Articles: vertigo.
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Vertigo and dizziness are among the most prevalent symptoms in neurologic disorders. Although many of these patients suffer from postural instability and gait disturbances, there is only limited data on their risk of falling. ⋯ Falls are common in patients presenting to a dizziness unit. Those with central syndromes are at risk of recurrent and injurious falling. Fall rates and fear of falling should be assessed in balance disorders and used to guide the regimen of rehabilitation therapy. The identification of risk factors would help provide protective measures to these groups of patients.
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Controlled Clinical Trial
Tetra-ataxiometric Posturography in Patients with Migrainous Vertigo.
Migraine is a common disorder characterized by headache attacks frequently accompanied by vestibular symptoms like dizziness, vertigo, and balance disorders. Clinical studies support a strong link between migraine and vertigo rather than between other headache types and vertigo or nonvertiginous dizziness. There is a lack of consensus regarding the pathophysiology of migrainous vertigo. Activation of central vestibular processing during migraine attacks and vasospasm-induced ischemia of the labyrinth are reported as the probable responsible mechanisms. Because vestibular examination alone does not provide enough information for diagnosis of migrainous vertigo, posturography systems which provide objective assessment of somatosensory, vestibular, and visual information would be very helpful to show concomitant involvement of the vestibular and somato-sensorial systems. There are few posturographic studies on patients with migraine but it seems that how balance is affected in patients with migraine and/or migrainous vertigo is still not clear. We want to investigate balance function in migraineurs with and without vertigo with a tetra-ataxiometric posturography system and our study is the first study in which tetra-ataxiometric static posturography was used to evaluate postural abnormalities in a well-defined population of patients with migrainous vertigo. ⋯ In this first study of tetra-ataxiometric static posturography evaluating postural abnormalities in a well-defined population of patients with migrainous vertigo, the central part of the vestibular apparatus would be responsible of postural abnormalities in patients with migraine and migrainous vertigo.
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Emergency (Tehran, Iran) · Jan 2016
True Vertigo Patients in Emergency Department; an Epidemiologic Study.
Vertigo prevalence is estimated to be 1.8% among young adults and more than 30% in the elderly. 13-38% of the referrals of patients over 65 years old in America are due to vertigo. Vertigo does not increase the risk of mortality but it can affect the patient's quality of life. Therefore, this study was designed to evaluate the epidemiologic characteristics of vertigo patients referred to the emergency department (ED). ⋯ Sensitivity and specificity of history and clinical examination in differentiating central and peripheral vertigo were 99 (95% CI: 57-99) and 99 (95% CI: 97-99), respectively.
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A 76-year-old woman complained of vertigo for two years. She manifested left deafness, loss of caloric response, and right-beaten nystagmus. ⋯ She had undergone surgery for breast cancer 33 years previously, and the current biopsy specimen showed identical pathology. Breast cancer may metastasize to the skull base; however, metastasis 33 years after surgery is very rare.
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The diagnosis and management of the dizzy patient presents the physician with significant challenges. Dizziness and imbalance are common complaints among the general population, affecting around one-third of people over the age of 65 years, and can result from a range of causes spanning many medical disciplines. ⋯ An understanding of the key features of the vestibular examination, and consideration of other pathologies including neurological and cardiac, are important. This conference was held with the aim of demystifying the dizzy patient by providing physicians with a practical approach to the assessment and management of dizziness, imbalance and 'funny turns'.