

    Dzięciołowska-Baran, E A; Gawlikowska-Sroka, A

    2015-01-01

    Sudden balance disorders with violent vegetative symptoms (nausea and vomiting) pose a diagnostic and therapeutic problem. In children vertigo/dizziness with symptoms of vestibular dysfunction is rare, but as vascular etiology is unlikely in children such symptoms arouse concern. This article presents two cases of this type of vertigo. The patients were two boys (6 and 9 years old). They came down with similar symptoms: sudden dizziness, disabled walking, nausea and vomiting, spontaneous nystagmus, and a positive Romberg test. The onset of the balance disorder was preceded by respiratory infection: common cold with symptoms of inflammation of the mucous membrane in the nose and throat. Laboratory tests revealed increased levels of C-reactive protein only in the older boy. Neuroinfection and a displacement process were ruled out. Videonystagmography revealed vestibular dysfunction and vestibular neuronitis on the left side.

  9. Vertigo and Dizziness in the Elderly

    OpenAIRE

    Lara eFernandez; Breinbauer, Hayo A.; Paul Hinckley Delano

    2015-01-01

    The prevalence of vertigo and dizziness in people aged more than 60 years reaches 30%, and due to aging of world population, the number of patients is rapidly increasing. The presence of dizziness in the elderly is a strong predictor of falls, which is the leading cause of accidental death in people older than 65 years. Balance disorders in the elderly constitute a major public health problem, and require an adequate diagnosis and management by trained physicians. In the elderly, common cause...

  10. 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. ...

  11. Prof.Luo Zhiqiang's Experience in Treating Cervical Vertigo

    Institute of Scientific and Technical Information of China (English)

    金明华

    2004-01-01

    @@ The common symptoms of cervical spondylopathy include dizziness and vertigo, headache, neck rigidity and numbness, or pain in the shoulders, arms, and fingers. Modem medicine has divided cervical spondylopathy into 6 types, namely, the cervical,radicular, spinal, vertebroarterial, sympathetic, and the mixed types. In TCM, according to the main symptoms of dizziness and vertigo, cervical spondylopathy is traditionally called ‘cervical vertigo'. Having been engaged in TCM for more than 40 years, Prof. Luo Zhiqiang (罗致强) has acquired a profound and unique knowledge about this disorder and obtained quite good therapeutic results. The following is a brief introduction of his experience in the TCM treatment of cervical vertigo.

  12. Management of vertigo: from evidence to clinical practice

    Directory of Open Access Journals (Sweden)

    Paola Gnerre

    2015-05-01

    Full Text Available Vertigo is a symptom, not a diagnosis and effective diagnosis and management begin with understanding what this symptom may represent. Thus the presence of postural insility includes a differential diagnosis for otologic, neurologic and other medical causes. The objective of this paper is to provide evidence-based recommendations for the proper management of vertigo by multi-parametric analysis of the guidelines available to date.

  13. Phobic postural vertigo treated with autogenic training: a case report

    OpenAIRE

    GOTO, FUMIYUKI; Nakai, Kimiko; Kunihiro, Takanobu; Ogawa, Kaoru

    2008-01-01

    Background Patients suffering from dizziness due to vertigo are commonly encountered in the department of otolaryngology. If various clinical examinations do not reveal any objective findings, then the patients are referred to the department of internal medicine or psychiatry. In many cases, the diagnosis is psychological dizziness. Phobic postural vertigo, which was first reported by Brandt T et al in 1994, is supposed to be a type of psychological dizziness. The diagnosis is based on 6 char...

  14. [Validation of the German version of the Vertigo Handicap Questionnaire (VHQ) in patients with vestibular vertigo syndromes or somatoform vertigo and dizziness].

    Science.gov (United States)

    Tschan, Regine; Wiltink, Jörg; Best, Christoph; Beutel, Manfred; Dieterich, Marianne; Eckhardt-Henn, Annegret

    2010-01-01

    The Vertigo Handicap Questionnaire (VHQ) by Yardley (1992) assesses physical and psychosocial impairments of vertigo or dizziness. Our study examines the structure, reliability, and aspects of validity of the German version of the VHQ. 98 vestibular vertigo syndromes vs. 90 patients with somatoform vertigo and dizziness were evaluated with the VHQ, symptom severity (VSS), distress (GSI), anxiety and depression (HADS), catastrophizing beliefs (ACQ), fear of body sensations (BSQ), and quality of life (SF-36). For diagnostic classification detailed clinical neurological, neuro-otological and psychosomatic testing were conducted. Principal components analysis identified two factors, which could be confirmed by confirmatory factor analyses: 'handicapped activity'(VHQ-ACT) and 'anxiety' (VHQ-ANX). The VHQ had good internal consistency (Cronbach's alpha: 0.92). Test-retest reliability was r = 0.80. We noted close relations between the VHQ, the VSS and measures of emotional distress as aspects of good construct validity. Together with the VSS, the VHQ completes a comprehensive diagnostic screening tool for vertigo or dizziness.

  15. 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

  16. 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.

  17. 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 ...

  18. 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...

  19. Death and Love: Bernard Herrmann's score for vertigo

    OpenAIRE

    Schneller, Tom; DMA Candidato en Composición, Departamento de Música, Cornell University, Ithaca, NY, USA

    2005-01-01

    Bernard Herrmann’s score for Alfred Hitchcock’s classic film Vertigo (1958) is a clear example of the composer’s uncanny ability in translating the basic thematic premise of a film into a compact musical structure. The connection between love and death that is a central issue of Vertigo finds its musical counterpart in the derivation of the love motif and of two motifs associated with death from the same ‘Primal cell’ in the main title. The structure of the main title itself reflects this lin...

  20. [Chronic dizziness and vertigo from a neurologists' perspective].

    Science.gov (United States)

    Obermann, M

    2013-02-01

    Dizziness and vertigo are among the most common symptoms in neurology and medicine in general. The differential diagnosis may be simplified by systematic and careful assessment of presenting symptoms. The most common conditions associated with vertigo and dizziness can be diagnosed by patient history and physical examination alone. Extensive apparative diagnostic work-up is seldomly required and often not helpful. The majority of these disorders can be well treated and have an excellent prognosis, when diagnosed adequately and within a reasonable time frame to prevent the development of chronic disease.

  1. [Assessment of driving in patients with vertigo and dizziness].

    Science.gov (United States)

    von Brevern, M; von Stuckrad-Barre, S; Fetter, M

    2014-07-01

    The driving performance of patients with dizziness and vertigo has gained only minor attention so far. Patients with permanent vestibular loss or with episodic vestibular symptoms can experience difficulties in driving a motor vehicle. The presence of a chronic or episodic syndrome presenting with dizziness and/or vertigo does not automatically exclude the ability to drive. Assessment of driving performance should consider the degree of the deficits and compensation in chronic dysfunction and the severity and frequency of attacks, prodromes and triggers of symptoms in episodic disorders.

  2. Otoneurologisk udredning ved akut opstået svimmelhed

    DEFF Research Database (Denmark)

    Hansen, Søren; Ninn-Pedersen, Mirjana; Thomasen, Per Caye

    2011-01-01

    Benign paroxysmal positional vertigo, vestibular neuronitis and Menière's disease cause most cases of acute vertigo. However, doctors must consider central neurological reasons to vertigo. If it is determined that a patient has oto-neurological vertigo, the next task is to determine whether...

  3. 伴眩晕的突发性聋患者的临床特征与疗效分析%Study of clinical characteristics and curative effects of sudden hearing loss patients with vertigo

    Institute of Scientific and Technical Information of China (English)

    高云; 王大勇; 粟秦; 王洪阳; 兰兰; 尹自芳; 于澜; 吴子明; 单希征

    2015-01-01

    Objective To analyze the clinical characteristics,prognosis and therapeutic effects of sudden sensorineural hearing loss (SSHL) patients associated with vertigo,and to investigate the strategy of diagnosis and treatment.Methods We retrospectively analyzed the clinical characteristics of 240 patients diagnosed as SSHL with vertigo,who were treated in the Chinese PLA General Hospital from July 2008 to August 2012.Various factors affecting the therapeutic effects were analyzed,such as audiological features,vestibular function tests,genders,audiograms,lasting before seeing a doctor,courses of vertigo and vascular factors.Result Among the contemporaneous SSHL patients (873 cases),the cases with vertigo accounted for 27.49% (240/873).Among the 240 patients with vertigo,the cases with different hearing impaired degree of mild,moderate,severe and profound were 30,13,28 and 34,respectively,primarily by the profound cases.Detailed vestibular function tests were performed in 97 patients,with 54 cases having unilateral vestibular disfunction and 43 patients having normal vestibular function,among which 23 cases were diagnosed as benign paroxymal positional vertigo (BBPV).The relationship between vestibular function and different hearing impaired degrees or various audiogram types had no statistically significant difference.219 cases had detailed records of the onset time of cochlear and vestibular symptoms,including 122 patients with cochlear symptoms and dizziness occurring simultaneously.After standardized drug treatment,the total effective rate was 46.67%,with recovery in 17 cases,excellent in 34 cases,better in 61 cases and poor in 128 cases,respectively.Statistical analysis showed that different genders,audiogram types,vertigo courses of time,the results of vestibular function and neck vascular ultrasounds were not related to the curative effects,while,the treatment time after onset was significantly associated with treatment effects.Conclusions SSHL with vertigo has

  4. 周围性眩晕和中枢性眩晕电生理特点的比较%Comparison of electrophysiological features in peripheral vertigo and central vertigo

    Institute of Scientific and Technical Information of China (English)

    薛海龙; 肖文; 李仓霞

    2015-01-01

    peripheral vertigo and central vertigo. Methods The electronystagmograph ( ENG ) and brainstem auditory evoked potentials ( BAEP ) were applied in peripheral vertigo group(85 cases) and central vertigo group(61 cases).Result ENG abnomal was in 67 cases (78.8%) in peripheral vertigo group.Overshoot or undershoot of dysmetria test was in 6 cases ( 7.1%);spontaneous nystagmus was in 5 cases(5.9%);abnormal of gaze test was in 16 cases(18.8%); eye tracking test typeⅠwas in 42 case(49.4%), typeⅡwas in 17 cases(20.0%), and typeⅢwas in 8 cases(9.4%); bilateral asymmetry of optokinetic nystagmus test was in 19 cases(22.4%);positioning nystagmus was in 51 cases(60.0%);abnormal of cold and hot test was in 31 cases(36.5%).ENG abnomal was 42 cases(49.4%) in central vertigo group.Overshoot or undershoot of dysmetria test was in 19 case(31.1%);spontaneous nystagmus was in 13 cases (21.3%);abnormal of gaze test was in 23 cases(37.7%);eye tracking test typeⅠwas in 35 cases(57.4%), typeⅡwas in 13 cases(21.3%), and typeⅢwas in 8 cases(13.1%);bilateral asymmetry of optokinetic nystagmus test was in 33 cases(54.1%); positioning nystagmus was in 2 cases(3.3%); abnormal of cold and hot test was in 6 cases(9.8%).Compared with peripheral vertigo group, the abnormal rates of optokinetic nystagmus test, gaze test, eye tracking test, optokinetic nystagmus test in central vertigo group were significantly increased, and the abnormal rates of positioning nystagmus, cold and hot test in central vertigo group were significantly decreased (all P<0.05). There were 32 cases(37.6%) in peripheral vertigo group with BAEP abnormal, and 31 cases(50.8%) were in central vertigo group with BAED abnormal.Compared with central vertigo group, the latency ofⅠwave andⅠ-Ⅲwave latency delayed in peripheral vertigo group were significantly increased, the latency ofⅤwave andⅠ-Ⅴwave latency delayed were significantly decreased ( all P<0.05 ) .Conclusions There are high sensitivity of optokinetic

  5. 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.

  6. 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.

  7. [Hashimoto's encephalopathy presenting with vertigo and muscle weakness in a male pediatric patient].

    Science.gov (United States)

    Ueno, Hiroe; Nishizato, Chizuru; Shimazu, Tomoyuki; Watanabe, Hiziri; Mizukami, Tomoyuki; Kosuge, Hiroshi; Ozasa, Shiro; Nomura, Keiko; Kimura, Shigemi; Takahashi, Yukitoshi

    2016-01-01

    Hashimoto's encephalopathy is an anti-thyroid antibody-positive autoimmune encephalopathy. We herein report the case of a 13-year-old male patient with subacute vertigo, muscle weakness in the extremities and gait disturbance who was diagnosed with Hashimoto's encephalopathy. He showed no severe impairment of consciousness and no seizures, and there were no abnormalities on the brain MRI. However, epileptic spike and wave complexes were observed on an electroencephalogram, and a decline in blood flow was diffusely observed on brain SPECT (single photon emission computed tomography). His thyroid function was normal, but he was positive for anti-thyroid antibodies, such as anti-TPO (thyroid peroxidase) antibodies. He was also positive for serum anti-NAE (NH2-terminal alpha-enolase) antibodies. Systemic corticosteroid therapy and high-dose intravenous immunoglobulin therapy were effective, greatly improving his quality of life.

  8. 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...

  9. 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 ...

  10. Balance Disorders (For Parents)

    Science.gov (United States)

    ... become benign positional vertigo or migraine-associated vertigo. Vestibular neuronitis (or neuritis ), an infection that causes inflammation of ... time a child is 5 years old. And vestibular neuronitis and labyrinthitis often disappear on their own, too. ...

  11. 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

  12. The Role of Lifestyle Modifications in the Management of Migraine Associated Vertigo

    OpenAIRE

    Omer Saglam

    2014-01-01

    Aim: To determine potential factors that may trigger vertigo attacks and evaluate the efficacy of lifestyle changes. Material and Method: We analyzed medical records of 23 patients with migraine associeted vertigo retrospectively. In the management of vertigo, lifestyle modifications, including limitation of the possible triggering factors such as diet, sleep problems, stress, physical activity, and other factors associated with migraine were determined for therapy. Result: Response to therap...

  13. VERTIGO AS AN ENT DISEASE : GENERAL PHYSICIAN AND THE COMMON MAN’S PERCEPTION

    Directory of Open Access Journals (Sweden)

    Sumit

    2015-08-01

    Full Text Available BACKGROUND : To study consciousness amongst General Physicians and common people, on their perception of Vertigo related to ENT disease. METHODS : Study was conducted in two different places of Eastern India from 2006 to 2015 . The patients with complaints of vertigo attending Otorhinolaryngologists at the first instance or by GP referral were studied . General Physicians also underwent a survey through a questionnaire. RESULTS : From the last 9 years of data , we find a defin ite increment in the number of vertigo patients at our OPD along with an increase in consciousness amongst the general physicians, though majority of doctors still don't think Vertigo to be predominantly an ENT disease

  14. Prolonged vertigo and ataxia after mandibular nerve block for treatment of trigeminal neuralgia

    Directory of Open Access Journals (Sweden)

    Arvind Chaturvedi

    2011-01-01

    Full Text Available Common complications of neurolytic mandibular nerve block are hypoesthesia, dysesthesia, and chemical neuritis. We report a rare complication, prolonged severe vertigo and ataxia, after neurolytic mandibular blockade in a patient suffering from trigeminal neuralgia. Coronoid approach was used for right sided mandibular block. After successful test injection with local anesthetic, absolute alcohol was given for neurolytic block. Immediately after alcohol injection, patient developed nausea and vomiting along with severe vertigo, ataxia and hypertension. Neurological evaluation was normal except for the presence of vertigo and ataxia. Computerised tomography scan brain was also normal. Patient was admitted for observation and symptomatic treatment was given. Vertigo and ataxia gradually improved over 24 hours.

  15. Persistent vertigo and dizziness after mild traumatic brain injury.

    Science.gov (United States)

    Fife, Terry D; Kalra, Deepak

    2015-04-01

    Vertigo, dizziness, and disequilibrium are common symptoms following concussion or mild traumatic brain injury (mTBI). Dizziness and vertigo may be the result of trauma to the peripheral vestibular system or the central nervous system, or, in some cases, may be due to anxiety, depression, or posttraumatic stress disorder; these mechanisms are not mutually exclusive. While most peripheral vestibular disorders can be identified by testing and examination, those without inner-ear causes that have persisting complaints of dizziness and motion sickness are more difficult to understand and to manage. Some of these patients exhibit features compatible with vestibular migraine and may be treated successfully with migraine-preventative medications. This paper reviews the nonotogenic causes of persisting dizziness, the possible mechanisms, and the pathophysiology, as a framework for patient management and for future research.

  16. On the vertigo due to static magnetic fields.

    Science.gov (United States)

    Mian, Omar S; Li, Yan; Antunes, Andre; Glover, Paul M; Day, Brian L

    2013-01-01

    Vertigo is sometimes experienced in and around MRI scanners. Mechanisms involving stimulation of the vestibular system by movement in magnetic fields or magnetic field spatial gradients have been proposed. However, it was recently shown that vestibular-dependent ocular nystagmus is evoked when stationary in homogenous static magnetic fields. The proposed mechanism involves Lorentz forces acting on endolymph to deflect semicircular canal (SCC) cupulae. To investigate whether vertigo arises from a similar mechanism we recorded qualitative and quantitative aspects of vertigo and 2D eye movements from supine healthy adults (n = 25) deprived of vision while pushed into the 7T static field of an MRI scanner. Exposures were variable and included up to 135s stationary at 7T. Nystagmus was mainly horizontal, persisted during long-exposures with partial decline, and reversed upon withdrawal. The dominant vertiginous perception with the head facing up was rotation in the horizontal plane (85% incidence) with a consistent direction across participants. With the head turned 90 degrees in yaw the perception did not transform into equivalent vertical plane rotation, indicating a context-dependency of the perception. During long exposures, illusory rotation lasted on average 50 s, including 42 s whilst stationary at 7T. Upon withdrawal, perception re-emerged and reversed, lasting on average 30 s. Onset fields for nystagmus and perception were significantly correlated (p<.05). Although perception did not persist as long as nystagmus, this is a known feature of continuous SSC stimulation. These observations, and others in the paper, are compatible with magnetic-field evoked-vertigo and nystagmus sharing a common mechanism. With this interpretation, response decay and reversal upon withdrawal from the field, are due to adaptation to continuous vestibular input. Although the study does not entirely exclude the possibility of mechanisms involving transient vestibular stimulation

  17. On the vertigo due to static magnetic fields.

    Directory of Open Access Journals (Sweden)

    Omar S Mian

    Full Text Available Vertigo is sometimes experienced in and around MRI scanners. Mechanisms involving stimulation of the vestibular system by movement in magnetic fields or magnetic field spatial gradients have been proposed. However, it was recently shown that vestibular-dependent ocular nystagmus is evoked when stationary in homogenous static magnetic fields. The proposed mechanism involves Lorentz forces acting on endolymph to deflect semicircular canal (SCC cupulae. To investigate whether vertigo arises from a similar mechanism we recorded qualitative and quantitative aspects of vertigo and 2D eye movements from supine healthy adults (n = 25 deprived of vision while pushed into the 7T static field of an MRI scanner. Exposures were variable and included up to 135s stationary at 7T. Nystagmus was mainly horizontal, persisted during long-exposures with partial decline, and reversed upon withdrawal. The dominant vertiginous perception with the head facing up was rotation in the horizontal plane (85% incidence with a consistent direction across participants. With the head turned 90 degrees in yaw the perception did not transform into equivalent vertical plane rotation, indicating a context-dependency of the perception. During long exposures, illusory rotation lasted on average 50 s, including 42 s whilst stationary at 7T. Upon withdrawal, perception re-emerged and reversed, lasting on average 30 s. Onset fields for nystagmus and perception were significantly correlated (p<.05. Although perception did not persist as long as nystagmus, this is a known feature of continuous SSC stimulation. These observations, and others in the paper, are compatible with magnetic-field evoked-vertigo and nystagmus sharing a common mechanism. With this interpretation, response decay and reversal upon withdrawal from the field, are due to adaptation to continuous vestibular input. Although the study does not entirely exclude the possibility of mechanisms involving transient

  18. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

    OpenAIRE

    Greco, A.; Macri, G. F.; Gallo, A.; M. Fusconi; DE VIRGILIO, A.; G. Pagliuca; Marinelli, C.; M. De Vincentiis

    2014-01-01

    Objectives. To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Systematic Review Methodology. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Results and Conclusions. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a su...

  19. [Vertigo induced by noise or pressure to the left ear].

    Science.gov (United States)

    Seidel, D U; Dülks, A; Remmert, S

    2011-06-01

    A 49-year-old male patient presented with recently acquired vertigo induced by noise or pressure to the left ear. With appropriate stimulation, oscillopsia with a rotatory component could be reproduced in videooculography. Cervical vestibular evoked myogenic potentials (VEMP) showed increased amplitudes and a lowered threshold on the left side. CT of the petrous bone showed a bony dehiscence of the left superior semicircular canal. Conservative therapy was initiated as a first step.

  20. Recent advances in diagnosis and treatment for patients with vertigo

    Institute of Scientific and Technical Information of China (English)

    Kazuo ISHIKAWA; Yan WANG; Weng Hoe WONG

    2002-01-01

    @@ The number of patients who suffer from vertigo or dizziness becomes greater during the sixth and seventh decades of life and is now increasing to total, which could be related to recent longer life expectancy. Pertinent medical care should be given to those patients to better obtain so-called quality of life (QOL), and this could be attained with the help of accurate diagnosis. In general,accurate diagnosis is made by thorough neurotological examinations.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. Migrainous vertigo%偏头痛性眩晕

    Institute of Scientific and Technical Information of China (English)

    杨碧晖; 王柠

    2011-01-01

    Migrainous vertigo(MV)has been considered as an independent disease mainly characterized by a history of repeated relapsing vertigo and migraine which cannot be interpreted by other central or peripheral nerve otology-related diseases.Although cited as an independent disease in majority of publications.it was not unti recent years when studies on etiology of migraine and vertigo were conducted and became a topic of increasing interest to clinicians and researchers.This study briefed on the historical evolution,clinical features and current status of diagnosis and treatment of MV.%偏头痛性眩晕主要以反复发作性眩晕和偏头痛病史为特征,且不能用其他中枢性或周围性神经耳科相关疾病解释.以往文献大多认为偏头痛性眩晕是一种独立疾病形式,直到近几年,才开始对偏头痛和眩晕进行病因学的关联研究.文章对偏头痛性眩晕的历史沿革、临床特点以及诊治现状做一简要介绍.

  6. [Vertigo/dizziness and syncope from a neurological perspective].

    Science.gov (United States)

    Machetanz, J

    2015-01-01

    Vertigo/dizziness and syncope are among the most frequent clinical entities encountered in neurology. In patients with presumed syncope, it is important to distinguish it from neurological and psychiatric diseases causing a transient loss of consciousness due to another etiology. Moreover, central nervous disorders of autonomic blood pressure regulation as well as affections of the peripheral autonomic nerves can be responsible for the onset of real syncope. This is particularly relevant in recurrent syncope. Vertigo occurs in the context of temporary disorders, relatively harmless diseases associated with chronic impairment, as well as in acute life-threatening states. Patient history and clinical examination play an important role in classifying these symptoms. It is of crucial importance in this context, e.g., to establish whether the patient is experiencing an initial manifestation or whether such episodes have been known to occur recurrently over a longer period of time, as well as how long the episodes last. Clinical investigations include a differential examination of the oculomotor system with particular regard to nystagmus. The present article outlines the main underlying neurological diseases associated with syncope and vertigo, their relevant differential diagnoses as well as practical approaches to their treatment.

  7. Recent advances in orthostatic hypotension presenting orthostatic dizziness or vertigo.

    Science.gov (United States)

    Kim, Hyun-Ah; Yi, Hyon-Ah; Lee, Hyung

    2015-11-01

    Orthostatic hypotension (OH), a proxy for sympathetic adrenergic failure, is the most incapacitating sign of autonomic failure. Orthostatic dizziness (OD) is known to be the most common symptom of OH. However, recent studies have demonstrated that 30-39 % of patients with OH experienced rotatory vertigo during upright posture (i.e., orthostatic vertigo, OV), which challenges the dogma that OH induces dizziness and not vertigo. A recent population-based study on spontaneously occurring OD across a wide age range showed that the one-year and lifetime prevalence of OD was 10.9 and 12.5 %, respectively. Approximately 83 % of patients with OD had at least one abnormal autonomic function test result. So far, 11 subtypes of OD have been proposed according to the pattern of autonomic dysfunction, and generalized autonomic failure of sympathetic adrenergic and parasympathetic cardiovagal functions was the most common type. Four different patterns of OH, such as classic, delayed, early, and transient type have been found in patients with OD. The head-up tilt test and Valsalva maneuver should be performed for a comprehensive evaluation of sympathetic adrenergic failure in patients with OD/OV. This review summarizes current advances in OH presenting OD/OV, with a particular focus on the autonomic dysfunction associated with OD.

  8. [Somatic symptoms in those hospitalized for dizziness or vertigo].

    Science.gov (United States)

    Goto, Fumiyuki; Tsutumi, Tomoko; Arai, Motohiro; Ogawa, Kaoru

    2010-09-01

    Anxiety and depression greatly affect the prognosis of and burden on subjects seen for dizziness or vertigo, who usually report multiple somatic symptoms. We studied the prevalence of these symptoms in 145 subjects hospitalized for dizziness or vertigo and taking part in 4-day group vestibular rehabilitation. Questionnaires given to determine the prevalence of somatic symptoms assessed headache, insomnia, diarrhea, constipation, stomachache, chest pain, palpitations, dyspnea, general fatigue, and stress. Quantitation used aerical rating scale (NRS). Anxiety and depression were assessed using the hospital anxiety and depression scale (HADS). Disability due to dizziness was assessed using the dizziness handicap inventory (DHI). We conducted correlational analysis between dizziness and somatic symptoms. The top four average NRS scores for somatic symptoms were dizziness at 3.5 +/- 2.8, general fatigue at 2.8 +/- 2.6, insomnia at 2.4 +/- 2.6, and headache at 1.8 +/- 2.3. These symptoms resembled those reported for subjects with anxiety and depression. The correlation between headache and dizziness NRS scores was R = 0.48 (P dizziness reported several somatic symptoms related to anxiety and depression attributable to dizziness. This underscores the need to treat these somatic symptoms when treating subjects seen chiefly dizziness or vertigo.

  9. Betahistine treatment in managing vertigo and improving vestibular compensation: clarification.

    Science.gov (United States)

    Lacour, Michel

    2013-01-01

    Betahistine dihydrochloride (betahistine) is currently used in the management of vertigo and vestibular pathologies with different aetiologies. The main goal of this review is to clarify the mechanisms of action of this drug, responsible for the symptomatic relief of vertigo and the improvement of vestibular compensation. The review starts with a brief summary recalling the role of histamine as a neuromodulator/neurotransmitter in the control of the vestibular functions, and the role of the histaminergic system in vestibular compensation. Then are presented data recorded in animal models demonstrating that betahistine efficacy can be explained by mechanisms targeting the histamine receptors (HRs) at three different levels: the vascular tree, with an increase of cochlear and vestibular blood flow involving the H1R; the central nervous system, with an increase of histamine turnover implicating the H3R, and the peripheral labyrinth, with a decrease of vestibular input implying the H3R/H4R. Clinical data from vestibular loss patients show the impact of betahistine treatment for the long-term control of vertigo, improvement of balance and quality of life that can be explained by these mechanisms of action. However, two conditions, at least, are required for reaching the betahistine therapeutic effect: the dose and the duration of treatment. Experimental and clinical data supporting these requirements are exposed in the last part of this review.

  10. 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.

  11. 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.

  12. 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."

  13. 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: ...

  14. 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.

  15. IV-DSA of vertigo patients. Asymmetry of cervical vertebral arteries

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Hiromi; Ito, Masatoshi; Takita, Kimio; Matsuzawa, Taiju.

    1988-04-01

    With IV-DSA(Intra-Venous Digital Subtraction Angiography), we examined the relations between vertigo or dizziness and asymmetries of cervical vertebral arteries. In this time, as the asymmetries we chose next three; hemi-stenosis, hemi-occulusion and hemi-strong tortuosity. In the appearance of the asymmetries, there was no differance between those who complain vertigo or dizziness and others.

  16. The Role of Lifestyle Modifications in the Management of Migraine Associated Vertigo

    Directory of Open Access Journals (Sweden)

    Omer Saglam

    2014-03-01

    Full Text Available Aim: To determine potential factors that may trigger vertigo attacks and evaluate the efficacy of lifestyle changes. Material and Method: We analyzed medical records of 23 patients with migraine associeted vertigo retrospectively. In the management of vertigo, lifestyle modifications, including limitation of the possible triggering factors such as diet, sleep problems, stress, physical activity, and other factors associated with migraine were determined for therapy. Result: Response to therapy was defined as greater than 50 % reduction in symptom recurrence and severity rate. Overall, 69,6 % of patients experienced resolution or dramatic reduction of frequency and severity in symptoms of their vertigo attacks. Discussion: With the high rate reduction of the vertiginous episodes frequency and severity, life-style modifications is effective therapy for the common problem of migraine associated vertigo.

  17. Clinico-psychological analysis of systematic (vestibular and nonsystematic (psychogenic vertigo, therapy optimization

    Directory of Open Access Journals (Sweden)

    Elena Mikhailovna Illarionova

    2011-01-01

    Full Text Available Objective: to study the clinical and psychoemotional characteristics in patients with systematic and nonsystematic vertigo and to optimize therapy. Patients and methods. The clinical features were analyzed in 25 patients with systematic vertigo and 25 patients with psychogenic vertigo. Their psychoemotional sphere was studied using the Beck depression inventory, the Spielberger-hanin personality- and situation-related anxiety inventory, and the vestibular inventory. Results. There were statistically significant clinical differences and a higher degree of anxiety-depressive disorders in the patients with psychogenic vertigo. Drug therapy in combination with stabilometric platform exercises based on the biological feedback principle was stated to be effective in patients with different types of vertigo, in those with psychogenic dizziness in particular.

  18. 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.

  19. 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

  20. 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.

  1. Psychometric properties of the Vertigo symptom scale – Short form

    Directory of Open Access Journals (Sweden)

    Nordahl Stein

    2008-03-01

    Full Text Available Abstract Background The aim of the study was to examine the psychometric properties of the Vertigo symptom scale – short form (VSS-SF, a condition-specific measure of dizziness, following translation of the scale into Norwegian. Methods A cross-sectional survey design was used to examine the factor structure, internal consistency and discriminative ability (sample I, n = 503. A cross-sectional pre-intervention design was used to examine the construct validity (sample II, n = 36 of the measure and a test-retest design was used to examine reliability (sub-sample of sample II, n = 28. Results The scree plot indicated a two factor structure accounting respectively for 41% and 12% of the variance prior to rotation. The factors were related to vertigo-balance (VSS-V and autonomic-anxiety (VSS-A. Twelve of the items loaded clearly on either of the two dimensions, while three items cross-loaded. Internal consistency of the VSS-SF was high (alpha = 0.90. Construct validity was indicated by correlation between path length registered by platform posturography and the VSS-V (r = 0.52, but not with the VSS-A. The ability to discriminate between dizzy and not dizzy patients was excellent for the VSS-SF and sub-dimension VSS-V (area under the curve 0.87 and 0.91, respectively, and acceptable for the sub-dimension VSS-A (area under the curve 0.77. High test-retest reliability was demonstrated (ICC VSS-SF: 0.88, VSS-V: 0.90, VSS-A: 0.90 and no systematic change was observed in the scores from test to retest after 2 days. Conclusion Using a Norwegian translated version of the VSS-SF, this is the first study to provide evidence of the construct validity of this instrument demonstrating a stable two factor structure of the scale, and the identified sub-dimensions of dizziness were related to vertigo-balance and autonomic-anxiety, respectively. Evidence regarding a physical construct underlying the vertigo-balance sub-scale was provided. Satisfactory internal

  2. Transient Ischemic Attacks Presenting with Dizziness or Vertigo.

    Science.gov (United States)

    Blum, Christina A; Kasner, Scott E

    2015-08-01

    Dizziness with or without associated neurologic symptoms is the most common symptom of posterior circulation transient ischemic attack (TIA) and can be more frequent before posterior circulation strokes. This entity carries a high risk of recurrent events and should be considered as a potential cause of spontaneous episodic vestibular syndrome. Diagnostic evaluation should include intracranial and extracranial imaging of the vertebral arteries and basilar artery. Aggressive medical management with antiplatelet therapy, statin use, and risk factor modification is the mainstay of treatment. This article highlights the importance of diagnosing, evaluating, and treating posterior circulation TIAs manifesting as dizziness or vertigo.

  3. 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

  4. 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....

  5. 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.

  6. 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.

  7. Why cold water delays the onset of vestibular vertigo-An functional MRI study

    Energy Technology Data Exchange (ETDEWEB)

    Wang Zhi [Department of Radiology, Beijing Hospital, No. 1 Dahua Road Dongdan, Beijing 100730 (China)], E-mail: zhiwang76@gmail.com; Chen Min [Department of Radiology, Beijing Hospital, No. 1 Dahua Road Dongdan, Beijing 100730 (China); Gong Xia; Huang Weining [Department of E.N.T., Beijing Hospital, No. 1 Dahua Road Dongdan, Beijing 100730 (China); Xu Liang [Department of Radiology, Beijing Hospital, No. 1 Dahua Road Dongdan, Beijing 100730 (China); Zhou Cheng [Department of Radiology, Beijing Hospital, No. 1 Dahua Road Dongdan, Beijing 100730 (China)], E-mail: chengzhou2000@yahoo.com

    2008-09-15

    The mechanism of vertigo is unclear. Generally, the peak time or the latency of blood oxygenation level dependent (BOLD) effect is about 6 s. However, clinically, the latency of vertigo or nystagmus induced by caloric stimulations is much longer than 6 s, commonly about 30 s induced by water of 30 deg. C or 44 deg. C. We hypothesize that there is an inhibitive power or mechanism for the occurrence of vestibular vertigo, since it is an unpleasant feeling. The caloric test was performed in healthy volunteers during the BOLD fMRI scanning. The overlaid results of statistical parametric mapping (SPM) showed that three brain regions showed neural activation during vestibular dizziness while deactivation occurred in response to cold water simulation: (1) supplementary motor area (SMA); (2) middle temporal area/medial superior temporal area (MT/MST); (3) visual association area (BA19). The time course of the regions further demonstrated that the signal decreased during the cold-water stimulation and increased during the period of vertigo. We therefore further hypothesize that there may be two forces for the production of vertigo: inhibitory power (IP) and promotive power (PP). The delayed onset of vertigo was the result of the interaction between IP and PP. All of our findings, for the first time, suggested such an original mechanism of vertigo.

  8. Is Vestibular Neuritis an Immune Related Vestibular Neuropathy Inducing Vertigo?

    Directory of Open Access Journals (Sweden)

    A. Greco

    2014-01-01

    Full Text Available Objectives. To review the current knowledge of the aetiology of vestibular neuritis including viral infections, vascular occlusion, and immunomediated mechanisms and to discuss the pathogenesis with relevance to pharmacotherapy. Systematic Review Methodology. Relevant publications on the aetiology and treatment of vestibular neuritis from 1909 to 2013 were analysed. Results and Conclusions. Vestibular neuritis is the second most common cause of peripheral vestibular vertigo and is due to a sudden unilateral loss of vestibular function. Vestibular neuronitis is a disorder thought to represent the vestibular-nerve equivalent of sudden sensorineural hearing loss. Histopathological studies of patients who died from unrelated clinical problems have demonstrated degeneration of the superior vestibular nerve. The characteristic signs and symptoms include sudden and prolonged vertigo, the absence of auditory symptoms, and the absence of other neurological symptoms. The aetiology and pathogenesis of the condition remain unknown. Proposed theories of causation include viral infections, vascular occlusion, and immunomediated mechanisms. The management of vestibular neuritis involves symptomatic treatment with antivertiginous drugs, causal treatment with corticosteroids, and physical therapy. Antiviral agents did not improve the outcomes.

  9. Fifty Cases of Vertebrobasilar Ischemic Vertigo Treated by Acupuncture

    Institute of Scientific and Technical Information of China (English)

    HUANG Qiong

    2009-01-01

    Objective:To observe the therapeutic effects of filiform needle acupuncture combined with dermal needle tapping for vertebrobasilar ischemic vertigo. Methods: Based on the etiopathogenesis of TCM, the disease is caused by turbid phlegm clouding the heart orifice combined with wind, leading to insufficient nourishment of the brain due to deficiency of blood. Fenglong (ST 40) was punctured with filiform needle to resolve phlegm; Fengchi (GB 20) to dispel wind; Baihui (GV 20) to stop dizziness; and Lieque (LU 7) to widen the inner diameter of the vertebral arteries and increase peak systolic velocity and minute blood flow volume, so as to improve blood supply to the vertebral arteries. Dazhui (GV 14) was stimulated by tapping with a dermal needle to improve blood supply to the head. Results: Of 50 patients in this series, 39 cases (78%) were cured,6 cases (12%) relieved, 4 cases (8%) improved, and 1 case (2%) failed, with a total effective rate of 98%.Conclusion: Acupuncture combined with dermal needle tapping is an effective therapy for treating vertebrobasilar ischemic vertigo.

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

    Directory of Open Access Journals (Sweden)

    Muhammad SAEED

    2014-07-01

    Full Text Available How to Cite This Article: Saeed M, Azam M, Shabbir N, Qamar ShA. Is "Benign Childhood Epilepsy with Centrotemporal Spikes" Always Benign? Iran J Child Neurol. 2014 Summer;8(3: 39-45.AbstractObjectiveTo determine the prevalence of associated behavioral problems and prognosis with Benign Childhood Epilepsy with CentroTemporal Spikes (BCECTS.Descriptive, Cross Sectional study that was conducted from October 2009 to April 2013 in the Department of Pediatric Neurology, the Children’s Hospital Taif, KSA.Material & MethodsThis study was conducted after approval from the Ethics Committee of the Children’s Hospital Taif, Saudi Arabia. Thirty-two patients from the age of 3 to 10 years old were recruited from the pediatric neurology clinic over a period of 4 years. All the patients were selected based on history, EEGs, and neuropsychological and neurological examinations.EEGs were performed for all the patients while in awake and sleep states. Those who had centrotemporal discharges were included in the study. All the patients also underwent a brain MRI. Only two patients had mild cortical atrophy but developmentally they were normal.ResultsIn our study, prevalence of BRE is 32/430 (7.44%. Among the 32 cases, 24 were male and eight were female. Six cases out of 32 indicated a family history of BRE. Twenty-eight cases had unilateral right sided centrotemporal discharges and four had bilateral discharges.ConclusionIt is possible that for BECTS, a high number of seizures might play an important role in the development of mild cognitive impairment and/or behavior disturbances.ReferencesBradley WG, Daroff RB, Fenichel JM, Jahrovic J. Neurology of clinical practice. 5th Ed. 2009: pp. 1953-1990.Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross H, Van Emde Boas M, et al: Revised terminology and concepts for organization of seizures and epilepsies: Report of the ILAE Commission on Classification and Terminology, 2005–2009. Epilepsia. 2010

  11. 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.

  12. 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)

  13. Acute vertigo in an anesthesia provider during exposure to a 3T MRI scanner.

    Science.gov (United States)

    Gorlin, Andrew; Hoxworth, Joseph M; Pavlicek, William; Thunberg, Christopher A; Seamans, David

    2015-01-01

    Vertigo induced by exposure to the magnetic field of a magnetic resonance imaging (MRI) scanner is a well-known phenomenon within the radiology community but is not widely appreciated by other clinical specialists. Here, we describe a case of an anesthetist experiencing acute vertigo while providing sedation to a patient undergoing a 3 Tesla MRI scan. After discussing previous reports, and the evidence surrounding MRI-induced vertigo, we review potential etiologies that include the effects of both static and time-varying magnetic fields on the vestibular apparatus. We conclude our review by discussing the occupational standards that exist for MRI exposure and methods to minimize the risks of MRI-induced vertigo for clinicians working in the MRI environment.

  14. Anterior and posterior inferior cerebellar artery infarction with sudden deafness and vertigo.

    Science.gov (United States)

    Murakami, Takenobu; Nakayasu, Hiroyuki; Doi, Mitsuru; Fukada, Yasuyo; Hayashi, Miwa; Suzuki, Takeo; Takeuchi, Yuichi; Nakashima, Kenji

    2006-12-01

    We report a patient with anterior and posterior inferior cerebellar artery infarction, which manifested as profound deafness, transient vertigo, and minimal cerebellar signs. We suspect that ischaemia of the left internal auditory artery, which originates from the anterior inferior cerebellar artery, caused the deafness and transient vertigo. A small lesion in the middle cerebellar peduncle in the anterior inferior cerebellar artery territory and no lesion in the dentate nucleus in the posterior inferior cerebellar artery territory are thought to explain the minimal cerebellar signs despite the relatively large size of the infarction. Thus a relatively large infarction of the vertebral-basilar territory can manifest as sudden deafness with vertigo. Neuroimaging, including magnetic resonance imaging, is strongly recommended for patients with sudden deafness and vertigo to exclude infarction of the vertebral-basilar artery territory.

  15. Pre and post betahistine therapy 99m Tc - HMPAO brain spect studies in patients with vertigo.

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    Krishna B

    2000-07-01

    Full Text Available Vertebro basilar insufficiency (VBI is a well known cause of vertigo. Brain Single Photon Emission Computed Tomography (SPECT is an important diagnostic tool to detect and to quantitate the perfusion abnormalities in different areas of the brain. Effect of an antivertigo drug Betahistine on improving the hypoperfusion in different areas of the brain in vertigo patients was studied using brain SPECT. Betahistine at a dose of 16 mg three times daily was shown to improve perfusion in the hypoperfused areas of the brain resulting in relief from symptoms of vertigo. The cerebellar region, which is the most important area involved in vertigo patients with vascular pathology, showed almost complete normalisation of perfusion following Betahistine therapy.

  16. 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.

  17. Vertigo, poetry and creed of Alfred Hitchcock's cinema

    Directory of Open Access Journals (Sweden)

    Rafael J. Pascual

    2011-09-01

    Full Text Available In this article we analyse the film Vertigo -undoubtedly one of the North-American film di- rector Alfred Hitchcock’s masterpiece- as an audiovisual poem we could identify with such a characteristic and defining name as film-poetry. We will try to show some elements very typical of cinema -the use of the light, colour, and music, the aesthetic treatment of image and the camera movement- they all aspects that in- fluence -as well as does plot- the rhythm, form and content in the same way as a poem does, in order to place cinema at the same level as poetry. We will try to describe in a very essential way the relations between cinema and arts such as music, painting and literature.

  18. Posterior semicircular canal dehiscence: a morphologic cause of vertigo similar to superior semicircular canal dehiscence

    Energy Technology Data Exchange (ETDEWEB)

    Krombach, G.A.; Schmitz-Rode, T.; Haage, P.; Guenther, R.W. [Department of Diagnostic Radiology, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); DiMartino, E. [Department of Otorhinolaryngology, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); Prescher, A. [Department of Anatomy, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany); Kinzel, S. [Department of Experimental Veterinarian Medicine, University of Technology, Pauwelstrasse 30, 52057, Aachen (Germany)

    2003-06-01

    Heading Abstract.The aim of this study was to assess imaging findings of posterior semicircular dehiscence on computed tomography and to evaluate incidence of posterior and superior semicircular canal dehiscence in patients presenting with vertigo, sensorineuronal hearing loss or in a control group without symptoms related to the inner ear. Computed tomography was performed in 507 patients presenting either with vertigo (n=128; 23 of these patients suffered also from sensorineuronal hearing loss), other symptoms related to the inner ear, such as hearing loss or tinnitus (n=183) or symptoms unrelated to the labyrinth (n=196). All images were reviewed for presence of dehiscence of the bone, overlying the semicircular canals. Twenty-nine patients had superior semicircular canal dehiscence. Of these patients, 83% presented with vertigo, 10% with hearing loss or tinnitus and the remaining 7% with symptoms unrelated to the inner ear. In 23 patients dehiscence of the posterior semicircular canal was encountered. Of these patients, 86% presented with vertigo, 9% with hearing loss or tinnitus and 5% with symptoms unrelated to the inner ear. Defects of the bony overly are found at the posterior semicircular canal, in addition to the recently introduced superior canal dehiscence syndrome. Significant prevalence of vertigo in these patients suggests that posterior semicircular canal dehiscence can cause vertigo, similar to superior semicircular canal dehiscence. (orig.)

  19. 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

  20. 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.

  1. 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.

  2. 10 years of Vertigo Clinic at National Hospital Abuja, Nigeria: what have we learned?

    Science.gov (United States)

    Olusesi, Abiodun D; Abubakar, J

    2016-11-01

    The clinician's major role in management of the dizzy patient involves determining what dizziness is vertigo, and what vertigo is of central or peripheral origin. These demand attention to details of history, otolaryngological workup including vestibular assessment, and often use of diagnostic and management algorithms. There is paucity of published reports of the management outcomes of peripheral vestibular diseases from Africa. Two tertiary care otologist-led dedicated vertigo clinics are located in Abuja, Nigeria. A prospective, non-randomized study of patients presenting with features of peripheral vestibular diseases attending the National Hospital Abuja Nigeria (between May 2005 and April 2014) and CSR Otologics Specialist Clinics (May 2010 to April 2014) was carried out. Both institutions adopted the same diagnostic and management protocols. Data extracted from anonymized databases created for this study include age, sex, vertigo duration (acute 12 weeks), dizziness handicap inventory score at presentation and at subsequent visits, otological and vestibular findings, ice-water caloric testing results, other investigation outcomes, treatments offered and outcomes. 561/575 (97.5 %) of the cases recorded had peripheral vestibular disease. The male-to-female ratio was 290:271. The mean age of the subjects was 44.7 years. Duration of vertigo at presentation was acute in 278 subjects and chronic in 283 subjects. Identifiable clinical diagnostic groups include BPPV (n = 200), Meniere's disease (n = 189), cervicogenic vertigo (n = 35), labyrinthitis (n = 32), Migraine-associated vertigo (MAV) (n = 32), cholesteatoma/perilymph Fistula (n = 10), climacteric vertigo (n = 8) and unclassified vertigo (n = 55). Migraine-associated vertigo recorded the highest DHI score (95 % CI 75 ± 4.3), followed by cholesteatoma/perilymph fistula (95 % CI 72 ± 6.1) and labyrinthitis (95 % CI 62 ± 1.9). Pure tone audiometry (95 % CI 67.3 ± 3

  3. 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.

  4. Benign Papules and Nodules of Oral Mucosa

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

  6. Elastography in Distinguishing Benign from Malignant Thyroid Nodules

    Directory of Open Access Journals (Sweden)

    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.

  7. 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

  8. 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.

  9. Benign paroxysmal torticollis in infancy

    Directory of Open Access Journals (Sweden)

    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.

  10. Benign fibroxanthoma of the mandible

    Directory of Open Access Journals (Sweden)

    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.

  11. Clinical Analysis of Acupuncture Combined with Tuina in Treating Cervical Vertigo

    Institute of Scientific and Technical Information of China (English)

    Wang Zheng-xin; Chen Guang-hui; Zhang Jin-yi; Shi Xiao-cheng; Wu Li-chun; Feng Zhi-wei; Wang Kang; Ding Hui-chun

    2014-01-01

    Objective: To investigate the clinical efficacy of acupuncture combined with tuina in treating patients with cervical vertigo. Methods: According to the principle of randomization, 258 cases with cervical vertigo who met the inclusion criteria for the study were randomly divided into an observation group and a control group, with 129 cases in each. The patients in the observation group received acupuncture combined with tuina therapy, while those in the control group were just treated by the same acupuncture therapy as in the observation group. After 10-day continuous treatments, the clinical efficacies of the two groups were analyzed and compared. Results: The total effective rate of the observation group was 100%, versus 86.0% of the control group, and the difference was significant (P Conclusion: Compared with simple acupuncture treatment, acupuncture combined with tuina therapy has a better effect in improving the ROM of cervical vertigo patients, with higher clinical efficacy.

  12. Efficacy of diphenhydramine in the prevention of vertigo and nausea at 7 T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Thormann, Markus, E-mail: markus.thormann@med.ovgu.de [Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke Universität, Leipziger Str. 44, 39120 Magdeburg (Germany); Amthauer, Holger [Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke Universität, Leipziger Str. 44, 39120 Magdeburg (Germany); Adolf, Daniela [Institut für Biometrie und Medizinische Informatik, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke Universität, Leipziger Str. 44, 39120 Magdeburg (Germany); Wollrab, Astrid [Biomedizinische Magnetresonanz, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke Universität, Leipziger Str. 44, 39120 Magdeburg (Germany); Ricke, Jens [Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke Universität, Leipziger Str. 44, 39120 Magdeburg (Germany); Speck, Oliver [Biomedizinische Magnetresonanz, Universitätsklinikum Magdeburg A.ö.R., Otto-von-Guericke Universität, Leipziger Str. 44, 39120 Magdeburg (Germany)

    2013-05-15

    Purpose: In this study the potential of diphenhydramine in reducing respectively preventing vertigo and nausea induced by the ultra-high static magnetic field at 7 T was evaluated. Materials and methods: In a prospective, double blinded, placebo controlled, cross-over randomized study the sensations of 34 volunteers before, during and after exposure to the static magnetic field with and without drug respectively placebo administration were quantified. Fast table motion was applied to increase the incidence of otherwise sparse reports of field related sensations. Results: The strength of vertigo can be reduced by the application of diphenhydramine. Conclusion: Diphenhydramine, even at a low dose, reduces the strength of vertigo at ultra-high static magnetic fields, may be used preventively, and could pave the way to even higher field strength.

  13. Detection of helicobacter pylori in benign laryngeal lesions by polymerase chain reaction: a cross sectional study

    Directory of Open Access Journals (Sweden)

    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.

  14. The minimal caloric test asymmetric response in vertigo-free migraine patients

    Directory of Open Access Journals (Sweden)

    Eliana Teixeira Maranhão

    2016-02-01

    Full Text Available ABSTRACT Vertigo symptoms and subclinical vestibular dysfunctions may occur in migraine. The Minimal Caloric Test (MCT, an easy-to-perform, convenient and yet informative procedure was used to test the vestibular function in 30 vertigo-free migraine patients outside attacks and 30 paired controls. Although not statistically significant, a right-to-left nystagmus duration asymmetry greater than 25% was present in both groups. This difference was greater in the patients group, suggesting the presence of subclinical vestibular imbalance in migraine.

  15. Jinger Moxibustion for Treatment of Cervical Vertigo--A Report of 40 Cases

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    In order to observe the therapeutic effects of jinger moxibustion for cervical vertigo, 78 cases were randomly divided into 2 groups, of whom 40 were treated with jinger moxibustion and 38 treated with acupuncture. The results showed a cure rate of 72.5% with a total effective rate of 97.5% in the jinger moxibustion group, while 44.7% and 73.7% respectively in the acupuncture group. The comparisons between the two groups in the cure rate and the total effective rate showed significant differences (P<0.05). The conclusion: Jinger moxibustion has a good therapeutic effect for treating cervical vertigo, superior to that of the acupuncture treatment.

  16. Clinical Observation of Tuina Therapy in Treating 47 Cases of Vertigo

    Institute of Scientific and Technical Information of China (English)

    耿中文

    2008-01-01

    In order to observe the clinical effect of Tuina therapy for vertigo, 47 cases of the patients with vertigo were treated by massaging Triple Energizer Meridian and Gallbladder Meridian on the head, and the results showed cure in 36 cases, improvement in 11 cases and the total effective rate was 100%.%为观察推拿治疗眩晕的临床疗效,以推拿头部三焦经及胆经为主,治疗眩晕患者47例,结果痊愈36例,好转11例,总有效率100%.

  17. [Characteristics and drug analysis associated with vertigo disease in real world].

    Science.gov (United States)

    Xie, Qian; Li, Yuan-Yuan; Xie, Yan-Ming; Yang, Wei; Zhao, Wei; Zhuang, Yan; Wang, Yong-Yan

    2014-09-01

    To explore the characteristics and influenced factors associated with the onset of vertigo disease, analysis of 3 719 cases of hospitalized patients with vertigo disease from the real world. Analysis the date of patients diagnosed with vertigo disease from the hospital information system of 19 grade-III class-A hospital from 2004 to 2011, include general information, the doctor's advice, other diseases combined, diagnostic information and the relationship with the onset of 24 solar terms, and the treatment drugs. The median age of hospitalized patients with vertigo disease was 59, the number of women (65.91%) was more than men (34.09%), manual workers (85.32%) were the majority career, most patients (81.63%) condition were general by the time they were hospital admission, patients more like admitted to neurologist (70.34%) when they first time to outpatient serves, hospitalization days were in 8-14 days (46.65%), 46.04% of the patients in the hospital total cost is in 5 000 RMB to 10 000 RMB, 73.86% of patients paid by National Health Medical Insurance. Hypertension (20.79%) was the most common underlying health problems, The most common syndromes was deficiency of liver-Yin and kidney-Yin(44. 21%) , followed by hyperactivity of liver-yang, disease of phlegm turbidity in mongolia and deficiency of Qi and blood. There were more deficiency syndrome and less excess syndrome. The highest rate of hospital admission solar terms in 2009 was the insects awaken throttle (5.21%), In 2010, the highest rate solar terms of hospital admission was the rain throttle (6.14%). The most frequently used traditional Chinese medicine was gastrodine injection (20.55%), the most frequently used western medicine for betahistine (10.19%), gastrodine injection was the most traditional Chinese medicine that combination with other western medicine. Hypertension was the most underlying health problems in the patients with vertigo disease in the real world, although the mental factors should

  18. 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.

  19. Dietary intakes, resting metabolic rates, and body composition in benign and malignant gastrointestinal disease.

    OpenAIRE

    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...

  20. Incidence and localizing value of vertigo and dizziness in patients with epilepsy: Video-EEG monitoring study.

    Science.gov (United States)

    Kim, Dong Wook; Sunwoo, Jun-Sang; Lee, Sang Kun

    2016-10-01

    Vertigo and dizziness are common neurological complaints that have long been associated with epilepsy. However, studies of patients with epileptic vertigo or dizziness with concurrent EEG monitoring are scarce. We performed the present study to investigate the incidence and localizing value of vertigo and dizziness in patients with epilepsy who had confirmation of EEG changes via video-EEG monitoring. Data of aura and clinical seizure episodes of 831 consecutive patients who underwent video-EEG monitoring were analyzed retrospectively. Out of 831 patients, 40 patients (4.8%) experienced vertigo or dizziness as aura (mean age, 32.8±11.8years), all of whom had partial seizures. Eight had mesial temporal, 20 had lateral temporal, four had frontal, one had parietal, and seven had occipital lobe onset seizures. An intracranial EEG with cortical stimulation study was performed in seven patients, and the area of stimulation-induced vertigo or dizziness coincided with the ictal onset area in only one patient. Our study showed that vertigo or dizziness is a common aura in patients with epilepsy, and that the temporal lobe is the most frequent ictal onset area in these patients. However, it can be suggested that the symptomatogenic area in patients with epileptic vertigo and dizziness may not coincide with the ictal onset area.

  1. Nocturia and benign prostatic hyperplasia

    Directory of Open Access Journals (Sweden)

    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. 中枢性头晕与眩晕的临床观点%Clinical opinions about central dizziness and vertigo

    Institute of Scientific and Technical Information of China (English)

    李晓荟; 姜树军

    2012-01-01

    Dizziness is the most frequent chief complaint in neurological clinic. Regarding the position of etiology, dizziness is divided into central dizziness and peripheral dizziness. Although it accounts for 25% only, the central dizziness draws great attention from clinicians because of its complex clinical condition and poor prognosis. In recent years, with the concept and coverage of the dizziness changing, those of central dizziness also change correspondingly. Most scholars hold that dizziness include vertigo, disequilibrium without vertigo, presyncope (near-faint), psychophysiologic dizziness. Correspondingly, central dizziness includes central vertigo, central dysequilibrium without vertigo, central presyncope, and central psychophysiologic dizziness. In this article, we introduced the concept, location, characteristics and common subtypes of central dizziness; we also reviewed its research progress.%头晕为神经科门诊最常见的主诉.从头晕原因的定位角度,可将头晕分为中枢性头晕和周围性头晕两大部分.中枢性头晕占全部头晕的25%,虽然比例较低,但因其病情复杂,判断困难,预后较差,更引起临床医师的重视.近年来随着头晕的概念和所涵盖的内容发生变化,中枢性头晕的概念和内容也发生了相应的变化.大部分国内外学者认为头晕包括眩晕、平衡失调感(不稳感)、晕厥前状态、精神性头晕四个部分;相应而言,中枢性头晕包括中枢性眩晕、中枢性平衡失调感、晕厥前状态和精神性头晕.本文分别介绍了中枢性头晕4个亚型的概念、定位、特点和常见的中枢性头晕疾病,对中枢性头晕近年的变化和进展进行了综述.

  3. Malondialdehyde in benign prostate hypertrophy: a useful marker?

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. Exposure to MRI-related magnetic fields and vertigo in MRI workers

    NARCIS (Netherlands)

    Schaap, Kristel; Portengen, Lutzen; Kromhout, Hans

    2016-01-01

    OBJECTIVES: Vertigo has been reported by people working around magnetic resonance imaging (MRI) scanners and was found to increase with increasing strength of scanner magnets. This suggests an association with exposure to static magnetic fields (SMF) and/or motion-induced time-varying magnetic field

  6. Dialectical Nursing for Vertigo%辨证施护眩晕

    Institute of Scientific and Technical Information of China (English)

    徐丽艳

    2015-01-01

    The paper discusses 58 vertigo cases treated in the dialectical nursing of traditional Chinese medicine theory and observes the treating result.%叙述了对58例眩晕病人运用中医辨证施护理论进行护理并观察结果。

  7. Acute vertigo in an anesthesia provider during exposure to a 3T MRI scanner

    Directory of Open Access Journals (Sweden)

    Gorlin A

    2015-03-01

    Full Text Available Andrew Gorlin,1 Joseph M Hoxworth,2 William Pavlicek,2 Christopher A Thunberg,1 David Seamans1 1Department of Anesthesiology, 2Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA Abstract: Vertigo induced by exposure to the magnetic field of a magnetic resonance imaging (MRI scanner is a well-known phenomenon within the radiology community but is not widely appreciated by other clinical specialists. Here, we describe a case of an anesthetist experiencing acute vertigo while providing sedation to a patient undergoing a 3 Tesla MRI scan. After discussing previous reports, and the evidence surrounding MRI-induced vertigo, we review potential etiologies that include the effects of both static and time-varying magnetic fields on the vestibular apparatus. We conclude our review by discussing the occupational standards that exist for MRI exposure and methods to minimize the risks of MRI-induced vertigo for clinicians working in the MRI environment. Keywords: occupational medicine, MRI worker safety, vestibular dysfunction, magnetic field, 3T MRI scanner

  8. Effect of Developmental Binocular Vision Abnormalities on Visual Vertigo Symptoms and Treatment Outcome

    OpenAIRE

    Pavlou, Marousa; Acheson, James; Nicolaou, Despina; Fraser, Clare L.; Bronstein, Adolfo M.; Davies, Rosalyn A.

    2015-01-01

    BACKGROUND AND PURPOSE: Customized vestibular rehabilitation incorporating optokinetic (OK) stimulation improves visual vertigo (VV) symptoms; however, the degree of improvement varies among individuals. Binocular vision abnormalities (misalignment of ocular axis, ie, strabismus) may be a potential risk factor. This study aimed to investigate the influence of binocular vision abnormalities on VV symptoms and treatment outcome.METHODS: Sixty subjects with refractory peripheral vestibular sympt...

  9. Reliability of foam posturography in assessment of postural balance in the patients with vertigo

    Institute of Scientific and Technical Information of China (English)

    Bo LIU; Weijia KONG

    2008-01-01

    The postural balance is a important aspect of assessment in vestibular rehabilitation therapy. As the computerized dynamic posturography, the foam posturo-graphy performed by using foam in posturography is a useful measurement tool for postural balance. Then, the reliability of foam posturography is critical in clinic. To our knowledge, there is no report about the test-retest reliability of foam posturography in the patients with ver-tigo in China. The foam posturography was taken on the patients with vertigo in stable state and repeated in 3 to 5 days. In the two assessments of test and retest, all subjects stood under 4 sensory conditions, such as firm surface with eyes open (T1), firm surface with eyes closed (T2), foam surface with eyes open (T3) and foam surface with eyes closed (T4) for 30 seconds respectively. The average sway velocity (SV) of center of pressure (COP) under feet of upright standing was recorded as research parameter. The results of patients with vertigo were compared with those of normal subjects. It demonstrated that all normal subjects did not fall in the two assessments. There were 10 of 34 patients with vertigo at least fell one time during the two assessments, and the SVs of these subjects did not taken the analysis of test-retest reliability. The results showed that: (1) The interclass correlation coefficients (ICC) of all 49 subjects including normal subjects and patients without falling were 0.887-0.973 according to the T1-T4 between two assessment. (2) The SVs between the normal subjects and patients were significantly differ-ent in the T2 (t=2.018, P=0.049) and T4 (t=3.905, P<0.001) in the first assessment and in the T4 (t= 3.715, P=0.001) in the second. And (3) the cases of falling between two assessments were not significant different (X2=0.073, P=0.787) in the patients with vertigo. It is concluded from this study that the foam posturography has high test-retest reliability to assess the postural bal-ance in the patients with

  10. 眩晕辨治体会%Experience of Syndrome Differentiation and Treatment of Vertigo

    Institute of Scientific and Technical Information of China (English)

    李波; 李彬

    2012-01-01

    目的:探讨中医辨证论治眩晕的临床体会.方法:总结中医对眩晕病因病机的认识和中医辨证论治的方法.结果:眩晕常见的病理因素为风、火、痰、虚、瘀,病位在脑,其病变脏腑与肝、脾、肾三脏相关.本病多属本虚标实,以肝肾阴虚、气血不足为本,风火痰瘀为标,但亦有实中带虚者,临床治疗应在辨病的基础上辨证施治,注重辨脏腑虚实,随证治之.结论:中医辨证论治眩晕的临床疗效显著.%Objective;To explore the clinical experience of TCM syndrome differentiating and treating vertigo. Methods:TCM understandings of etiology,pathogenesis and methods of TCM syndrome differentiation and treatment of vertigo were summarized. Results: Wind, fire, phlegm, deficiency and stasis were the common pathogenic factors of vertigo and the disease location was in brain. The diseased zang and fu-organs involved with the liver,spleen and kidney. Most pathogenesis mechanisms of vertigo were deficiency in root and ex-cess in superficial level. Yin deficiency of liver and kidney was the root, while the wind, fire, phlegm and stasis were the superficial pathogenesis. But it also had type of excess complicated with deficiency. Clinical treatment should make syndrome differentiation based on disease differentiation, pay more attention to the deficiency or excess of zang and fu-organs, and treat disease on the basis of syn-drome. Conclusion: TCM has noticeable curative effects on syndrome differentiating and treating vertigo.

  11. 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.

  12. 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

  13. 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 ...

  14. 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.

  15. 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.

  16. 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.

  17. 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 ...

  18. 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.

  19. 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.)

  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. Understanding of vertigo inTCM and the western medicine%中西医对眩晕的认识

    Institute of Scientific and Technical Information of China (English)

    张双勇

    2016-01-01

    Understanding of vertigo in TCM and the western medicine was different. TCM believed that vertigo was a disease, while the western medicine considered that vertigo was a clinical symptom. Their different points on vertigo mainly were relfected in the concept, etiology, pathogenesis, clinical manifestations and treatment principles.%中西医对眩晕有不同的认识,中医学把眩晕作为一个疾病来认识,而西医学则认为眩晕是一个临床症状,它们对眩晕认识的不同点主要体现在眩晕的概念、病因、发病机制、临床表现及治疗原则上。

  2. [Height-induced vertigo and its medical interpretation: Goethe and the Strassburger Münster].

    Science.gov (United States)

    Jagella, C

    2000-02-19

    An analysis combining medicine and literature challenges the methodology of both disciplines. This essay on the vertigo Goethe suffered on the tower of the Strasbourg Minster attempts to trace the vicissitudes of interpreting an emblem, like vertigo, burdened by cultural meaning and implications. Thus, Goethe's own report of this event 40 years after the fact, in his "Dichtung und Wahrheit", has to be related to another, hidden chronology of vertigo and fear in his account which, at first glance, conveys quite different implications. The first part of this paper refers to a medical interpretation of Goethe's dread of high places and his way of coping with it which, today, could be defined as a typical example of a behaviourist approach. In the second part, Goethe's vertigo is linked to psychoanalytic, literary, and historical reflections on the meanings of symptoms we connect today with medical terms like anxiety, phobia, and vertigo. Goethe's vertigo is shown as a complex problem--not only for himself but also for its interpreters: on the one hand, it tells its own story-within-a-story; on the other, it depends on the tools it was written with. Traditional approaches of medical history try to find symptoms and traces of diseases known to us today in literary texts, an approach which is as dubious as taking today's tools of medical analysis, such as psychoanalytic terms and concepts, to explain specific phenomena in literature without first carefully analysing these methods themselves, and only then subjecting the text to an analysis based on them. Nevertheless, this essay does not contest the justification of interpreting literary texts in the light of today's medical knowledge, but postulates that it should be clear which type of medical knowledge is applied. It is quite possible to read Goethe's account only as an old tale of acrophobia, but how will this help us? It seems more interesting to look at the link between the feeling of dizziness he experienced on

  3. Increased Risk of Vascular Events in Emergency Room Patients Discharged Home with Diagnosis of Dizziness or Vertigo: A 3-Year Follow-Up Study

    OpenAIRE

    Ching-Chih Lee; Hsu-Chueh Ho; Yu-Chieh Su; Brian C-H Chiu; Yung-Cheng Su; Yi-Da Lee; Pesus Chou; Sou-Hsin Chien; Yung-Sung Huang

    2012-01-01

    BACKGROUND: Dizziness and vertigo symptoms are commonly seen in emergency room (ER). However, these patients are often discharged without a definite diagnosis. Conflicting data regarding the vascular event risk among the dizziness or vertigo patients have been reported. This study aims to determine the risk of developing stroke or cardiovascular events in ER patients discharged home with a diagnosis of dizziness or vertigo. METHODOLOGY: A total of 25,757 subjects with at least one ER visit in...

  4. 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.

  5. 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.

  6. 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.

  7. Quality of life questionnaire application in patients before and after vestibular rehabilitation

    Directory of Open Access Journals (Sweden)

    Nishino, Lucia Kazuko

    2008-12-01

    Full Text Available Introduction: Conventional vestibular tests are not efficient instruments to evaluate the level of commitment in the life quality of a patient with dizziness. The quality of life questionnaire specific for dizziness, the Dizziness Handicap Inventory, was translated and validated into Portuguese intending to get over this difficulty in quantifying the vertiginous patient symptoms. Objective: This study aims at comparing the Brazilian Dizziness Handicap Inventory results before and after personalized vestibular rehabilitation in patients diagnosed with chronic vertigo from benign paroxist positional vertigo and chronic vertigo from other causes. Method: Retrospective study of 30 medical records; all of which were submitted to the Brazilian Dizziness Handicap Inventory before and after the personalized vestibular rehabilitation treatment. Results: In the total scores average of vestibular pre-rehabilitation, the benign paroxist positional vertigo had a score of 47.93±24.46 and the chronic vertigo for other causes of 54.40±20.97. At discharge, the benign paroxist positional vertigo scores average was of 6.13±7.22 and in the chronic vertigo from other causes, the scores average was of 26.13±20.51. Conclusion: The commitment of the life quality of individuals with dizziness, both for chronic vertigo from other causes and benign paroxist positional vertigo, was very similar, confirming an important commitment. The vestibular rehabilitation effect for both cases was also efficient and the Dizziness Handicap Inventory was an efficient instrument to evaluate the vertiginous case evolution.

  8. 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.)

  9. 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.

  10. 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.

  11. 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.

  12. An Unusual Presentation of Vertigo: Is Head Titubation the Key to Diagnosis?

    Directory of Open Access Journals (Sweden)

    O. Judd

    2009-01-01

    Full Text Available Objective. Discuss complex interplay of pathophysiological effects of cerebellar space occupying lesions on the vestibular pathway. Discuss challenges of diagnosis and referral along with differential and final diagnosis of unusual presentation. Case Report. We describe the case of a patient with vertiginous symptoms complicated by neurological features, namely, head titubation and tremor. The patient also had signs of oscillopsia and possible impairment of the vestibulo-ocular reflex. The resulting symptom and sign complex made for a difficult diagnosis, as the interplay of the pathophysiology of these signs, were unusual. Conclusion. The discussion has revealed that the cerebellar lesions themselves may have simultaneously caused head tremor and an inability for the vestibulo-ocular reflex to compensate, resulting in vertigo. However, whether the vertigo was a result of an oscillopsia, nystagmus, or central cause, the referral route should initially be via a general physician to rule out such a life threatening cause as a tumour.

  13. Lymphoma of the Internal Auditory Canal Presenting as Facial Palsy, Vertigo, and Hearing Loss.

    Science.gov (United States)

    Ryou, Namhyung; Ko, Dong-yn; Jun, Hyung Jin; Chae, Sung Won

    2015-12-01

    The combined symptoms of vertigo, hearing loss, and facial palsy indicate the presence of lesions in the internal auditory canal (IAC). Differential diagnoses, such as inner/middle ear infections and IAC neoplasms, can make the definitive diagnosis of IAC lymphomas challenging. Lymphomas can infiltrate the central nervous system at various sites; however, IAC involvement in metastatic lymphomas is very rare. Herein we report the case of a patient with IAC lymphoma presenting with aural fullness of the left ear and intractable otalgia followed by symptoms of facial weakness, hearing loss, and vertigo within 48 h. The uncharacteristic clinical manifestations and concurrent middle ear infection meant that the conclusive diagnosis of IAC lymphoma was delayed.

  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. 眩晕虚证浅议%Brief discussion on vertigo caused by Xuzheng

    Institute of Scientific and Technical Information of China (English)

    郭甜甜; 张怀亮

    2015-01-01

    Vertigo is common in clinic. Pathogenesis is complicated, include Xu and Shi. The article introduces the syndrome differentiation and treatment of the disease from Xuzheng.%眩晕为临床常见病症,病机复杂,大体分为虚实两端,本文主要从眩晕虚证角度,针对辨证论治方面进行论述。

  16. The epidemiology of vertigo, dizziness and unsteadiness and its links to co-morbidities.

    Directory of Open Access Journals (Sweden)

    Alexandre eBisdorff

    2013-03-01

    Full Text Available Vertigo, dizziness and unsteadiness (VDU are common symptoms traditionally considered to result from different kinds of vestibular and non-vestibular dysfunctions. The epidemiology of each symptom and how they relate to each other and to migraine, agoraphobia, motion sickness susceptibility (MSS, vaso-vagal episodes (VVE and anxiety-depression (AD was the object of this population-based study in north-eastern France. A self-administered questionnaire was returned by 2987 adults (age span 18-86 years, 1471 women. The 1-year prevalence for vertigo was 48.3%, for unsteadiness 39.1% and for dizziness 35.6%. The three symptoms were correlated with each other, occurred mostly (69.4% in various combinations rather than in isolation, less than once per month, and 90% of episodes lasted ≤ 2 minutes. The three symptoms were similar in terms of female predominance, temporary profile of the episodes and their link to falls and nausea. Symptom episodes of >1 hour increase the risk of falls. VDU are much more common than the known prevalence of vestibular disorders. The number of drugs taken increase VDU even when controlling for age. Each VDU symptom was correlated with each co-morbidity in Chi2 tests. The data suggest that the three symptoms are more likely to represent a spectrum resulting from a range of similar — rather than from different, unrelated — mechanisms or disorders. Logistic regressions controlling for each vestibular symptom showed that vertigo correlated with each co-morbidity but dizziness and unsteadiness did not, suggesting that vertigo is certainly not a more specific symptom than the other two. A logistic regression using a composite score of VDU, controlling for each co-morbidity showed a correlation of VDU to migraine and VVE but not to MSS and not to agoraphobia in men, only in women.

  17. Queixa de vertigem e hipertensão arterial Vertigo complaint and blood hypertension

    Directory of Open Access Journals (Sweden)

    Luciana Lozza de Moraes Marchiori

    2007-03-01

    Full Text Available OBJETIVO: investigar a presença de queixa de vertigem em pacientes de meia idade com hipertensão arterial. MÉTODOS: estudo do tipo prospectivo, transversal. Composto por 154 indivíduos de ambos os gêneros com idade de 45 a 64 anos. A hipertensão foi verificada por meio de medição da pressão arterial e de questionário sistematizado sobre hipertensão e uso de medicamentos para pressão arterial. A queixa de vertigem foi verificada por meio de anamnese audiológica. RESULTADOS: pode-se verificar que existe associação significante entre hipertensão arterial e queixa de vertigem. CONCLUSÃO: os resultados da presente pesquisa, por meio da constatação da associação entre hipertensão arterial e queixa de vertigem, servirão de base a profissionais da área de saúde que estão envolvidos com sintomas provenientes da hipertensão arterial.PURPOSE: to investigate the presence of vertigo complaint in middle-aged hypertension patients. METHODS: a transversal study. Composed by 154 patients of both genders, aged from 45 to 64 years, included in the research after sample estimation. Hypertension was verified through blood pressure readings and by a systematized questionnaire about hypertension and the use of medication for blood pressure. Vertigo was assessed through audiological anamneses. RESULTS: there is a significant association between blood hypertension and vertigo. CONCLUSION: the results in this research, through evidence of association between blood hypertension and vertigo complaint, can be a base for health professionals concerned with alterations caused by blood hypertension.

  18. Puerarin and betahistine treatment of vertebrobasilar ischemia vertigo: A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Chen, Yan-Yan; Chen, Wen; Zhang, Qing; Li, Hui; Zhang, Ye-Wen; Kang, Qian; Lan, Y I; Wu, Qing

    2016-03-01

    The present meta-analysis aimed to evaluate the effectiveness and safety of puerarin co-treatment with betahistine in treating vertebrobasilar ischemia (VBI) vertigo. A total of 6 medical databases were searched, identifying randomized controlled trials (RCTs) of VBI vertigo performed until August 2014 that investigated a combined treatment of puerarin with betahistine or with other conventional drugs. The quality of the literature was evaluated using the Cochrane Collaboration's tool for assessing risk of bias, and Rev Man 5.0 software was used for statistical analysis and evaluation. The present study included 7 RCTs, involving a total of 664 subjects, and revealed a statistically significant increase in efficacy between the control and the experimental group (odds ratio [OR], 4.99; 95% confidence interval [CI], 3.05 to 8.15). The average blood flow velocity within the vertebrobasilar arteries increased following treatment with puerarin and betahistine compared with that of the control groups (OR, 7.59; 95% CI, 6.19 to 9.00); however, no difference was detected between these groups in the average flow velocity within the left vertebral artery (OR, 6.17; 95% CI, 5.22 to 7.13). The frequency of adverse reactions in the experimental group was lower (OR, 0.75; 95% CI, 0.32 to 1.77) compared with the control group. Combined puerarin and betahistine regimens were more effective in treating VBI vertigo compared with other, conventional drugs; effectively alleviating the associated symptoms, including dizziness and increased average blood flow velocity within the vertebrobasilar arteries, without causing an increased number of serious side effects. However, the efficacy and safety of puerarin and betahistine use in treating VBI vertigo requires additional investigation.

  19. The study of mucin histochemistry in benign and malignant lesions of prostate

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    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.

  20. 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.

  1. 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.

  2. 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.

  3. [Study on rules of acupoints selection for vertigo in ancient acupuncture].

    Science.gov (United States)

    Zhan, Qiana; Chen, Hua-De

    2014-04-01

    The characteristics of selection and matching acupoint and application rules of meridians in ancient acupuncture literature for vertigo were explored. The data were collected from literature regarding acupuncture for vertigo from the pre-Qin period to Qing dynasty and then database was established. Frequency statistics method and comparison of support degree were applied to analyze and explore application rules of acupoints and meridians, while association rules in data mining was used to extract combinations of acupoints. As a result, for treatment of vertigo, according to frequency of use and support degree, generally the most selected acupoints, in turn, were Fengchi (GB 20), Shangxing (GV 23), Yanggu (SI 5), Jiexi (ST 41), Zulinqi (GB 41) and Shenting (GV 24), etc.; the most methods for matching acupoint were combination of adjacent acupoints, combination of same-meridian acupoints, combination of the superior-inferior acupoints, combination of yang-meridian and yang-meridian acupoints and combination of child-mother meridians acupoints; the most selected meridians were bladder meridian of foot-taiyang, gallbladder meridian of foot-shaoyang and governor vessel. Compared between the ancient and modern literature, it was found out that the ancient and modern clinic has same points in selection of acupoint-meridian and matching acupoints methods. However, the use of Yanggu (SI 5), Jiexi (ST 41) and Feiyang (BL 58) as well as combination of child-mother meridians acupoints were less seen in modern clinic, which could provide new reference.

  4. Pathogenesis of Cervical Vertigo%颈性眩晕发病机制

    Institute of Scientific and Technical Information of China (English)

    李军; 叶秀兰; 唐占英; 崔学军; 王拥军

    2013-01-01

    颈性眩晕是指椎动脉的颅外段受颈部病变的影响导致血流障碍引起的眩晕综合征,又称椎动脉压迫综合征、椎动脉缺血综合征、颈后交感神经综合征等,发病机制复杂,笔者结合文献将颈性眩晕的发病机制从颈椎病变、血液与血管病变、本体感觉及前庭神经核学说等三个方面作系统阐述.%Cervical vertigo refers to vertigo syndrome,which is casued by blood disorders due to the extracranial vertebral artery neck lesions,and it is also known as the vertebral artery compression syndrome,vertebral artery occlusion syndrome,posterior cervical sympathetic syndrome.The pathogenesis is complex.Combined with the literature,the pathogenesis of cervical vertigo was expained from three apsects systematically:cervical lesions,blood vessel disease,proprioceptive and vestibular nuclear doctrine.

  5. OBSERVATION ON THE TREATMENT OF VERTEBROARTERY TYPE CERVICAL SPONDYLOPATHY INDUCED VERTIGO WITH HYDRO-ACUPUNCTURE THERAPY

    Institute of Scientific and Technical Information of China (English)

    HUANG Xueyong

    2002-01-01

    Objective: To observe the therapeutic effect of hydro-acupuncture therapy for treatment of vertigo induced by vertebroartery type cervical spondylopathy and to study its action mechanisms. Methods: A total of 54 cases of vertebroartery type cervical spondylopathy patients were observed in the present study. Fengfu (GV 16) and Jiaji (EX-B 2) near the regenerated cervical vertebral body were used for injection of Ligustrazine injectio, 1 mL every acupoint, once every other day, with 7 sessions being a therapeutic course. Before and after treatment, cerebral blood flow volume was determined using a Doppler velocimeter. Results: After 2 weeks' treatment, of the 54 cases, 28 (51.9% ) had their vertigo disappeared, 13 (24.1% ) had remarkable improvement, 10 (18.5%) had improvement and 3(5.5%) failed in the treatment, with an effective rate of 94.5%. After treatment, the peak and mean values of the blood flow velocity of the bilateral vertebral arteries and the basilar artery increased significantly in comparison with pre-treatment (P < 0.01 ). Conclusion: Hydro-acupuncture therapy has an obvious therapeutic effect for relieving vertebroartery type vertigo and ameliorating cerebral blood supply.

  6. Safety of different acupuncture manipulations for posterior circulation ischemia with vertigo

    Institute of Scientific and Technical Information of China (English)

    Yan Wen; Chao Zhang; Xiao-feng Zhao; Shi-zhe Deng; Si He; Ling-hui Huang; Guang Tian; Zhi-hong Meng

    2016-01-01

    Acupuncture at Fengchi (GB20) in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi. Laboratory tests and adverse event reports were used to evaluate the safety of different acupuncture manipulations for the treat-ment of posterior circulation ischemia with vertigo. A total of 136 patients were randomly assigned to four groups. Verum acupuncture was conducted with different needle insertion directions (contralateral paropia or prominentia laryngea) and different needle twisting frequencies (60 or 120 times/minute) at Fengchi and matching acupoints (for example, Zhongwan [CV12], Qihai [CV6], Zusanli [ST36], and Fenglong [ST40]). The patients received 14 treatments over 3–4 weeks. Routine blood analysis, hepatic and renal function tests, urine and feces tests and electrocardiography were performed before the ifrst treatment session and after the ifnal session. Adverse events were recorded after every session. Of the 136 patients, 120 completed the study. There were no signiifcant differences between pretreatment and posttreatment test results in any of the groups. Only ifve patients suffered from minor adverse events (needling pain, slight hematoma and transient chest tightness). No serious adverse events were found. Our results indicate that a 14-session course of needling at Fengchi is rela-tively safe for treating posterior circulation ischemia with vertigo.

  7. Persistence of symptoms in primary somatoform vertigo and dizziness: a disorder "lost" in health care?

    Science.gov (United States)

    Tschan, Regine; Best, Christoph; Wiltink, Jörg; Beutel, Manfred E; Dieterich, Marianne; Eckhardt-Henn, Annegret

    2013-04-01

    The aim of this study was to perform a 3-year follow-up of primary somatoform vertigo and dizziness (SVD) regarding health care use and treatment. Ninety-two patients with dizziness underwent detailed vestibular neurophysiological testing and a Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Psychometric assessments comprised the Vertigo Symptom Scale, the Vertigo Handicap Questionnaire, the SCL-90-R, and the Short-Form-36 Health Survey. At the 3-year follow-up, 65 patients with primary SVD (anxiety, n = 29; depression, n = 14; somatoform disorders, n = 22) were reassessed (70.7% response). The patients improved in symptom severity (p < 0.05), handicap (p < 0.01), and physical quality of life (QoL; p < 0.05) but showed no change in emotional distress. A total of 63.1% (of n = 65) had ongoing SVD. A total of 69.2% (of n = 65) received different forms of treatments. A total of 46.1% (of n = 65) searched redundant medical diagnostic procedures. The patients with decreased coping capacity over time obtained the best prognosis. Primary SVD is an ineffectively treated disorder. Recommendations for specific complaint-oriented psychotherapy programs were given.

  8. Safety of different acupuncture manipulations for posterior circulation ischemia with vertigo

    Science.gov (United States)

    Wen, Yan; Zhang, Chao; Zhao, Xiao-feng; Deng, Shi-zhe; He, Si; Huang, Ling-hui; Tian, Guang; Meng, Zhi-hong

    2016-01-01

    Acupuncture at Fengchi (GB20) in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi. Laboratory tests and adverse event reports were used to evaluate the safety of different acupuncture manipulations for the treatment of posterior circulation ischemia with vertigo. A total of 136 patients were randomly assigned to four groups. Verum acupuncture was conducted with different needle insertion directions (contralateral paropia or prominentia laryngea) and different needle twisting frequencies (60 or 120 times/minute) at Fengchi and matching acupoints (for example, Zhongwan [CV12], Qihai [CV6], Zusanli [ST36], and Fenglong [ST40]). The patients received 14 treatments over 3–4 weeks. Routine blood analysis, hepatic and renal function tests, urine and feces tests and electrocardiography were performed before the first treatment session and after the final session. Adverse events were recorded after every session. Of the 136 patients, 120 completed the study. There were no significant differences between pretreatment and posttreatment test results in any of the groups. Only five patients suffered from minor adverse events (needling pain, slight hematoma and transient chest tightness). No serious adverse events were found. Our results indicate that a 14-session course of needling at Fengchi is relatively safe for treating posterior circulation ischemia with vertigo. PMID:27651774

  9. Safety of different acupuncture manipulations for posterior circulation ischemia with vertigo

    Directory of Open Access Journals (Sweden)

    Yan Wen

    2016-01-01

    Full Text Available Acupuncture at Fengchi (GB20 in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi. Laboratory tests and adverse event reports were used to evaluate the safety of different acupuncture manipulations for the treatment of posterior circulation ischemia with vertigo. A total of 136 patients were randomly assigned to four groups. Verum acupuncture was conducted with different needle insertion directions (contralateral paropia or prominentia laryngea and different needle twisting frequencies (60 or 120 times/minute at Fengchi and matching acupoints (for example, Zhongwan [CV12], Qihai [CV6], Zusanli [ST36], and Fenglong [ST40]. The patients received 14 treatments over 3–4 weeks. Routine blood analysis, hepatic and renal function tests, urine and feces tests and electrocardiography were per