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1.
Artigo em Chinês | MEDLINE | ID: mdl-34628805

RESUMO

The diagnostic criteria for "Vestibular Migraine of Childhood", "Probable Vestibular Migraine of Childhood" and "Recurrent Vertigo of Childhood" is put forth by the Committee for the Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification subgroup of the International Headache Society at the beginning of 2021. It provides directions for the diagnosis and treatment of these syndromes to international community of pediatricians, otolaryngologists, neurologists, neurosurgeons, neuro-otologists physiotherapists, neurophysiologists, and audiologists. The paper concludes the current situation and research progress of diagnosis and treatment of children vertigo diseases.


Assuntos
Transtornos de Enxaqueca , Doenças Vestibulares , Criança , Consenso , Tontura , Humanos , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/terapia , Vertigem/diagnóstico , Vertigem/terapia , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/terapia
2.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 35(9): 784-787;795, 2021 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-34628829

RESUMO

Objective:To evaluate the efficacy and safety of topiramate and flunarizine hydrochloride in the prophylactic treatment of vestibular migraine prophylaxis. Methods:47 patients with confirmed or probable vestibular migraine(VM) treated at the vertigo clinic of our neurology department from August 2020 to April 2021 were reviewed, and 42 patients were finally included. They were divided into topiramate group (n=22) and flunarizine hydrochloride group (n=20). The two groups were treated with topiramate 50 mg daily and flunarizine hydrochloride 10 mg daily, respectively. The visual analogue scale, vertigo duration, vertigo frequency, and Dizziness Handicap Inventory (DHI) scores of patients with VM before and 3 months after treatment were compared. The anxiety screening scale (GAD-7) and depression screening scale (PHQ-9) were recorded to assess the improvement of patients' anxiety and depression, and the occurrence of adverse events. Results:Topiramate and flunarizine hydrochloride effectively reduced vertigo intensity, vertigo duration, and vertigo frequency in VM patients (P<0.05). Meanwhile, total DHI score, DHI physical (DHI-P), DHI emotional (DHI-E), DHI functional (DHI-F), PHQ-9 and GAD-7 were significantly decreased(P<0.05). Furthermore, topiramate was superior to flunarizine hydrochloride in reducing vertigo intensity, vertigo duration, vertigo frequency, DHI-P, and DHI-F, while there was no significant difference between two drugs in improving patients' mood(P>0.05). No serious adverse events were reported in either group. Conclusion:This study suggests that topiramate and flunarizine hydrochloride are safe and effective in the prevention of VM, and the daily dose of topiramate 50 mg is superior to the daily dose of flunarizine hydrochloride 10 mg. However, there was no significant difference between the two drugs in terms of mood improvement.


Assuntos
Flunarizina , Transtornos de Enxaqueca , Ansiedade , Flunarizina/uso terapêutico , Humanos , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/prevenção & controle , Topiramato/uso terapêutico , Vertigem/tratamento farmacológico , Vertigem/prevenção & controle
3.
BMC Neurol ; 21(1): 394, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34641808

RESUMO

BACKGROUND: Persistent postural-perceptual dizziness (PPPD) is the most common functional vestibular disorder. A multisensory mismatch altered by psychological influences is considered to be an important pathophysiological mechanism. Increased cortical and subcortical excitability may play a role in the pathophysiology of PPPD. We hypothesized that decreased motion perception thresholds reflect one mechanism of the abnormal vestibular responsiveness in this disorder. We investigated the vestibular perception thresholds and the vestibular ocular reflex with a rotatory chair experiment to gain insights in the processing and adaption to vestibular provocation. METHODS: In this cross-sectional study 26 female PPPD patients and 33 healthy female age matched controls (HC) were investigated sitting in a motorized rotary chair shielded regarding visual and acoustic stimuli. The chair was rotated for 20 minutes with slowly increasing velocity to a maximum of 72°/s. We functionally tested motion perception thresholds and vegetative responses to rotation as well as vestibular-ocular reflex thresholds. We additionally investigated several psychological comorbidities (i.e. depression, anxiety, somatosensory amplification) using validated scores. Conventional dizziness scores were obtained to quantify the experienced dizziness and impact on daily life. RESULTS: PPPD patients showed a significant reduced vestibulo-perceptual threshold (PPPD: 10.9°/s vs. HC: 29.5°/s; p<0.001) with increased motion sensitivity and concomitant vegetative response during and after the chair rotation compared to healthy controls. The extent of increased vestibular sensitivity was in correlation with the duration of the disease (p=0.043). No significant difference was measured regarding nystagmus parameters between both groups. CONCLUSION: PPPD patients showed increased vegetative response as well as decreased vestibulo-perceptual thresholds which are related to disease duration. This is of interest as PPPD might be sustained by increased vestibular excitability leading to motion intolerance and induction of dizziness when exposed to movement.


Assuntos
Tontura , Doenças Vestibulares , Estudos Transversais , Feminino , Humanos , Percepção , Vertigem
4.
Artigo em Russo | MEDLINE | ID: mdl-34481445

RESUMO

A review of the current literature shows that the combined use of neurophysiological and structural-functional neuroimaging methods has significantly expanded the understanding of the mechanisms of migraine with vestibular dysfunction: functional and structural disorders were found in brain regions involved in multisensory vestibular control and Central vestibular processing. Analysis of numerous studies shows that epilepsy can also cause vestibular symptoms, they can occur both without epileptic markers, and in combination with epileptic paroxysms. In isolated epileptic vertigo, according to studies widely presented in the literature, epileptic activity was most often detected by EEG data in the temporal regions, to a lesser extent in the parietal regions. In these studies, neuroimaging findings of foci of reduced substance density were found, which could be a consequence of deafferentation, as well as violations of connections with the focus of neuronal activity. In the absence of structural abnormalities, numerous studies have shown using magnetic resonance spectroscopy, diffusion MRI, and PET that the physiological basis for impaired neuronal metabolism was a decrease in synaptic activity, a violation of maintaining the difference in membrane potentials on the surface of the hippocampus, or changes in neighboring tracts of the white matter of the brain.


Assuntos
Epilepsia , Transtornos de Enxaqueca , Epilepsia/diagnóstico por imagem , Neuroimagem Funcional , Humanos , Imageamento por Ressonância Magnética , Transtornos de Enxaqueca/diagnóstico por imagem , Neuroimagem , Vertigem/diagnóstico por imagem
5.
Artigo em Russo | MEDLINE | ID: mdl-34481447

RESUMO

The review article provides a definition and classification of different nystagmus types, a comparative description of the central and peripheral vestibular nystagmus. The pathogenetic patterns of up-beating and down-beating nystagmus are accurately described. The features of nystagmus formation in various diseases are discussed, such as Wernicke encephalopathy, Arnold-Chiari anomaly, spinocerebellar ataxia and vestibular migraine. The authors provide their own data on oculomotor disorders in 100 patients with vestibular migraine and migraine with a brain stem aura. This article considers approaches to treatment: surgical and conservative. In conclusion, was noted the possibility of differentiating the central and peripheral vestibular nystagmus by means of clinical study. As well, the differences between vertical nystagmus associated with organic lesions of the brain stem or cerebellum and transient nystagmus with vestibular migraine are highlighted. The authors note the need for in-depth studies of nystagmus in vestibular migraine patients and methods of dealing with it.


Assuntos
Malformação de Arnold-Chiari , Transtornos de Enxaqueca , Nistagmo Patológico , Cerebelo , Humanos , Nistagmo Patológico/diagnóstico , Vertigem
6.
Physiother Res Int ; 26(4): e1923, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34585499

RESUMO

BACKGROUND AND PURPOSE: Associations between dizziness, health-related quality of life, and musculoskeletal pain have not been systematically explored in patients with vestibular disorders. Such knowledge may be important for choice of treatments. The study objectives were to examine the extent and localization of musculoskeletal pain and explore whether pain was associated with dizziness and health-related quality of life. METHODS: The cross-sectional study investigated anonymized data from an earlier survey on patients with long-lasting dizziness (>3 months) examined in an oto-rhino-laryngological department. The sample includes patient between 18 and 70 years with Ménière's disease, vestibular schwannoma, benign positional paroxysmal vertigo, vestibular neuritis, non-otogenic dizziness, and cervicogenic dizziness. General musculoskeletal, that is, pain in muscles, tendons, and joints was registered by a yes/no question. A pain drawing registered localization of pain. Multiple binary logistic regression models were used to determine the association between pain and vertigo-balance and autonomic-anxiety related dizziness by the short Vertigo Symptom Scale (VSS) and sub-scales (VSS-V, VSS-A), and between pain and health-related quality of life by the SF-36, mental and physical component summary scale (SF-36 MCS, SF-36 PCS). RESULTS: The sample consisted of 503 patients, 60.2% were women, the median age was 50 years. General musculoskeletal pain was reported by 72.8% of patients, neck pain by 59.2% and widespread pain by 21.9%. Multiple binary logistic regression models demonstrated that all the pain measures were significantly associated with VSS-V and VSS-A and SF-36 PCS, but not SF-36 MCS. DISCUSSIONS: Musculoskeletal pain is prevalent in patients with long-lasting dizziness. The strong associations between pain, VSS, and SF-36 PCS could result in a self-sustaining complex condition. The findings imply that in addition to assessing and treating the vestibular symptoms, musculoskeletal symptoms and physical health should be addressed.


Assuntos
Tontura , Qualidade de Vida , Estudos Transversais , Tontura/diagnóstico , Tontura/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Cervicalgia/diagnóstico , Cervicalgia/epidemiologia , Vertigem/diagnóstico , Vertigem/epidemiologia
10.
Laryngorhinootologie ; 100(S 01): S1-S40, 2021 04.
Artigo em Inglês, Alemão | MEDLINE | ID: mdl-34352900

RESUMO

The differential diagnosis of vertigo syndromes is a challenging issue, as many - and in particular - rare disorders of the vestibular labyrinth can hide behind the very common symptoms of "vertigo" and "dizziness". The following article presents an overview of those rare disorders of the balance organ that are of special interest for the otorhinolaryngologist dealing with vertigo disorders. For a better orientation, these disorders are categorized as acute (AVS), episodic (EVS) and chronic vestibular syndromes (CVS) according to their clinical presentation. The main focus lies on EVS sorted by their duration and the presence/absence of triggering factors (seconds, no triggers: vestibular paroxysmia, Tumarkin attacks; seconds, sound and pressure induced: "third window" syndromes; seconds to minutes, positional: rare variants and differential diagnoses of benign paroxysmal positional vertigo; hours to days, spontaneous: intralabyrinthine schwannomas, endolymphatic sac tumors, autoimmune disorders of the inner ear). Furthermore, rare causes of AVS (inferior vestibular neuritis, otolith organ specific dysfunction, vascular labyrinthine disorders, acute bilateral vestibulopathy) and CVS (chronic bilateral vestibulopathy) are covered. In each case, special emphasis is laid on the decisive diagnostic test for the identification of the rare disease and "red flags" for potentially dangerous disorders (e. g. labyrinthine infarction/hemorrhage). Thus, this chapter may serve as a clinical companion for the otorhinolaryngologist aiding in the efficient diagnosis and treatment of rare disorders of the vestibular labyrinth.


Assuntos
Doenças Vestibulares , Vestíbulo do Labirinto , Tontura , Humanos , Doenças Raras , Vertigem/diagnóstico , Vertigem/etiologia , Doenças Vestibulares/diagnóstico
11.
Med Clin North Am ; 105(5): 901-916, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34391542

RESUMO

Vertigo is defined as the illusion of internal or external motion. The evaluation of a patient with vertigo in the primary care setting should not necessarily focus on providing a specific diagnosis. Rather, the physician should aim to localize the lesion. This practice streamlines the workup of patients. This article provides detailed information regarding appropriate organ system-based clinical history and the clinical workup of vertigo. Additional signs and symptoms that can facilitate appropriate referral and treatment are highlighted. Although disorder-specific treatments exist the mainstay of therapy for vertigo-induced pathology is physical therapy.


Assuntos
Vertigem/patologia , Diagnóstico Diferencial , Humanos , Exame Físico , Modalidades de Fisioterapia , Atenção Primária à Saúde , Vertigem/diagnóstico , Vertigem/etiologia , Vertigem/terapia
12.
J Neurol Phys Ther ; 45(4): 246-258, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34369452

RESUMO

BACKGROUND AND PURPOSE: A crossover, double-blinded randomized controlled trial to investigate once-daily incremental vestibulo-ocular reflex (VOR) adaptation (IVA) training over 2 years in people with stable and chronic peripheral vestibular hypofunction. METHODS: Twenty-one patients with peripheral vestibular hypofunction were randomly assigned to intervention-then-control (n = 12) or control-then-intervention (n = 9) groups. The task consisted of either x1 (control) or IVA training, once daily every day for 15 minutes over 6-months, followed by a 6-month washout, then repeated for arm 2 of the crossover. Primary outcome: vestibulo-ocular reflex gain. Secondary outcomes: compensatory saccades, dynamic visual acuity, static balance, gait, and subjective symptoms. Multiple imputation was used for missing data. Between-group differences were analyzed using a linear mixed model with repeated measures. RESULTS: On average patients trained once daily 4 days per week. IVA training resulted in significantly larger VOR gain increase (active: 20.6% ± 12.08%, P = 0.006; passive: 30.6% ± 25.45%, P = 0.016) compared with x1 training (active: -2.4% ± 12.88%, P = 0.99; passive: -0.6% ± 15.31%, P = 0.68) (P < 0.001). The increased IVA gain did not significantly reduce with approximately 27% persisting over the washout period. x1 training resulted in greater reduction of compensatory saccade latency (P = 0.04) and increase in amplitude (P = 0.02) compared with IVA training. There was no difference between groups in gait and balance measures; however, only the IVA group had improved total Dizziness Handicap Inventory (P = 0.006). DISCUSSION AND CONCLUSIONS: Our results suggest IVA improves VOR gain and reduces perception of disability more than conventional x1 training. We suggest at least 4 weeks of once-daily 4 days-per-week IVA training should be part of a comprehensive vestibular rehabilitation program.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A356).


Assuntos
Adaptação Fisiológica , Reflexo Vestíbulo-Ocular , Tontura , Marcha , Humanos , Vertigem
13.
Ther Umsch ; 78(7): 381-388, 2021 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-34427108

RESUMO

Smarter medicine in Otorhinolaryngology - Top 5 List Abstract. Many diseases or symptoms with a high prevalence in the population, such as vertigo / dizziness, tinnitus, or sinusitis, but also nasal bone fractures and otitis externa, lead to a high number of visits to the physicians due to their frequency alone. Often, conventional X-rays (sinusitis, nasal bone fractures) or - in cases of vertigo and tinnitus - magnetic resonance imaging are ordered for further diagnostic clarification even though the benefit of theses is not generally given according to the current state of knowledge. The indication for imaging can be set much more restrictive after critical review of these clinical conditions without reducing the quality of treatment. The same applies to the usage of systemic antibiotics in uncomplicated otitis externa, which can be reduced without any problems. The extensive discussion of these issues within the Society of Otorhinolarnygology (SGORL) formed the basis for the creation of the Top 5 -list with its recommendations which are presented in detail below.


Assuntos
Otolaringologia , Médicos , Humanos , Imageamento por Ressonância Magnética , Vertigem
14.
AMIA Annu Symp Proc ; 2021: 355-364, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34457150

RESUMO

Federated learning of data from multiple participating parties is getting more attention and has many healthcare applications. We have previously developed VERTIGO, a distributed logistic regression model for vertically partitioned data. The model takes advantage of the linear separation property of kernel matrices of a dual space model to harmonize information in a privacy-preserving manner. However, this method does not handle the variance estimation and only provides point estimates: it cannot report test statistics and associated P-values. In this work, we extend VERTIGO by introducing a novel ring-structure protocol to pass on intermediary statistics among clients and successfully reconstructed the covariance matrix in the dual space. This extension, VERTIGO-CI, is a complete protocol to construct a logistic regression model from vertically partitioned datasets as if it is trained on combined data in a centralized setting. We evaluated our results on synthetic and real data, showing the equivalent accuracy and tolerable performance overhead compared to the centralized version. This novel extension can be applied to other types of generalized linear models that have dual objectives.


Assuntos
Privacidade , Vertigem , Intervalos de Confiança , Humanos , Modelos Lineares , Modelos Logísticos , Vertigem/diagnóstico
15.
Acta Otorhinolaryngol Ital ; 41(3): 263-269, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34264920

RESUMO

Objective: This prospective study aimed to investigate the role of migraine in favouring the onset of persistent postural perceptual dizziness (PPPD) following paroxysmal positional vertigo (PPV). Methods: A group of patients who came to our attention suffering of PPV with or without migraine and/or vestibular migraine (VM) was examined. Three months after the resolution, an anamnestic research was conducted aimed at establishing whether any patient-related dizziness could meet the diagnostic criteria for PPPD. Results: 12 of the 240 patients recruited met the diagnostic criteria for PPPD for an overall incidence of 5%, with 3 (1.85%) belonging to the non-migraine group and 9 (11.5%) to the migraine group. In the latter, 6 (28.6%) patients with VM and 3 (5.26%) without VM were affected. Conclusions: The study shows a significant increase of PPPD diagnosis in migraine compared to patients without migraine (p = 0.003). Within migraine there was a significant increase in those with VM compared to patients without VM (p = 0.0016). No difference emerged between patients without migraine and migraine patients without VM (p > 0.05). The presence of VM in patient's history, but not migraine without VM, appears to significantly increase the incidence of PPPD in patients with PPV.


Assuntos
Tontura , Transtornos de Enxaqueca , Tontura/etiologia , Humanos , Transtornos de Enxaqueca/complicações , Estudos Prospectivos , Vertigem/complicações , Vertigem/diagnóstico
16.
BMJ Case Rep ; 14(7)2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34253526

RESUMO

Pneumolabyrinth refers to the presence of air within the inner ear and is a fairly common occurrence immediately after stapes surgery, but rarely occurs in a delayed manner years after the initial operation. We present a case of a patient with a history of left stapedotomy 15 years prior, who presented with acute onset vertigo, tinnitus and hearing loss in her operated ear. Her symptoms were preceded by an upper respiratory tract infection associated with bouts of sneezing. Examination revealed a spontaneous right beating nystagmus and positive head thrust to the left. Pure tone audiometry demonstrated a left mixed hearing loss which subsequently deteriorated to a profound sensorineural hearing loss. CT showed the presence of air within the left vestibule and semicircular canals. The patient underwent an exploratory tympanotomy and repair of perilymphatic leak with resolution of vestibular symptoms but no improvement in sensorineural hearing thresholds.


Assuntos
Doenças do Labirinto , Cirurgia do Estribo , Audiometria de Tons Puros , Orelha Média , Feminino , Humanos , Doenças do Labirinto/cirurgia , Espirro , Cirurgia do Estribo/efeitos adversos , Vertigem/etiologia
17.
Orv Hetil ; 162(30): 1216-1221, 2021 07 25.
Artigo em Húngaro | MEDLINE | ID: mdl-34304155

RESUMO

Összefoglaló. Bevezetés: A szédülés gyakori panasz, amellyel a betegek felkeresik a sürgosségi osztályt. Emellett fontos tünet, hiszen kihívást jelent mind a diagnosztika, mind a terápia szempontjából, és nagy hatással lehet a betegek életminoségére. Célkituzés: Kutatásunk célja annak vizsgálata, hogy mennyire befolyásolta a szédülés a betegek életminoségét a sürgosségi osztály elhagyását követoen. Módszer: A vizsgálat idotartama alatt 879, szédülést panaszoló beteg jelent meg a Semmelweis Egyetem sürgosségi osztályán. Részükre kérdoív került kiküldésre, amely tartalmazta a 'Dizziness Handicap Inventory' (DHI-) kérdoívet is. Megkeresésünkre 308 beteg (110 férfi, 198 no; átlagéletkor: 61,8 ± 12,31 SD) válaszolt, az általuk visszaküldött kérdoíveket részletesen elemeztük. Eredmények: A leggyakoribb diagnózisok közé a benignus paroxysmalis positionalis vertigo, a centrális egyensúlyrendszeri eltérések és a szédülékenység tartoztak. Az elemzés alapján különbség volt látható a fizikális, a funkcionális és az emocionális pontszámok között. Kiemelendo, hogy a legmagasabb értékeket a fizikális csoportban regisztráltuk. A részletes otoneurológiai kivizsgáláson átesett betegek DHI-értékeit összevetettük azokéival, akik nem jártak ilyen vizsgálaton, a két csoport értékei között azonban nem volt szignifikáns különbség (p = 0,97). Emellett a DHI-érték emelkedése volt látható a végleges diagnózisig eltelt ido függvényében. Következtetés: A végleges diagnózisig eltelt ido, illetve a megfelelo kivizsgálás hiánya jelentos hatással van a szédülo betegek életminoségére. Lényeges a kivizsgálás, a mielobbi diagnózis és a részletes egyensúlyrendszeri vizsgálat szerepe, ugyanakkor az utóbbi indokolt esetben kell, hogy történjen. Orv Hetil. 2021; 162(30): 1216-1221. INTRODUCTION: Dizziness and vertigo are among the most common complaints in the emergency department. This may require interdisciplinary cooperation due to their complex presentation in the department and the effects on the patients' quality of life. OBJECTIVE: Our study aimed to assess the effect of an acute vertigo episode on the quality of life after patients' discharge from the emergency department. METHOD: 879 patients examined at the Semmelweis University emergency department with vertigo and dizziness were included in the study. A questionnaire, including the Dizziness Handicap Inventory (DHI), was addressed to this population. We received 308 answered questionnaires back (110 males, 198 females; mean age 61.8 years ± 12.31 SD), which were further analyzed. RESULTS: The most frequent diagnoses were benign paroxysmal positional vertigo, central lesions and dizziness. According to the analysis of the DHI questionnaire, a difference between physical, functional and emotional scores was shown, whereas the highest scores were registered in the physical group. The DHI questionnaire scores of patients undergoing a neurotological examination and those who did not were further compared, whereas no significant statistical difference was indicated (p = 0.97). In addition, an increase in DHI scores was seen depending on the time elapse for the definitive diagnosis. CONCLUSION: The absence of adequate examination and a late diagnosis of the dizziness cause have a significant impact on the quality of life of patients. Therefore, substantial investigation, early diagnosis, and detailed vestibular examination are essential, but the latter should take place in justified cases. Orv Hetil. 2021; 162(30): 1216-1221.


Assuntos
Tontura , Qualidade de Vida , Tontura/etiologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Vertigem
18.
Artigo em Chinês | MEDLINE | ID: mdl-34304484

RESUMO

Objective:To research the differences of sensory organization testing in maintaining postural stability between patients with type 2 diabetes mellitus and patients with peripheral vertigo using computerized posturography. Methods:Participants were divided into the control group (52 cases), the type 2 diabetes mellitus group (T2DM) (45 cases), and the peripheral vertigo group (PV) (47 cases). All participants were examined under six conditions by computerized posturography: The sensory organization test, a part of computerized dynamic posturography, was used to assess the abilities of vision, somatosensory and vestibular systems in maintaining postural stability. Results:The scores of statokinesiogram (SKG) of the T2DM group in condition 1 (standing on static platform with eye open), condition 4(standing on foam platform with eyes open) and condition 6(standing on foam platform with servo-controlled vision) were significantly greater than that in the vertigo group (P<0.01). The visual scores in the T2DM group were lower than those of the PV group(P<0.01) in the anteroposterior and lateral directions. Conclusion:Patients with type 2 diabetes and peripheral vertigo have a decreased ability to maintain balance in the upright position. Patients with type 2 diabetes have a poorer ability to maintain balance with visual systems than patients with peripheral vertigo.


Assuntos
Diabetes Mellitus Tipo 2 , Doenças Vestibulares , Diabetes Mellitus Tipo 2/complicações , Humanos , Equilíbrio Postural , Vertigem/diagnóstico , Doenças Vestibulares/diagnóstico , Visão Ocular
19.
Artigo em Chinês | MEDLINE | ID: mdl-34304512

RESUMO

Objective:To compare and analyze the clinical features of family clustered vestibular migraine(FCVM) and sporadic vestibular migraine(SVM). Methods:A total of 118 patients with vestibular migraine were selected and divided into FCVM group(66 cases) and SVM group(52 cases), and the clinical features such as age, the form of symptoms, provoking and relieving factors, audiological manifestations, sequelae and complications, were compared and analyzed. Results:The onset of headache in FCVM group was earlier than that in SVM group ([23.88±11.45] years old and [28.77±11.85] years old, χ²=2.267, P=0.025) with a longer interval between headache and vertigo attack ([13.11±10.08] years old and [8.50±9.26] years old, χ²=2.554, P=0.012).Patients with positional vertigo in the FCVM group were more than those in the SVM group (12[18.2%] and 0[0], χ²=3.171, P=0.002). Mental anxiety(P<0.001), neck stiffness(P=0.028), and concentration difficulties(P=0.001) were more common in patients with FCVM at the end of the episode than in patients with SVM. Comorbid primary motion sickness combined was more common in FCVM group than in SVM group(49 cases[74.2%] and 25 cases[48.1%], χ²=2.906, P=0.004). Conclusion:The onset of FCVM is earlier and the prognosis is often poor. Primary motion sickness can be used as a reference for the early diagnosis of FCVM.


Assuntos
Audiologia , Transtornos de Enxaqueca , Adolescente , Adulto , Ansiedade , Criança , Pré-Escolar , Cefaleia , Humanos , Vertigem , Adulto Jovem
20.
Otol Neurotol ; 42(7): e858-e865, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34260506

RESUMO

OBJECTIVE: Idiopathic sudden sensorineural hearing loss (ISSNHL) may not only impair cochlear function but also damage vestibular structures, including the saccule, utricle, semicircular canals, and vestibular afferents. Poor recovery often occurs in patient with serious ISSNHL and accompanying vertigo. To define the severity of the disease and to predict prognosis, galvanic vestibular-evoked myogenic potentials (VEMPs) are added to the inner ear test battery. STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Thirty patients with unilateral severe to profound ISSNHL and accompanying vertigo were enrolled in this retrospective study. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: All subjects underwent pure tone audiometry, cervical and ocular VEMPs, and caloric tests before the initiation of treatment. The treatment outcome, rates of abnormal responses in the tests, and the characteristic parameters of VEMPs such as latencies and amplitudes, were analyzed. RESULTS: In affected ears, the rates of abnormal acoustic cVEMPs, vibratory oVEMPs, galvanic cVEMPs, and galvanic oVEMPs were 60, 47, 37, and 20%, respectively. The improvement in the hearing of the affected ear was specified as good recovery or poor recovery. The normal galvanic VEMP group had a significant higher rate of good recovery than abnormal galvanic VEMP group (87% versus 27%; p = 0.003). CONCLUSIONS: Patients with unilateral severe to profound ISSNHL and accompanying vertigo who have normal galvanic VEMPs have a higher likelihood of hearing recovery than those who have abnormal galvanic VEMPs.


Assuntos
Perda Auditiva Neurossensorial , Perda Auditiva Súbita , Potenciais Evocados Miogênicos Vestibulares , Vestíbulo do Labirinto , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Súbita/diagnóstico , Humanos , Prognóstico , Estudos Retrospectivos , Vertigem/diagnóstico
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