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1.
Acta Otorhinolaryngol Ital ; 41(5): 461-466, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34734582

RESUMO

Objectives: Benign paroxysmal positional vertigo (BPPV) is a disorder of the inner ear with a high rate of recurrence. Vascular disorders, migraine and autoimmune disorders have been considered facilitating factors for relapsing episodes. Our aim was to assess the role of vascular disorders, migraine and anti-thyroid antibodies in patients with recurrences. Methods: We retrospectively analysed records of 3042 patients treated for BPPV without other lifetime vertigo. Clinical data included previous vascular disorders of the central nervous system, heart disorders, migraine and recent head trauma. The presence of anti-thyroid autoantibodies was assessed in all patients. Results: Mean age of the first BPPV was 52.8 ± 14.5 years; there were 2339 females (76.9%), while 2048 (67.3%) of patients presented recurrences within two years of follow-up. Previous disorders of the central nervous system, presence of anti-thyroid antibodies, head trauma and migraine showed an association with recurrences. Above all, in subjects having the first BPPV while aged between 40 and 60 years, anti-thyroid antibodies were predictive for recurrences. Conclusions: Our data are consistent with the hypothesis that anti-thyroid autoantibodies may play a role in recurrences in subjects with initial manifestations between 40 and 60 years.


Assuntos
Transtornos de Enxaqueca , Neoplasias , Adulto , Vertigem Posicional Paroxística Benigna/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos
2.
Vestn Otorinolaringol ; 86(5): 4-11, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34783466

RESUMO

The results of a comprehensive examination of 82 patients with clinical signs of definite Ménière's disease, unilateral lesion and confirmed by extratympanic electrocochleography endolymphatic hydrops are presented. The results of the study showed that only 38% of patients had cochleovestibular syndrome due to Ménière's disease. In 45% of patients, Ménière's disease was combined with other diseases: benign paroxysmal positional vertigo, vestibular migraine, persistent postural-perceptual dizziness, superior semicircular canal dehiscence. In 17% of patients cochleovestibular syndrome was due to other reasons: vestibular migraine, tumor of the posterior cranial fossa, superior canal dehiscence syndrome, Cogan's syndrome, enlarged vestibular aqueduct, otosclerosis. Complaints, medical history of the disease and life, brain MRI, temporal bone CT and pure tone audiometry in dynamics are important in suspected Ménière's disease. For 1 and 2 Ménière's disease stages the most important characteristic are: progressive unilateral sensorineural hearing loss and reduced slow faze velocity values of caloric nystagmus in dynamics, mainly in warm response if attacks of vertigo is maintain; normal head impulse test between vertigo attacks and pathological result of this test in attack of vertigo with the normalization of gain during the first day.


Assuntos
Hidropisia Endolinfática , Doença de Meniere , Audiometria de Resposta Evocada , Vertigem Posicional Paroxística Benigna , Diagnóstico Diferencial , Humanos , Doença de Meniere/diagnóstico
3.
Vestn Otorinolaringol ; 86(5): 22-27, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34783469

RESUMO

Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibulopathy. Ppatients with BPPV contact with otorhinolaryngologists in 25% of cases. Due to the polymorphism of this pathology, an urgent task is to asess differential diagnosis of BPPV with various variants of the central positional syndrome: vestibular migraine, myofascial cervical syndrome, organic changes in the structures of the cerebellum. OBJECTIVE: To distinguish atypical forms of BPPV with downbeating vertical nystagmus and the central positional syndrome.


Assuntos
Transtornos de Enxaqueca , Nistagmo Patológico , Vertigem Posicional Paroxística Benigna/diagnóstico , Diagnóstico Diferencial , Humanos , Transtornos de Enxaqueca/diagnóstico , Nistagmo Patológico/diagnóstico , Nistagmo Patológico/etiologia , Canais Semicirculares
4.
Artigo em Chinês | MEDLINE | ID: mdl-34628813

RESUMO

〓 Objective: To analyze the clinical characteristics of patients with benign paroxysmal positional vertigo, summarize experience for diagnosis and treatment activities and to explore the risk factors related to the onset of BPPV and provide reference for early intervention to reduce the risk factor exposure of BPPV. Methods:One hundred and twelve patients with BPPV were included in the study, and clinical data including age, gender, onset symptoms and duration, past medical history and family history were analyzed. A One-way ANOVA was performed on 16 variables using age, gender, diabetes, hyperuric acid, hyperlipidemia, osteoporosis, hypertension, coronary heart disease, stroke, Meniere's disease, suppurative otitis media, vestibular neuronitis, sudden deafness, head injury, ear nose/maxillofacial surgery and autoimmune thyroiditis. The statistically significant parameters of the one-way ANOVA were included in the multivariate regression analysis to explore the independent risk factors for BPPV. Results:Seventy-six cases(67.86%) of BPPV patients were primary BPPV, 36 cases(32.14%) were secondary BPPV(P<0.01). The gender composition(male, female), ears involvement(unilateral, bilateral) and semicircular canal involvement(posterior semicircular canal, horizontal semicircular canal, anterior semicircular canal, mixed type) were different between the two groups(P<0.05). During the follow-up period, 34(30.36%) patients relapsed, of which 19(25.00%) were the primary patients and 15(41.67%) were the secondary patients(P<0.01). Diabetes(P=0.004), osteoporosis(P=0.017), hypertension(P=0.013), stroke(P=0.005) and suppurative otitis media(P=0.031) were related to the onset of BPPV. Conclusion:BPPV patients are mainly primary, while the secondary patients are more likely to relapse after being cured. Diabetes, osteoporosis, hypertension, stroke and suppurative otitis media are independent risk factors for the onset of BPPV.


Assuntos
Vertigem Posicional Paroxística Benigna , Doença de Meniere , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia , Fatores de Risco , Canais Semicirculares
5.
Artigo em Chinês | MEDLINE | ID: mdl-34628836

RESUMO

Objective:By observing the nystagmus forms at different positions during Epley reduction in patients with posterior semicircular canal benign parochial positional vertigo(PC-BPPV), to compare the effects of the first reduction, and to further summarize the possible causes of reduction failure and the prognosis of patients with different nystagmus forms. Methods:A retrospective analysis of 191 PC-BPPV patients diagnosed with PC-BPPV showed that 95 cases had positive nystagmus during the reduction process(group A), 69 cases had no nystagmus (group B), and 27 cases had reverse nystagmus (group C). All the patients were diagnosed by G-Force BPPV and were treated through simulative Epley CRP. The form of nystagmus and the effect of the first reduction were compared. Results:The first reduction effect of group A was better than that of group C(P<0.05). The reduction effect of group B was better than that of group C(P<0.05). There was no significant difference in the reduction effect between group A and group B(P>0.05). Conclusion:The form of nystagmus in the reduction process of PC-BPPV has a certain guiding significance for the evaluation of the first reduction effect and the successful reduction. The reverse nystagmus during the reduction process indicates a poor reduction effect.


Assuntos
Nistagmo Patológico , Procedimentos Cirúrgicos Reconstrutivos , Vertigem Posicional Paroxística Benigna/terapia , Humanos , Nistagmo Patológico/terapia , Estudos Retrospectivos , Canais Semicirculares
6.
J Int Adv Otol ; 17(5): 417-421, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34617892

RESUMO

OBJECTIVE: Benign Paroxysmal Positional Vertigo (BPPV) as the most common vestibular disorder can affect the quality of life. This study aimed to compare the effectiveness of the half somersault maneuver (HSM) as a treatment to that of the Epley maneuver (EM) as a clinical-based treatment in subjects with PC-BPPV. METHODS: In this randomized study, 43 participants with unilateral posterior canal BPPV were recruited. The experimental group received the HSM, whereas the control group received the EM. All participants were asked to fill in the Vestibular Rehabilitation Benefit Questionnaire (VRBQ), Dizziness Handicap Inventory (DHI), and Vertigo Symptom Scale (VSS) questionnaires at pretreatment and at 48 hours, 1 week, and 1 month posttreatment. The severity of residual dizziness was determined by the visual analog scale (VAS) weekly for up to 4 weeks after treatment. The success rate and the recurrence rate were assessed after the 3-month follow-up. RESULTS: The differences between the results of pretreatment and post-treatment questionnaires for both groups were significant. However, the differences were not significant between the 2 groups for the DHI scores, the total, dizziness, motion-provoked dizziness, and symptom subscale scores of the VRBQ, and the anxiety subscale scores of the VSS. There were significant differences between the 2 groups for VAS, the total VSS and vertigo subscale scores, and the VRBQ anxiety subscale scores. CONCLUSION: Even though both maneuvers are significantly effective in the treatment of PC-BPPV, subjects in the HSM group reported more improvement in terms of psychometric symptoms and residual dizziness compared to the EM group.


Assuntos
Vertigem Posicional Paroxística Benigna , Qualidade de Vida , Vertigem Posicional Paroxística Benigna/terapia , Tontura/terapia , Humanos , Posicionamento do Paciente , Inquéritos e Questionários
7.
Artigo em Inglês | MEDLINE | ID: mdl-34639856

RESUMO

The aim of the present study was to estimate the risk of dementia in patients with benign paroxysmal positional vertigo (BPPV), using a population cohort. Data from the Korean National Health Insurance Service-National Sample Cohort for the population ≥60 years of age from 2002 to 2013 were collected. A total of 11,432 individuals with dementia were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia with 45,728 individuals comprising the control group. The crude (simple) and adjusted odds ratios (ORs) of dementia in BPPV patients were analyzed using non-conditional logistic regression analyses. Subgroup analyses were conducted according to age and sex. A history of BPPV characterized 5.3% (609/11,432) of the dementia group and 2.6% (1,194/45,728) of the control group (p < 0.001). The adjusted OR of dementia for BPPV was 1.14 (95% CI = 1.03-1.26, p = 0.009). In subgroup analyses according to age and sex, males had higher ORs of dementia for BPPV. BPPV increases the risk of dementia in the 60 years of age or older population.


Assuntos
Demência , Diabetes Mellitus , Vertigem Posicional Paroxística Benigna/epidemiologia , Estudos de Coortes , Demência/epidemiologia , Humanos , Masculino , Razão de Chances
8.
Zhonghua Yi Xue Za Zhi ; 101(37): 2925-2929, 2021 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-34638183

RESUMO

As we know, benign paroxysmal positional vertigo is a peripheral vestibular disorder,while vestibular migraine is a central vestibular disease. Although they are two different independent diseases, patients often choose to consult otolaryngology and neurology. The clinical manifestations of some patients with these two diseases are similar and the diagnosis is easy to be confused, but the treatment methods are completely different, and incorrect treatment methods will inevitably affect the curative effect and prognosis. Vestibular migraine is characterized by a diversity of clinical manifestations and signs, and the migraine symptoms of some patients do not match with the vestibular symptoms. There are 30% of vestibular migraine patients who showed isolated paroxysmal vertigo/dizziness and nystagmus, which is easily confused with benign paroxysmal positional vertigo and needs to be identified. Under the framework of the international classification of vestibular diseases, according to the new guideline of nystagmus examination and classification issued by Barany Association and new diagnostic criteria of two diseases, differential diagnosisof benign paroxysmal positional vertigo from vestibular migrainecan make up for one-sided understanding caused by the specialization of disciplines, improve thediagnosis and treatment of vestibular diseases, and thus reduce the misdiagnosis and mistreatment.


Assuntos
Transtornos de Enxaqueca , Nistagmo Patológico , Atenção , Vertigem Posicional Paroxística Benigna/diagnóstico , Tontura , Humanos , Transtornos de Enxaqueca/diagnóstico
9.
Asia Pac J Clin Nutr ; 30(3): 383-391, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34587698

RESUMO

BACKGROUND AND OBJECTIVES: Poor nutritional status is associated with benign paroxysmal positional vertigo (BPPV). Transthyretin (TTR) is a more sensitive marker than is albumin for nutritional status assessment. This study was conducted to confirm an association between serum transthyretin levels and BPPV. METHODS AND STUDY DESIGN: In total, 320 patients with BPPV and 320 age- and gender-matched controls were recruited between July 1, 2018, and July 1, 2020. All patients underwent audiovestibular tests, including the Dix-Hallpike test for the posterior semicircular canal and the supine roll test for the horizontal semicircular canal. Furthermore, serum transthyretin levels and other biochemical indicators were tested. Risk factors, including a history of heart and cerebral vascular diseases, were examined, and compared between groups. Hematolgical and biochemical tests were performed and subjected to between-group analysis. Multiple logistic regression models were employed to evaluate the TTR-BPPV. Interaction and stratified analyses were conducted. RESULTS: Patients with BPPV had significantly lower TTR levels than controls (213±49.3 vs 284±56.4 p<0.001). Alcohol consumption and anemia played an interactive role in the association between BPPV and low TTR levels. After adjustments for triglycerides, BMI, uric acid, HbA1C, 25-OH vitamin D3, alcohol consumption, and anemia, the multiple logistic regression revealed that participants with low TTR levels had a significantly increased risk of BPPV (OR: 5.5; 95% CI, 2.55-11.9; p<0.001). CONCLUSIONS: Chinese older adults with low serum transthyretin levels have an increased risk of BPPV.


Assuntos
Vertigem Posicional Paroxística Benigna , Pré-Albumina , Idoso , China/epidemiologia , Humanos , Estado Nutricional , Canais Semicirculares
10.
Artigo em Inglês | MEDLINE | ID: mdl-34574385

RESUMO

We aimed to evaluate the overall clinical characteristics of patients treated by a neuro-emergency expert dedicated to the emergency department (ED) as an attending neurologist during the COVID-19 pandemic. We included adult patients who visited the ED between 1 January and 31 December 2020 and were treated by a neuro-emergency expert. We retrospectively obtained and analyzed the data on patients' clinical characteristics and outcome. The neuro-emergency expert treated 1155 patients (mean age, 62.9 years). The proportion of aged 18-40 years was the lowest, and the most common modes of arrival were public ambulance (50.6%) and walk-in (42.3%). CT and MRI examinations were performed in 94.4 and 33.1% of cases, respectively. The most frequent complaints were dizziness (31.8%), motor weakness (24.2%), and altered mental status (15.8%). The ED diagnoses were acute ischemic stroke (19.8%), benign paroxysmal positional vertigo (14.2%), vestibular neuritis (9.9%), and seizure (8.8%). The mean length of stay in the ED was 207 min. Of the patients, 55.0% were admitted to the hospital, and 41.8% were discharged for outpatient follow-up. Despite the longer stay and the complexity and difficulty of neurological diseases during the COVID-19 pandemic, the accurate diagnosis and treatment provided by a neuro-emergency expert can be presented as a good model in the ED.


Assuntos
Isquemia Encefálica , COVID-19 , Acidente Vascular Cerebral , Adulto , Vertigem Posicional Paroxística Benigna , Serviço Hospitalar de Emergência , Humanos , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , SARS-CoV-2
11.
HNO ; 69(10): 843-860, 2021 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-34491373

RESUMO

Benign paroxysmal positional vertigo (BPPV) is the most frequent form of vertigo seen in patients attending emergency departments. Leading symptoms are short attacks of vertigo provoked by head or body rotations. BPPV is caused by small calcium crystals, so-called otoconia, which are dislocated from the macula of the utricle mostly into the posterior semicircular canal. Free floating otoconia can move under the influence of gravity inside the semicircular canal (canalolithiasis) or adhere to the cupula (cupulolithiasis) causing displacement of the cupula. This results in positional nystagmus, whose directions and time courses are characteristic for the affected semicircular canal and the underlying cause. In recent years, however, a number of cases were reported, in which direction and times course of nystagmus differed from typical clinical findings. This may cause diagnostic problems.


Assuntos
Vertigem Posicional Paroxística Benigna , Nistagmo Patológico , Vertigem Posicional Paroxística Benigna/diagnóstico , Humanos , Nistagmo Patológico/diagnóstico , Nistagmo Patológico/etiologia , Nistagmo Fisiológico , Membrana dos Otólitos , Canais Semicirculares
12.
Vestn Otorinolaringol ; 86(4): 4-8, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34499439

RESUMO

OBJECTIVES: BPPV is the most common cause of recurrent vertigo. Except vertigo attacks main clinical symptoms of BPPV can include autonomic symptoms and imbalance, which sometimes complicate the diagnosis of BPPV.Purpose To evaluate clinical symptoms and management of patients with BPPV before the setting of correct diagnose. MATERIAL AND METHODS: A total of 640 patients (504 (78.8%) women) aged from 20 to 86 years old, mean age 56.43±0.54 years with BPPV were included and diagnosed by roll and Dix-Hallpike tests. Among them 144 (22.5%) patients were inpatient and 496 (77.5%) patients were outpatient. The detailed patient intake comprised the disease onset, the type of dizziness, vertigo triggers, autonomic symptoms, similar attacks in the past and previously made definite diagnosis of BPPV. The period from the appearance of the first symptoms to the correct diagnosis was assessed. RESULTS: The majority of patients (75.3%) consult a neurologist at the initial visit. Only 30.6% of patients had a correct diagnosis within a week of the onset of the disease. Initial BPPV symptoms included persistent dizziness that increased with head turns (38.8%), nausea and vomiting (21.6%), significant increase in blood pressure (13.4%), persistent imbalance while walking (73.4%). Inpatients more frequently had constant continuous dizziness, high blood pressure, severe nausea and vomiting, and the onset of symptoms in the morning when getting out of bed (p<0.05). CONCLUSION: Initial BPPV symptoms may be similar to other diseases. Focusing on medical history and complaints leads to frequent diagnostic errors, unnecessary hospitalization and prolonged treatment of patients. Positional tests are necessary for the correct diagnosis of BPPV.


Assuntos
Vertigem Posicional Paroxística Benigna , Tontura , Adulto , Idoso , Idoso de 80 Anos ou mais , Vertigem Posicional Paroxística Benigna/diagnóstico , Vertigem Posicional Paroxística Benigna/epidemiologia , Vertigem Posicional Paroxística Benigna/etiologia , Tontura/diagnóstico , Tontura/etiologia , Feminino , Hospitalização , Humanos , Pessoa de Meia-Idade , Náusea , Adulto Jovem
13.
Zhonghua Yi Xue Za Zhi ; 101(29): 2310-2315, 2021 Aug 03.
Artigo em Chinês | MEDLINE | ID: mdl-34333947

RESUMO

Objective: To investigate the seasonal changes of benign paroxysmal positional vertigo (BPPV) onset, and explore the relationship between vascular risk factors and the seasonal patterns of BPPV. Methods: Data of 3 886 patients subjected to vestibular function examination and diagnosed with BPPV who underwent manipulation or instrumental repositioning from January 1, 2016 to December 31, 2019 in the Department of Neurology, Beijing Tiantan Hospital were retrospectively analyzed. Demographic information and medical history of the patients were recorded. Weather temperature data of Beijing were obtained and monthly averages were calculated. The relationship between the BPPV onset and temperature and seasonality was investigated. Meanwhile, the influence of vascular risk factors on the seasonal patterns of BPPV was determined. Results: BPPV is more common in women (n=2 667). The male to female ratio of patients was approximately 1∶2, with a mean age of (55±13) years. The cases of BPPV in spring (March-May), summer (June-August), autumn (September-November) and winter (December-February) were 1 000 (25.7%), 911 (23.4%), 808 (20.8%) and 1 167 (30.0%), respectively. The peak incidence of BPPV occurred in December (n=491) and the lowest occurred in September (n=251). The number of BPPV cases diagnosed monthly was inversely correlated with mean temperature (R2=0.317; P<0.001). Patients with ≥2 vascular risk factors were at higher risk of developing BPPV in spring or winter than those without risk factors (OR=1.32, 95%CI: 1.13-1.53,P<0.001). Proportion of onset in spring or winter increased with each additional risk factor (P trend<0.001). Conclusions: BPPV often occurs in the months with low temperature (spring and winter) and the number of cases is inversely correlated with temperature. Compared with those with no vascular risk factors, patients with more vascular risk factors are more likely to develop BPPV in spring and winter.


Assuntos
Vertigem Posicional Paroxística Benigna , Vestíbulo do Labirinto , Adulto , Idoso , Vertigem Posicional Paroxística Benigna/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
14.
Int J Mol Sci ; 22(16)2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34445792

RESUMO

Otolin-1 is a scaffold protein of otoliths and otoconia, calcium carbonate biominerals from the inner ear. It contains a gC1q domain responsible for trimerization and binding of Ca2+. Knowledge of a structure-function relationship of gC1q domain of otolin-1 is crucial for understanding the biology of balance sensing. Here, we show how natural variants alter the structure of gC1q otolin-1 and how Ca2+ are able to revert some effects of the mutations. We discovered that natural substitutions: R339S, R342W and R402P negatively affect the stability of apo-gC1q otolin-1, and that Q426R has a stabilizing effect. In the presence of Ca2+, R342W and Q426R were stabilized at higher Ca2+ concentrations than the wild-type form, and R402P was completely insensitive to Ca2+. The mutations affected the self-association of gC1q otolin-1 by inducing detrimental aggregation (R342W) or disabling the trimerization (R402P) of the protein. Our results indicate that the natural variants of gC1q otolin-1 may have a potential to cause pathological changes in otoconia and otoconial membrane, which could affect sensing of balance and increase the probability of occurrence of benign paroxysmal positional vertigo (BPPV).


Assuntos
Proteínas da Matriz Extracelular/genética , Mutação/genética , Domínios Proteicos/genética , Sequência de Aminoácidos , Vertigem Posicional Paroxística Benigna/genética , Cálcio/metabolismo , Proteínas de Ligação ao Cálcio/genética , Proteínas de Ligação ao Cálcio/metabolismo , Proteínas da Matriz Extracelular/metabolismo , Humanos
15.
Nervenarzt ; 92(8): 819-836, 2021 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-34338803

RESUMO

Benign paroxysmal positional vertigo (BPPV) is the most frequent form of vertigo seen in patients attending emergency departments. Leading symptoms are short attacks of vertigo provoked by head or body rotations. BPPV is caused by small calcium crystals, so-called otoconia, which are dislocated from the macula of the utricle mostly into the posterior semicircular canal. Free floating otoconia can move under the influence of gravity inside the semicircular canal (canalolithiasis) or adhere to the cupula (cupulolithiasis) causing displacement of the cupula. This results in positional nystagmus, whose directions and time courses are characteristic for the affected semicircular canal and the underlying cause. In recent years, however, a number of cases were reported, in which direction and times course of nystagmus differed from typical clinical findings. This may cause diagnostic problems.


Assuntos
Vertigem Posicional Paroxística Benigna , Nistagmo Patológico , Vertigem Posicional Paroxística Benigna/diagnóstico , Humanos , Nistagmo Patológico/diagnóstico , Nistagmo Fisiológico , Membrana dos Otólitos , Canais Semicirculares
16.
J Laryngol Otol ; 135(10): 874-878, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34348804

RESUMO

BACKGROUND: Benign paroxysmal positional vertigo is classified into five subtypes according to the features of positional nystagmus: lateral canalolithiasis, lateral light cupula, lateral heavy cupula, posterior canalolithiasis and posterior heavy cupula. OBJECTIVES: The first aim of the study was to clarify whether the lateral canal type or posterior canal type was more common. The second aim of the study was to assess the aetiology of benign paroxysmal positional vertigo by investigating the onset time of each subtype. METHODS: The subjects were 512 consecutive patients with benign paroxysmal positional vertigo. The patients were prospectively aggregated, and interviews were used to evaluate onset time. RESULTS: The lateral canal type (55.5 per cent) was more common than the posterior canal type (44.5 per cent). Time of awakening was the most common onset time in every subtype. CONCLUSION: The incidence of lateral canal type is higher than that of posterior canal type. The aetiology of benign paroxysmal positional vertigo is closely related to sleep.


Assuntos
Vertigem Posicional Paroxística Benigna/classificação , Vertigem Posicional Paroxística Benigna/diagnóstico , Nistagmo Fisiológico/fisiologia , Membrana dos Otólitos/fisiopatologia , Nível de Alerta/fisiologia , Vertigem Posicional Paroxística Benigna/epidemiologia , Vertigem Posicional Paroxística Benigna/etiologia , Feminino , Humanos , Incidência , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Canais Semicirculares/fisiopatologia , Sono/fisiologia , Fatores de Tempo , Testes de Função Vestibular/métodos
17.
J Laryngol Otol ; 135(10): 887-891, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34372958

RESUMO

OBJECTIVE: Visual-vestibular mismatch patients experience persistent postural and perceptual dizziness. Previous studies have shown the benefit of vestibular rehabilitation for visual desensitisation using gaze stabilisation exercises and optokinetic stimulation. This study assessed the benefit of customised vestibular rehabilitation with visual desensitisation and virtual reality based therapy rehabilitation in the management of patients with persistent postural-perceptual dizziness. METHODS: This retrospective study included 100 patients with Situational Characteristic Questionnaire scores of more than 0.9. All patients received virtual reality based therapy along with usual vestibular rehabilitation using gaze stabilisation exercises with a plain background followed by graded visual stimulation and optokinetic digital video disc stimulation. Patients' symptoms were assessed before and after vestibular rehabilitation using the Situational Characteristic Questionnaire, Generalised Anxiety Disorder Assessment-7, Nijmegen Questionnaire and Dizziness Handicap Inventory. RESULTS: There were statistically significant improvements in Situational Characteristic Questionnaire scores, Nijmegen Questionnaire scores and Dizziness Handicap Inventory total score. However, there was a statistically insignificant difference in Generalised Anxiety Disorder Assessment-7 scores. There was a significant positive correlation between post-rehabilitation Situational Characteristic Questionnaire scores and other questionnaire results. CONCLUSION: Incorporating virtual reality based therapy with customised vestibular rehabilitation exercises results in significant improvement in persistent postural-perceptual dizziness related symptoms.


Assuntos
Vertigem Posicional Paroxística Benigna/diagnóstico , Vertigem Posicional Paroxística Benigna/reabilitação , Doenças Vestibulares/fisiopatologia , Realidade Virtual , Adulto , Vertigem Posicional Paroxística Benigna/psicologia , Terapia por Exercício/métodos , Feminino , Fixação Ocular/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Nistagmo Optocinético/fisiologia , Estimulação Luminosa/métodos , Propriocepção/fisiologia , Estudos Retrospectivos , Autorrelato/estatística & dados numéricos , Inquéritos e Questionários
18.
Rev Neurol (Paris) ; 177(7): 773-778, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34366172

RESUMO

Four episodic syndromes are recognized in the current version of the International Classification of Headache Disorders (ICHD): cyclic vomiting syndrome (CVS); abdominal migraine; benign paroxysmal vertigo; benign paroxysmal torticollis. Previously called childhood periodic syndromes, they are thought to be early expressions of a migrainous spectrum. They usually occur in childhood or adolescence and some of these patients will develop migraine later in childhood or in adulthood. More rarely, some of these disorders, in particular CVS and abdominal migraine, can persist or even begin at adulthood. The concept of episodic syndromes associated with migraine in adults is relatively recent, recognized for the first time in the version III-beta of the ICHD (2013). It is important for the adult neurologist to recognize the clinical pattern of these disorders. Lack of knowledge of these disorders often leads to delayed diagnosis, and a large number of complementary tests. Treatments are often borrowed from migraine abortive and preventive treatments. This review summarizes the characteristics of episodic syndromes and is particularly focused on data in adults.


Assuntos
Transtornos da Cefaleia , Transtornos de Enxaqueca , Adolescente , Adulto , Vertigem Posicional Paroxística Benigna , Humanos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/epidemiologia , Neurologistas , Síndrome
19.
Int Tinnitus J ; 25(1): 107-111, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-34410088

RESUMO

BACKGROUND: Benign paroxysmal positional vertigo is a frequent diagnosed disorder, most of the patients are successfully treated with reposition maneuvers. In between 3-12.5% of these patients remain symptomatic. Recent studies support the use of intratympanic corticosteroid for intractable vertigo with promising results. MATERIAL AND METHODS: Patients diagnosed with benign paroxysmal positional vertigo between June 2017 and December 2019 in a tertiary university hospital and in two private hospitals were included in the study and analyzed prospectively. They were treated and followed with repositioning maneuvers and intratympanic dexamethasone injections if the criteria was met. RESULTS: 4 out 72 patients included in the study developed criteria for intractable vertigo after at least 6 repositioning maneuvers. The posterior semicircular canal was affected in all cases, 3 out of 4 patients experienced symptom resolution, after two, four and five intratympanic dexamethasone injections respectively. CONCLUSIONS: The use of intratympanic steroids to treat patients with refractory benign paroxysmal positional vertigo showed encouraging results. We believe a multicenter randomized clinical trial should be performed to assess the efficacy of intratympanic steroids in the treatment of this pathology.


Assuntos
Vertigem Posicional Paroxística Benigna , Canais Semicirculares , Vertigem Posicional Paroxística Benigna/diagnóstico , Vertigem Posicional Paroxística Benigna/tratamento farmacológico , Dexametasona , Humanos , Injeção Intratimpânica , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Centros de Atenção Terciária
20.
Sci Rep ; 11(1): 16855, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34413436

RESUMO

Benign paroxysmal positional vertigo (BPPV) is the most common cause of positional vertigo. Vitamin D deficiency may be one of the causes of its development. To assess the relation between recurrent attacks BPPV and Vitamin D deficiency. A case control study in which 40 patients were clinically diagnosed as posterior canal BPPV, Serum 25(OH) D was measured at 1st visit. Patients were divided into two groups; group A (20 patients) received Vitamin D supplementation in addition to canal repositioning maneuver and group B (20 patients) treated by canal repositioning maneuver only. Follow up of all patients for 6 months, neuro-otological assessment was repeated and recurrent attacks were recorded. Serum vitamin D was repeated after 6 month. This study included 14 males and 26 females age ranged from 35 to 61 years, Average serum of 25 (OH) D at the first visit was (12.4 ± 2 ng/ml) for group A, and (12.2 ± 1.7 ng/ml) for group B, all patients had low serum level of 25(OH) D (below 20 ng/ml). Recurrent BPPV episodes, were significantly lower in group A than that of group B. There is a relation between BPPV recurrence and low serum Vitamin D.


Assuntos
Vertigem Posicional Paroxística Benigna/sangue , Vertigem Posicional Paroxística Benigna/complicações , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Recidiva , Vitamina D/sangue , Vitamina D/uso terapêutico , Deficiência de Vitamina D/tratamento farmacológico
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