Residual Dizziness in Elderly Patients after Benign Paroxysmal Positional Vertigo.

INTRODUCTION: The aim of this study was to compare the effects of Brandt-Daroff (BD) exercise and shopping exercise (SE) on the resolution of residual dizziness (RD) in patients with benign paroxysmal positional vertigo (BPPV) following a successful modified Epley canalith repositioning maneuver (CRP). METHODS: This single-blind, randomized clinical trial included patients with posterior semicircular canal type of BPPV. Following the modified Epley maneuver, patients that experienced RD were randomly assigned to 3 groups: (i) BD, (ii) SE, and (iii) control groups. Primary outcomes were quantified using the Dizziness Handicap Inventory (DHI). RESULTS: Following CRP, 240 (63%) participants experienced RD. All these patients were followed up weekly for RD. After the resolution of RD, patients were followed up monthly for recurrence. Mean time to recovery was 16.4 ± 10 (range, 5-49) days in the BD group, 11.5 ± 4.6 (range, 6-32) days in the SE group, and 23.4 ± 16.8 (range, 6-89) days in the control group. The SE group recovered significantly faster than the BD and control groups (p < 0.001). Baseline emotional DHI (E-DHI) scores were significantly correlated with the duration of pre-CRP symptoms (p < 0.001). Correlation analysis indicated that patients with obesity and diabetes mellitus (DM) recovered later than patients without these comorbidities. CONCLUSION: We found that RD improved significantly in the SE group compared to the BD and control groups. Additionally, a significant relationship was established between RD and high anxiety levels and DM, and obesity had a negative impact on the resolution of RD.

Farming, well water consumption, rural living, and pesticide exposure in early life as the risk factors for Parkinson disease in Igdir province.

OBJECTIVE: To investigate potential risk factors for Parkinson`s disease (PD) in elderly individuals rural living in Turkey. METHODS: In total, 72 consecutive elderly Parkinson disease patients referred to the Neurology Clinic, Igdir State Hospital, Igdir, Turkey were included in the study. A structured questionnaire comprising questions on history of pastoral living, pit water consumption, and exposure to ionizing radiation and pesticides was administered to the patients. The patients were divided into 2 groups on the basis of water consumption: well water consumption group and city network consumption group. RESULTS: Of 72 patients with PD, 49 (68.1%) exposed to well water while 23 (31.9%) did not exposed to well water. The average duration of well water consumption was 20 (standard deviation 6) years (p less than 0.01) in group 1. Nitrate, sulfate and heavy metal levels were significantly higher in well water than in city network water (p less than 0.05). CONCLUSION: Consumption of well water containing heavy metals and nitrates in early life may contribute to the etiology of Parkinson disease in elderly individuals in Igdir province of Turkey.

Effects of omalizumab therapy on peripheral nerve functions: short observational study.

INTRODUCTION: Peripheral neuropathy (PN) is a common neurological condition causing symmetrical and diffuse damage in nerves. The etiology of PN includes systemic diseases, toxic exposure, medications, infections, and hereditary diseases. Omalizumab is a humanized monoclonal anti-IgE antibody that exerts its activity by binding to free IgE in circulation. AIM: To investigate the relationship between omalizumab and peripheral neuropathy. MATERIAL AND METHODS: The study included 30 patients who underwent omalizumab therapy (Xolair) due to the diagnosis of chronic urticaria. A detailed neurological and physical examination was performed in each patient both before and 3 months after the therapy. Electrophysiological examination was also performed using a Medelec Synergy instrument. RESULTS: The 30 patients included 8 (26.7%) men and 22 (73.3%) women with a mean age of 37.5 ±14.14 years. No serious side effect of the medication was detected in any patient although local wound irritation occurred in 3 (10%) patients. Moreover, no change occurred in the pre-treatment Neuropathy Symptom Score (NSS) or Neurological Disability Score (NDS) of the patients and no pathological values that could result in neuropathy were observed during motor/sensory nerve conduction. However, significant changes were detected in the sensory and motor components of the nerves with regards to pre- and post-treatment values. CONCLUSIONS: Omalizumab therapy caused no peripheral neuropathy in any of our patients but altered the latency, amplitude, and velocity values of the peripheral nerves.