Articles: vertigo.
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Acta oto-laryngologica · Sep 2006
Life events and benign paroxysmal positional vertigo: a case-controlled study.
Within the poorly understood mechanisms implicated in the aetiology of benign paroxysmal positional vertigo (BPPV), the results of this trial provide clinical evidence of a potential role of emotional stress connected to adverse life events as a trigger of otoconial dysfunction. High levels of anxiety, depression and somatization were recorded and considered psychogenic precursors of BPPV, thus emphasizing the role of psychological distress in precipitating peripheral vestibular disorders. Therefore, appraisal of life stress and psychological attitudes may have potential implications in the clinical assessment of this labyrinthine vertigo and its frequent relapses. ⋯ Patients with BPPV reported significantly more life events than control subjects in the year preceding the onset of vertigo (p<0.005). Negative life events, objective negative impact and a poor degree of control were also significantly more frequent in patients compared with controls (p<0.005). There were no significant differences between groups concerning positive life events (p>0.05). Psychometric questionnaires recorded significantly higher levels of anxiety, depression and somatization in the pathological sample (p<0.005), as well as an increased obsessive-compulsive attitude (p<0.05).
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Case Reports
Simultaneous acute superior nerve neurolabyrinthitis and benign paroxysmal positional vertigo.
An acutely vertiginous 47-year-old woman presented to the emergency department with simultaneous acute left neurolabyrinthitis and left posterior canal benign paroxysmal positional vertigo (BPPV). Gaze nystagmus from the neurolabyrinthitis hampered diagnosis of the BPPV. However, once the BPPV was identified and treated, the patient's subjective vertigo improved rapidly. Concomitant BPPV should not be overlooked when a diagnosis of acute neurolabyrinthitis is made in the emergency department.
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The aim of the present study was to characterize the relation between quality of life (QOL) and the four major complaints (hearing loss, tinnitus, vertigo, and unsteadiness) caused by unilateral vestibular schwannomas (VS) in a cohort of well-characterized untreated patients. ⋯ Vertigo is the symptom causing the most pronounced negative effect on QOL in patients with VS. The more frequent VS symptoms, unilateral hearing loss and tinnitus, seem to be less important in the patients' perception of QOL as evaluated by the questionnaires used in this study. If vertigo could be relieved by treatment, this symptom should be a primary focus when discussing treatment options in small- to medium-sized VS.
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Migrainous vertigo (MV) is increasingly recognized as a common cause of episodic vertigo. MV displays several clinical similarities with familial hemiplegic migraine (FHM) and episodic ataxia type 2 (EA-2), which have been linked to mutations in 3 genes, CACNA1A, encoding a neuronal calcium channel alpha subunit, ATP1A2, encoding a catalytic subunit of a Na(+)/K(+)-ATPase, and most recently the voltage-gated sodium channel SCN1A. The present study explored the hypothesis that mutations in CACNA1A, ATP1A2, SCN1A, and the calcium channel beta(4) subunit CACNB4 confer susceptibility to MV. ⋯ Based on this group of patients there is no evidence that the genes causing FHM and EA-2 represent major susceptibility loci for MV.
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J. Korean Med. Sci. · Jun 2006
Multicenter StudyClinical characteristics of benign paroxysmal positional vertigo in Korea: a multicenter study.
Benign paroxysmal positional vertigo (BPPV) is characterized by episodic vertigo and nystagmus provoked by head motions. To study the characteristics of BPPV in a large group of patients in Korea, we retrospectively analyzed clinical features of 1,692 patients (women: 1,146, 67.7%; men: 54.6, 32.3%; mean age: 54.8+/-14.0 yr), who had been diagnosed as BPPV by trained neuro-otologists Dizziness Clinics. The diagnosis of BPPV was based on typical nystagmus elicited by positioning maneuvers. ⋯ We could observe significant negative correlation between the proportion of HC-BPPV of each clinic and the mean time interval between the symptom onset and the first visit to the clinics (r=-0.841, p<0.05). Most patients were successfully treated with canalith repositioning maneuvers (86.9%). The high incidence of HC-BPPV in this study may be explained by relatively shorter time interval between the symptom onset and visit to the Dizziness Clinics in Korea, compared with previous studies in other countries.