RESUMO
Balance disorders and recurring falls are the most frequent causes of medical treatment in old age. Chronic cerebral vascular insufficiency is considered to be the cause of instability in most of these cases, and its role in the development of postural instability in old age is likely to be greatly overrated. At the same time, the role of chronic peripheral vestibular disorders, by contrast, is underestimated. The emergence in recent years of sensitive, specific and, at the same time, relatively accessible methods of diagnosing peripheral vestibulopathies has led to a much more frequent diagnosis of peripheral vestibulopathies, and their role in the development of postural instability in elderly patients is being revisited. This review considers current approaches to the diagnosis and treatment of bilateral vestibulopathy.
Assuntos
Vestibulopatia Bilateral , Doenças Vestibulares , Acidentes por Quedas , Idoso , Tontura , Humanos , Pacientes , Equilíbrio Postural , Doenças Vestibulares/diagnósticoRESUMO
Persistent postural perceptual dizziness (PPPD) is a common cause of complaints to dizziness and unitability among patients of all-ages. The disease is characterized by a permanent feeling of non-rotatory dizziness or unsteadiness that at first can be caused by an acute vestibular dizziness, somatic disturbance that causes sudden unsteadiness and loss of balance or, for example, by a panic attack. Despite the permanent feeling of unsteadiness and dizziness, a regular instrumental examination cannot reveal important changes that can explain personal feeling. The diagnosis can be made according to the diagnostic criteria developed by the International Barani Society. Treatment consists of psychotherapy, drug therapy and vestibular rehabilitation.
Assuntos
Tontura , Equilíbrio Postural , Doenças Vestibulares , Idoso , Humanos , VertigemRESUMO
A rare syndrome is described. Combined investigation, including CT, yielded in a patient a typical clinical picture of nonatherosclerotic brain vessel calcification, especially within basal ganglia, parkinsonism, psychoemotional disorders, motor paroxysms. The syndrome etiology is discussed. Hypoparathyroidism with blood Ca metabolism and hereditary causes seem plausible. Differential diagnosis and treatment are described.