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Acta Otorhinolaryngologica Italica :... Jun 2015The aim of this paper is to analyse, after clinical experience with a series of patients with established diagnoses and review of the literature, all relevant anamnestic... (Review)
Review
The aim of this paper is to analyse, after clinical experience with a series of patients with established diagnoses and review of the literature, all relevant anamnestic features in order to build a simple diagnostic algorithm for vertigo in childhood. This study is a retrospective chart review. A series of 37 children underwent complete clinical and instrumental vestibular examination. Only neurological disorders or genetic diseases represented exclusion criteria. All diagnoses were reviewed after applying the most recent diagnostic guidelines. In our experience, the most common aetiology for dizziness is vestibular migraine (38%), followed by acute labyrinthitis/neuritis (16%) and somatoform vertigo (16%). Benign paroxysmal vertigo was diagnosed in 4 patients (11%) and paroxysmal torticollis was diagnosed in a 1-year-old child. In 8% (3 patients) of cases, the dizziness had a post-traumatic origin: 1 canalolithiasis of the posterior semicircular canal and 2 labyrinthine concussions, respectively. Menière's disease was diagnosed in 2 cases. A bilateral vestibular failure of unknown origin caused chronic dizziness in 1 patient. In conclusion, this algorithm could represent a good tool for guiding clinical suspicion to correct diagnostic assessment in dizzy children where no neurological findings are detectable. The algorithm has just a few simple steps, based mainly on two aspects to be investigated early: temporal features of vertigo and presence of hearing impairment. A different algorithm has been proposed for cases in which a traumatic origin is suspected.
Topics: Adolescent; Algorithms; Child; Child, Preschool; Female; Humans; Infant; Male; Retrospective Studies; Vertigo
PubMed: 26246662
DOI: No ID Found -
PloS One 2021In recent population-based case-control studies, sleep apnea was significantly associated with a higher incidence (hazard ratio, 1.71) of vertigo and the risk of...
BACKGROUND
In recent population-based case-control studies, sleep apnea was significantly associated with a higher incidence (hazard ratio, 1.71) of vertigo and the risk of tinnitus was found to increase 1.36 times in patients with sleep apnea. The possibility that obstructive sleep apnea (OSA) might affect neurotological consequences was not noticed, until studies using polysomnography (PSG) for these patients.
OBJECTIVES
The purpose of this study was to investigate the relationship between vertigo and OSA.
METHODS
The collected data among patients from May 1st, 2018 to October 31th, 2018 at Shuang Ho Hospital. Eligibility criteria included an age older than 20 years, a diagnosis of obstructive sleep apnea. The diagnosis of OSA was defined as an oxygen desaturation index of at least 5, was established with the use of polysomnographic examination at hospital. Patients were excluded from the study if they had head injury, brain tumour, headache history and hearing loss. Patients who had vertigo were labeled as Vertigo group. In the other hand, patients who had no dizziness were labeled as control group. 58 patients were in the Vertigo group, and 113 were in the control group.
RESULTS
After PSG examination, 58 patients who had vertigo, were diagnosed OSA (29 males, average age = 57.07 years old, BMI = 26.64, RDI = 24.69, ESS = 8.65), and 24 patients of them (41.3%) were REM-related OSA. Meanwhile, in the control group, 113 patients had OSA (92male, average age = 49.66 years old, BMI = 26.06, RDI = 35.19, ESS = 11.43), and 18 patients of them (15.9%) were REM-related OSA (Table 1). Therefore, patient who had vertigo, would have higher proportion of REM OSA (P<0.001).
CONCLUSIONS
The vertigo patients have a higher rate of REM-related OSA, and the acceptance rate to CPAP use is low. Further research is needed to explore novel therapeutic approaches, or combination of currently available non-CPAP therapies, in patients with REM OSA.
Topics: Adult; Case-Control Studies; Female; Humans; Male; Middle Aged; Retrospective Studies; Sleep Apnea, Obstructive; Sleep, REM; Vertigo
PubMed: 34115792
DOI: 10.1371/journal.pone.0252844 -
The Journal of International Advanced... Nov 2023Labyrinthitis is an inner ear disorder of unknown incidence, characterized by sudden hearing loss and concurrent vertigo. Cohort studies of patients diagnosed with...
BACKGROUND
Labyrinthitis is an inner ear disorder of unknown incidence, characterized by sudden hearing loss and concurrent vertigo. Cohort studies of patients diagnosed with labyrinthitis are nonexistent. This study aims to describe the clinical characteristics and prognosis of patients diagnosed with idiopathic labyrinthitis.
METHODS
Patients with labyrinthitis in the absence of a clear viral, bacterial, or autoimmune pathogenesis were retrospectively identified from electronic patient files. Symptoms at presentation and results from vestibular testing were retrieved. The 9-item Vestibular Activity Avoidance Instrument, administered during follow-up interviews by telephone, was used to assess the presence of persistent balance problems and activity avoidance behavior.
RESULTS
Sixty-one patients with idiopathic labyrinthitis were included. All patients had vestibular weakness at presentation. After a median of 61 months of follow-up (interquartile range 81), 72.5% of patients still experienced balance problems. Subjective hearing recovery only occurred in 20% of cases.
CONCLUSION
Patients presenting in a tertiary dizziness clinic with idiopathic labyrinthitis have a poor prognosis for both hearing and balance function impairment. Prospective observational cohorts are required to establish objectifiable vestibular and audiological follow-up data.
Topics: Humans; Hearing Loss, Sudden; Labyrinthitis; Prognosis; Retrospective Studies; Vertigo; Vestibule, Labyrinth
PubMed: 38088320
DOI: 10.5152/iao.2023.231096 -
JMIR MHealth and UHealth Sep 2023Dizziness and vertigo can be caused by various factors, such as peripheral vestibular and central disorders. Although consultations with specialists are advisable when... (Review)
Review
BACKGROUND
Dizziness and vertigo can be caused by various factors, such as peripheral vestibular and central disorders. Although consultations with specialists are advisable when necessary, patients with severe vertigo symptoms may have limited mobility, which may interfere with hospital visits. The spread of COVID-19 has further limited the number of hospital visits for patients with dizziness; therefore, a method of medical care that enables more accurate treatment under time and geographical constraints is needed. Telemedicine has become widespread, owing to the popularity of smartphone and tablet devices in recent years, and the use of devices and systems has made it possible to provide efficient medical care. However, no previous scoping review has mapped existing studies on telemedicine for vertigo and dizziness, and no recommendations have been made regarding which devices and systems should be used for specific diseases.
OBJECTIVE
The aim of this review was to map and assess previous studies on the use of information communications technology, smartphones, and apps for treating patients with vertigo and discuss the added value of introducing telemedicine to improve the quality of medical care and create an environment that builds security and trust among patients.
METHODS
A scoping review was conducted with the methodological framework of Arksey and O'Malley and in accordance with the of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews) guidelines. The PubMed, MEDLINE, and Cochrane Library databases were searched to retrieve previous reports on smartphone-assisted telemedicine treatment for vertigo published between January 2000 and May 2023. Two authors independently assessed eligibility and extracted data.
RESULTS
This review included 20 papers that reported devices or systems for telemedicine for vestibular dysfunction. Among studies that reported the use of a device or app, 2 were related to anamnesis and subjective symptoms, 12 were related to objective examination, 7 were related to remote diagnosis, and 7 were related to treatment and rehabilitation.
CONCLUSIONS
With the advancement of technology, the use of telemedicine in patients with dizziness may be feasible. In the future, it will be necessary to consider how telemedicine can be used in dizziness treatment and develop an effective treatment system combining in-person medical care and the effective use of devices for the management of severe vertigo and related diseases. The smooth introduction of telemedicine in vertigo treatment is expected to improve the quality of treatment, increase opportunities for patients to receive medical care, and reduce time and travel costs, leading to a sense of security and trust among patients.
Topics: Humans; Smartphone; Dizziness; COVID-19; Vertigo; Telemedicine
PubMed: 37695671
DOI: 10.2196/48638 -
Maturitas Feb 2024We used a cohort of community-dwelling adults to establish the 10-year incidence and predictors of dizziness/vertigo, and its impacts on health-related quality of life.
OBJECTIVES
We used a cohort of community-dwelling adults to establish the 10-year incidence and predictors of dizziness/vertigo, and its impacts on health-related quality of life.
STUDY DESIGN
Of the 1152 participants aged 55 + years who did not have dizziness/vertigo at baseline, 799 and 377 participants were followed up after 5 and 10 years, respectively, and had complete data and so were included in the incidence analysis. Hearing loss was determined as the pure-tone average of audiometric hearing thresholds at 500, 1000, 2000 and 4000 Hz, and any hearing loss was defined as >25 dB hearing level. Tinnitus and migraine were assessed by a positive response to a single question.
MAIN OUTCOME MEASURES
Audiologists screened participants for reported dizziness using a single question. Quality of life was measured using the Short Form 36-item Health Survey (SF-36).
RESULTS
The cumulative 10-year incidence of dizziness/vertigo, vestibular vertigo and non-vestibular vertigo were 39.8 %, 27.1 %, and 11.9 %, respectively. Age and presence of migraine were significant predictors of incident dizziness/vertigo: multivariable-adjusted hazard ratio (HR) 1.03 (95 % confidence interval, CI, 1.01-1.06) and HR 1.63 (95 % CI 1.13-2.35), respectively. A significant decrease in scores for the following SF-36 domains was observed over the 10 years among participants reporting baseline dizziness/vertigo: physical functioning (P-trend ≤ 0.0001), role limitation due to physical problems (P-trend ≤ 0.0001), general health (P-trend = 0.01), and vitality (P-trend = 0.01).
CONCLUSIONS
Dizziness/vertigo was a frequent and detrimental symptom in this population of community-dwelling adults. Our study highlights the burden imposed by dizziness, as evidenced by a significant prospective association with poorer quality of life.
Topics: Humans; Dizziness; Quality of Life; Incidence; Independent Living; Vertigo; Hearing Loss; Migraine Disorders
PubMed: 38006814
DOI: 10.1016/j.maturitas.2023.107890 -
Turkish Journal of Medical Sciences Dec 2020Vertigo is one of the rarely diagnosed disorders during childhood due to insufficient description of the children regarding their experiences to the physicians. The...
BACKGROUND/AIM
Vertigo is one of the rarely diagnosed disorders during childhood due to insufficient description of the children regarding their experiences to the physicians. The clinical features of children and adolescents admitted by acute vertigo symptoms were investigated to elaborate the subject retrospectively.
MATERIALS AND METHODS
BetweenJanuary 2017–July 2019, records of cases admitted with acute vertigo complaints to pediatric neurology were retrospectively examined.
RESULTS
Of 761 patients, mean age was 13.8 years, 64% (n = 487) were women, 22.6% (n = 172) of which were children (1–11 years). A total of 37.3% of the cases (n = 284) had unknown etiology of acute vertigo symptoms, 39.6% (n = 301) had acute vertigo, and 23.1% (n = 176) were considered with no organicity problems but a group of the families stopped cooperating to the full extent in the study. Among all the patients, 25.6% (195/761) had paroxymal vertigo, 6.8% (52/761) had migraine-associated vertigo, 4.5% (34/761) had psychogenic vertigo, and 2.6% (20/761) had epileptic vertigo. Epileptic vertigo was significantly higher in younger children (mean age = 10.6, F(3) = 8874, P < .001), and the ratio of its occurence was also higher among children (60%, χ2 (3) = 20.347, P < .001).
CONCLUSION
Vertigo complaints are 1.7 times more common among the girls. Epileptic vertigo is significantly higher among the children. Among younger children, it seems important to consider epilepsy when vertigo emerged.
Topics: Acute Disease; Adolescent; Adult; Age Factors; Child; Child, Preschool; Cross-Sectional Studies; Electroencephalography; Epilepsy; Female; Humans; Infant; Male; Retrospective Studies; Sex Factors; Vertigo; Young Adult
PubMed: 33306337
DOI: 10.3906/sag-2010-228 -
South African Family Practice :... Apr 2023Dizziness is an extremely common, yet complex neurological symptom that reflects a disturbance of normal balance perception and spatial orientation. Dizziness is a...
Dizziness is an extremely common, yet complex neurological symptom that reflects a disturbance of normal balance perception and spatial orientation. Dizziness is a non-specific, catch-all term commonly used by patients to describe a wide array of symptoms, including a sensation of motion, weakness, light-headedness, unsteadiness, emotional upset and depression. The national 1-year prevalence of dizziness is around 50%, accounting for 4% of emergency department presentations and 1% of primary care consultations in South Africa. This article will focus on a diagnostic approach to the most common cause of dizziness (vertigo).
Topics: Humans; Dizziness; Vertigo; Space Perception; Orientation, Spatial; Primary Health Care
PubMed: 37132567
DOI: 10.4102/safp.v65i1.5712 -
Acta Otorhinolaryngologica Italica :... Apr 2023
Topics: Humans; Benign Paroxysmal Positional Vertigo
PubMed: 37698102
DOI: 10.14639/0392-100X-suppl.1-43-2023-08 -
Ugeskrift For Laeger Jun 2017Benign paroxysmal positional vertigo (BPPV) remains the most frequent cause of vertigo. The TRV chair is a mechanical device suited for optimization of managing complex... (Review)
Review
Benign paroxysmal positional vertigo (BPPV) remains the most frequent cause of vertigo. The TRV chair is a mechanical device suited for optimization of managing complex cases of BPPV. Although the use of repositioning devices in the management of BPPV is increasing, no applicable guide for the TRV management of the different BPPV subtypes exists. This article presents the techniques for addressing canalolithiasis and cupulolithiasis in the TRV chair for each affected semicircular canal. In a tertiary referral centre like our unit the TRV chair is an asset in the management of BPPV.
Topics: Benign Paroxysmal Positional Vertigo; Humans; Patient Positioning; Physical Therapy Modalities
PubMed: 28606300
DOI: No ID Found -
European Archives of... Aug 2022Intratympanic (IT) drug delivery receives attention due to its effectivity in treatment for Menière's disease (MD). Due to the release of the consensuses and new... (Review)
Review
PURPOSE
Intratympanic (IT) drug delivery receives attention due to its effectivity in treatment for Menière's disease (MD). Due to the release of the consensuses and new evidence on IT drug delivery for MD have been published, the review with a view to supplementing the details of IT treatment of MD is indispensable.
METHODS
The literatures on IT injection for MD treatment over the last two decades are retrieved, International consensus (ICON) on treatment of Menière's disease (2018), Clinical Practice Guideline (2020) and European Position statement on Diagnosis and Treatment of Meniere's Disease (2018) are taken into account for reference, and follow advice from experts from Europe, USA and China.
RESULTS
Experts agree on the following: (1) The effectiveness of IT methylprednisolone (ITM) on vertigo control seems to be somewhat better than that of IT dexamethasone (ITD), and ITM can restore hearing in some cases. (2) Due to the ototoxicity of aminoglycosides, the application of intratympanic gentamicin (ITG) in MD patients with good hearing is conservative. However, some studies suggest that ITG with low doses has no significant effect on hearing, which needs to be further proved by clinical studies with high levels of evidence. (3) Currently, generally accepted treatment endpoint of ITG is no vertigo attack in a 12-month period or a vestibular loss in objective tests in the affected ear.
CONCLUSION
More studies with high level of evidence are needed to evaluate the drug type, efficacy, and therapeutic endpoint of IT therapy for MD.
Topics: Anti-Bacterial Agents; Consensus; Gentamicins; Humans; Injection, Intratympanic; Meniere Disease; Treatment Outcome; Vertigo
PubMed: 35469039
DOI: 10.1007/s00405-022-07374-y