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Zhurnal Nevrologii I Psikhiatrii Imeni... 2019The review of domestic and foreign literature was conducted to identify the current terminology, diagnostic criteria, mechanisms of ethiopathogenesis, and the methods of...
The review of domestic and foreign literature was conducted to identify the current terminology, diagnostic criteria, mechanisms of ethiopathogenesis, and the methods of treatment of psychogenic vertigo. The article covers the questions of combined approach to treatment, including vestibular rehabilitation combined with cognitive behavioral therapy.
Topics: Cognitive Behavioral Therapy; Dizziness; Humans; Psychophysiologic Disorders; Vertigo
PubMed: 31793549
DOI: 10.17116/jnevro201911910189 -
Journal of Neurology Mar 2021Early identification of cardiogenic vertigo (CV) is necessary to prevent serious complications of cardiovascular diseases. However, the literature is limited to case...
Early identification of cardiogenic vertigo (CV) is necessary to prevent serious complications of cardiovascular diseases. However, the literature is limited to case reports without detailed clinical features or diagnostic criteria. The aim of this study was to define characteristics of CV and propose diagnostic criteria. This study included patients with CV diagnosed at Pusan National University and Keimyung University Hospitals. Demographic, clinical, laboratory, and treatment data were analyzed. Of 72 patients with clinically suspicious CV, 27 were finally included. The age ranged from 63 to 88 years (75.1 ± 7.2 years). Recurrent vertigo occurred without syncopal attacks in 52% [95% CI, 32-71], while it preceded (37% [19-58]) or followed (11% [2-29]) syncope. The patients with recurrent isolated vertigo had suffered from symptoms from 15 days to 5 years until final diagnosis (median 122 days). The vertigo lasted only for a few seconds (93% [76-99]) or a few minutes (7% [1-24]). Fourteen patients presented with spinning vertigo, and one of them showed spontaneous downbeat nystagmus during the attack. Accompanying symptoms including chest discomfort, palpitation, headache, arm twitching, and lightheadedness were found in 70% [50-86]. Between patients with and without syncope, there was no difference in clinical parameters and results of cardiac function tests. The most common cardiac abnormality during the attacks of vertigo was bradyarrhythmia (89% [71-98]). Cardiovascular diseases can develop recurrent isolated vertigo without or preceding syncope. Onset age, duration of vertigo, accompanying symptoms, and underlying cardiac diseases can aid in differentiation from other vestibular disorders. Early identification of CV would reduce morbidity and mortality associated with cardiac syncope.
Topics: Aged; Aged, 80 and over; Dizziness; Headache; Humans; Middle Aged; Nystagmus, Pathologic; Vertigo; Vestibular Diseases
PubMed: 33025120
DOI: 10.1007/s00415-020-10252-4 -
Current Opinion in Neurology Feb 2015Herein we discuss the recent literature concerning cervicogenic vertigo including vertigo associated with rotational vertebral artery syndrome, as well as whiplash and... (Review)
Review
PURPOSE OF REVIEW
Herein we discuss the recent literature concerning cervicogenic vertigo including vertigo associated with rotational vertebral artery syndrome, as well as whiplash and degenerative disturbances of the cervical spine. We conclude with a summary of progress regarding diagnostic methods for cervicogenic vertigo.
RECENT FINDINGS
Several additional single case studies of the exceedingly rare rotational vertebral artery syndrome have been added to the literature over the last year. Concerning whiplash and degenerative disturbances of the cervical spine, four reviews were published concerning using physical therapy as treatment, and two reviews reported successful surgical management. Publications regarding diagnostic methodology remain few and unconvincing, but the cervical torsion test appears the most promising.
SUMMARY
Little progress has been made over the last year concerning cervicogenic vertigo. As neck disturbances combined with dizziness are commonly encountered in the clinic, the lack of a diagnostic test that establishes that a neck disturbance causes vertigo remains the critical problem that must be solved.
Topics: Dizziness; Humans; Neck; Postural Balance; Vertigo
PubMed: 25502050
DOI: 10.1097/WCO.0000000000000161 -
FP Essentials Feb 2019Dizziness is seen frequently in patients in the family medicine and emergency department settings. The differential diagnosis of dizziness can be expansive but with a...
Dizziness is seen frequently in patients in the family medicine and emergency department settings. The differential diagnosis of dizziness can be expansive but with a targeted history and physical examination, a correct diagnosis often can be established and appropriate treatment offered. Common etiologies of dizziness include hypotension, benign paroxysmal positional vertigo (BPPV), and Meniere disease. Strokes and malignancies also can cause this symptom. Imaging is indicated if intracranial pathology is suspected. BPPV typically is self-limited but maneuvers such as the Epley maneuver can be used for more rapid resolution. Meniere disease can be difficult to manage. First-line treatments are lifestyle and diet modification. Avoidance of triggers is important for patients with vestibular migraine. Some vestibular-suppressive drugs and anticonvulsants may be useful in the prevention and management of vestibular migraine. (This is an off-label use of some anticonvulsants.).
Topics: Benign Paroxysmal Positional Vertigo; Diagnosis, Differential; Dizziness; Humans; Migraine Disorders; Physical Examination; Vertigo
PubMed: 30747510
DOI: No ID Found -
Internal Medicine Journal Mar 2022Vestibular presentations are common in both the acute and recurrent setting, burdening emergency departments and community clinics alike. Commonly, an unease among the... (Review)
Review
Vestibular presentations are common in both the acute and recurrent setting, burdening emergency departments and community clinics alike. Commonly, an unease among the emergency or general physician is felt, and historically focus has been on gaining knowledge of each potential disease rather than honing the diagnostic process. Consequently, this paper focuses on the approach itself, helping to categorise this common complaint into one of four main syndromes: the Acute Vestibular Syndrome, Recurrent Positional Vertigo, Recurrent Spontaneous Vertigo, and Imbalance. Its simplicity is aimed to minimise uncertainty and highlight clear scenarios when to refer. Together with descriptions of the clinically relevant pathophysiology, the reader should approach the vertiginous patient with a new clarity.
Topics: Acute Disease; Dizziness; Humans; Nausea; Syndrome; Vertigo
PubMed: 32786023
DOI: 10.1111/imj.15013 -
Ugeskrift For Laeger Dec 2015Dizziness caused by migraine, vestibular migraine (VM), has been highly debated over the last three decades. The co-morbidity of migraine and dizziness is higher than a... (Review)
Review
Dizziness caused by migraine, vestibular migraine (VM), has been highly debated over the last three decades. The co-morbidity of migraine and dizziness is higher than a random concurrence. One third of the patients with migraine and dizziness have VM. Recently, The International Headache Society approved VM as a diagnostic entity and the diagnostic criteria for VM appear in the appendix for The International Classification of Headache Disorders. VM is common but often underdiagnosed. Treatment follows migraine management guidelines although evidence is sparse.
Topics: Diagnosis, Differential; Humans; Migraine Disorders; Vertigo
PubMed: 26692036
DOI: No ID Found -
Handbook of Clinical Neurology 2016Vertigo and dizziness of at least moderate severity occur in >5% of school-aged children and cause considerable restrictions in participation in school and leisure...
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.
Topics: Adolescent; Child; Dizziness; Humans; Pediatrics; Vertigo
PubMed: 27638083
DOI: 10.1016/B978-0-444-63437-5.00025-X -
Vestnik Otorinolaringologii 2017At present, the skeptical attitude toward the term 'cervical vertigo' (CV) predominates in the ENT-community. Such point of view is attributable to the absence of... (Review)
Review
At present, the skeptical attitude toward the term 'cervical vertigo' (CV) predominates in the ENT-community. Such point of view is attributable to the absence of specific CV symptoms and well-defined diagnostic criteria. The present literature review was designed to consider the results of the clinical observations and experimental investigations obtained during the past 150 years that give evidence of the possibility to regard cervical vertigo as a separate nosological entity. The characteristic signs of this condition are analyzed and systematized. Four CV variants are currently distinguished. The principles of diagnostics and treatment of cervical vertigo are discussed and general concept of CV is formulated.
Topics: Diagnosis, Differential; Humans; Migraine Disorders; Postural Balance; Sensation Disorders; Vertigo; Vestibular Diseases
PubMed: 28980603
DOI: 10.17116/otorino201782472-76 -
Journal of Immunology Research 2018The prevalence of autoimmune diseases has been increasing over the last 20 years. The clinical presentation of this large and heterogeneous group of disorders depends on... (Review)
Review
The prevalence of autoimmune diseases has been increasing over the last 20 years. The clinical presentation of this large and heterogeneous group of disorders depends on whether the involvement is organ-specific or non-organ-specific. Dizziness, vertigo, and disequilibrium are common symptoms reported by patients with vestibulocochlear involvement. The association of vertigo and autoimmune diseases has been largely documented, suggesting that autoimmune disorders could be overrepresented in patients with vertigo in comparison to the general population. The aim of this review is to present the recent literature findings in the field of autoimmune-mediated diseases with cochleovestibular involvement, focusing on the clinical presentation, diagnosis, and treatment of immune-mediated inner ear diseases including autoimmune inner ear disease (AIED), Meniere's disease, and bilateral vestibulopathy, as well as of systemic autoimmune diseases with audiovestibular disorders, namely, Behçet's disease, Cogan's syndrome, sarcoidosis, autoimmune thyroid disease, Vogt-Koyanagi-Harada syndrome, relapsing polychondritis, systemic lupus erythematosus, antiphospholipid syndrome, IgG4-related disease, and ANCA-associated vasculitides.
Topics: Autoimmune Diseases; Diagnosis, Differential; Ear; Humans; Labyrinth Diseases; Organ Specificity; Vertigo
PubMed: 30356417
DOI: 10.1155/2018/5072582 -
Musculoskeletal Science & Practice Aug 2023Migraine is associated with motion sensitivity symptoms such as kinetosis, vestibular symptoms and balance alterations. While focus is given to headache management,...
BACKGROUND
Migraine is associated with motion sensitivity symptoms such as kinetosis, vestibular symptoms and balance alterations. While focus is given to headache management, addressing these symptoms is often neglected, although they are related to additional migraine burden and increased disability.
PURPOSE
Our aim is to disseminate the current understanding of the motion sensitivity symptoms among patients with migraine, with focus on balance impairments. We discuss the susceptibility of migraine to motion sensitivity, its suggested mechanisms, the balance alterations during quiet standing, mobility tasks and reactions to external perturbations. The role of migraine subdiagnosis, implications for clinical practice and future perspectives are also acknowledged.
IMPLICATIONS
Balance disorders are one of the signs reflecting a broader and complex spectrum of motion sensitivity, which are present even between attacks. Migraineurs are especially inherent to these symptoms probably due to brain hyperexcitability and to shared pathophysiological mechanisms. Patients, especially with aura and chronic migraine, exhibit balance instability during quiet standing under different surface and visual input conditions. Migraineurs demonstrated reduced limits of stability and lower performance on walk, transposing obstacles and sit to stand tasks. Only patients with aura present impairment of motor control reactions following external perturbations. Balance alterations are associated with falls and are influenced by aura, migraine frequency and psychosocial aspects, but not by vestibular symptoms or vestibular migraine diagnosis. There is a high demand for high quality of evidence regarding the assessment and care of motion sensitivity symptoms in migraineurs, considering approaches to manage not just the pain, but its associated symptoms.
Topics: Humans; Migraine Disorders; Vertigo; Postural Balance; Headache; Epilepsy
PubMed: 37263900
DOI: 10.1016/j.msksp.2023.102783