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Front Neurol 2022 9;13:836337. Epub 2022 May 9.

Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States.

Objective: The present study sought to differentiate multiple sclerosis and neuromyelitis optica spectrum disorder patients at their first attack by describing and distinguishing their clinical features, radiographic characteristics, and immunologic characteristics of serum and cerebrospinal fluid.

Methods: We retrospectively studied 58 patients with multiple sclerosis (MS) and 52 patients with neuromyelitis optica spectrum disorder (NMOSD) by referencing brainstem lesions as the prodromal events. Their demographics and presentation at the time of the first attack was evaluated including their gender, age, clinical features of the first attack, the expanded disability status scale (EDSS), brainstem lesion(s) by head MRI, and immunological indices of serum and cerebrospinal fluid. Read More

Intern Med J 2022 May 23. Epub 2022 May 23.

Epworth HealthCare, Richmond, Australia.

Background: Exclusion of stroke is the focus of guidelines in Emergency Department assessment of acute vertigo, especially with new onset atrial fibrillation (AF). Early diagnosis of vestibular neuritis (VN) is also important but may be deferred awaiting brain MRI for exclusion of stroke. This may delay potentially beneficial corticosteroid therapy. Read More

Int Arch Otorhinolaryngol 2022 Apr 20;26(2):e281-e288. Epub 2021 Jul 20.

Department of Medicine, JSS Medical College, Mysuru, Karnataka, India.

 Diabetes mellitus is a metabolic disease associated with a rise in the level of blood glucose. Individuals with diabetes mellitus are more likely to develop hearing loss, tinnitus, and dizziness due to macro- and microvascular complications. The extent to which auditory and vestibular functions are impaired in individuals with type-2 diabetes mellitus is still under debate. Read More

World J Otorhinolaryngol Head Neck Surg 2022 Apr 6. Epub 2022 Apr 6.

Philippine National Ear Institute, National Institutes of Health University of the Philippines Manila Manila Philippines.

Background: Otologic and vestibular symptoms have been seen in patients confirmed to have COVID-19 disease. Further discussion of these symptoms may provide insight into short- and long-term management for these patients.

Objective: The aim of this review was to describe the otologic and vestibular symptoms that present in patients with COVID-19. Read More

BMJ Neurol Open 2022 3;4(1):e000284. Epub 2022 May 3.

Department of Neurophysiology, Liverpool Hospital, Liverpool, New South Wales, Australia.

Background And Aims: Vertigo is a common presentation to the emergency department (ED) with 5% of presentations due to posterior circulation stroke (PCS). Bedside investigations such as the head impulse test (HIT) are used to risk stratify patients, but interpretation is operator dependent. The video HIT (v-HIT) provides objective measurement of the vestibular-ocular-reflex (VOR) and may improve diagnostic accuracy in acute vestibular syndrome (AVS). Read More

Intern Med 2022 May 14. Epub 2022 May 14.

Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Japan.

Bow hunter's stroke is a rare cause of vertebrobasilar infarction. There is no consensus regarding the optimal treatment. We herein report a case of bow hunter's stroke successfully treated by endovascular treatment. Read More

Appl Biochem Biotechnol 2022 May 14. Epub 2022 May 14.

Department of Kidney Disease Unit & Dialysis, Central Hospital Affiliated to Shandong First Medical University, No. 105, Jiefang Road, Jinan City, Shandong, 250013, China.

Diabetes is an amalgamation of metabolic disorders marked by hyperglycemia. Over time diabetes brings up several other complications with it like cardiovascular disease, retinopathy, neuropathy, and nephropathy. among which diabetic nephropathy (DN) is the one we are concerned about in the present study. Read More

J Neurol 2022 May 11. Epub 2022 May 11.

Department of Neurology, Seoul National University College of Medicine, Seoul, South Korea.

In central as well as peripheral vestibular lesions, right-beating horizontal nystagmus is almost always associated with clockwise (top poles of the eyes beating to the right ear) torsional nystagmus when observed and vice versa (concordant nystagmus). This study aimed to determine the etiologies and mechanisms of horizontal and torsional nystagmus beating in the opposite directions (discordant nystagmus). We reviewed the medical records of 16 consecutive patients with discordant horizontal-torsional nystagmus who had been evaluated at the dizziness clinics of Seoul National University Bundang Hospital (n = 11, from March 2003 to March 2021) and Korea University Medical Center (n = 5, from March 2019 to March 2021). Read More

PLoS One 2022 5;17(5):e0266252. Epub 2022 May 5.

West Moreton Health Service, Ipswich, Queensland, Australia.

This systematic review aims to evaluate whether point-of-care emergency physicians, without special equipment, can perform the HINTS examination or STANDING algorithm to differentiate between central and non-central vertigo in acute vestibular syndrome with diagnostic accuracy and reliability comparable to more specialized physicians (neuro-ophthalmologists and neuro-otologists). Previous research has concluded that emergency physicians are unable to utilize the HINTS examination with sufficient accuracy, without providing any appropriate education or training. A comprehensive systematic search was performed using MEDLINE, Embase, the Cochrane CENTRAL register of controlled trials, Web of Science Core Collection, Scopus, Google Scholar, the World Health Organization International Clinical Trials Registry Platform, and conference programs and abstracts from six medical organizations. Read More

Cell Death Discov 2022 May 4;8(1):247. Epub 2022 May 4.

Department of Neurology, Shengjing Hospital of China Medical University, 110004, Shenyang, P.R. China.

Circular RNAs (circRNAs) have been noted to express in the brain and thus participate in various diseases related to the central nervous system. However, the potential role of circRNAs in cerebral ischemia (CI)-induced vertigo remains unknown. We initially predicted through bioinformatics analysis the poor expression of circ_0000811 related to CI. Read More

Am J Otolaryngol 2022 May-Jun;43(3):103201. Epub 2021 Sep 10.

Department of Otolaryngology, Renqiu People's Hospital, Renqiu, Hebei, China.

Objective: The current study was conducted aimed at investigating the effect of stellate ganglion injection guided with different approaches on hearing threshold in patients harboring sudden deafness.

Methods: There involved a total of 68 patients with sudden deafness in our study. The patients were randomly allocated into control group and study group, with 34 cases in each group. Read More

Otolaryngol Clin North Am 2022 Apr 27. Epub 2022 Apr 27.

Keck School of Medicine of the University of Southern California, 1975 Zonal Avenue, Los Angeles, CA 90033, USA.

Patients often report symptoms of headache and dizziness concomitantly. Symptoms of dizziness can be explored with a comprehensive vestibular assessment, allowing for the investigation of central and peripheral vestibular system contributions to symptoms of dizziness. Patients who report both symptoms of headache and dizziness demonstrate abnormalities of the vestibular system which can be measured quantitatively. Read More

J Vestib Res 2022 Apr 17. Epub 2022 Apr 17.

Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA.

Background: The Visual Vertigo Analogue Scale (VVAS) assesses visual vertigo. Instead of the original scoring methods (positive VVAS >  1), we propose categorizing patients as having No (0), Mild (0.1-40), Moderate (40. Read More

Biomolecules 2022 03 28;12(4). Epub 2022 Mar 28.

Structural Motility, Institut Curie, Paris Université Sciences et Lettres, Sorbonne Université, CNRS UMR144, F-75005 Paris, France.

Ménière's disease is a chronic illness characterized by intermittent episodes of vertigo associated with fluctuating sensorineural hearing loss, tinnitus and aural pressure. This pathology strongly correlates with a dilatation of the fluid compartment of the endolymph, so-called hydrops. Dexamethasone is one of the therapeutic approaches recommended when conventional antivertigo treatments have failed. Read More

Eur Arch Otorhinolaryngol 2022 Apr 22. Epub 2022 Apr 22.

Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany.

Background: In medicine, the symptom of dizziness is one of the most common multidisciplinary causes of emergency medical presentation. Attending physicians are often faced with difficult decisions when evaluating patients with dizziness. A rapid differential diagnostic decision must be made during the initial examination. Read More

J Clin Lipidol 2022 Apr 3. Epub 2022 Apr 3.

Department of Neurology, 417 Army Share Fund Hospital, 10-12 Monis Petraki Str., PO 11521, Athens, Greece.

Cerebrotendinous xanthomatosis (CTX) is a rare inherited disorder of the alternative pathway of bile acid biosynthesis, due to mutation(s) of the gene CYP27A1, leading to sterol 27-hydroxylase deficiency. The latter results in a systematic deposition of cholestanol and cholesterol to the central nervous system and tendons, premature cataract, as well as the manifestation of systematic symptoms, such as chronic diarrhea, osteoporosis, and premature atherosclerosis. Due to its marked clinical heterogeneity, prompt diagnosis of this disorder is challenging. Read More

J Neurol 2022 Apr 12. Epub 2022 Apr 12.

German Center for Vertigo and Balance Disorders, University Hospital, LMU, Munich, Germany.

Downbeat nystagmus (DBN) is a common form of acquired fixation nystagmus related to vestibulo-cerebellar impairments and associated with impaired vision and postural imbalance. DBN intensity becomes modulated by various factors such as gaze direction, head position, daytime, and resting conditions. Further evidence suggests that locomotion attenuates postural symptoms in DBN. Read More

J Clin Med 2022 Apr 3;11(7). Epub 2022 Apr 3.

Department of Neurology, Jena University Hospital, Friedrich Schiller University, 07743 Jena, Germany.

Background: Vertigo and dizziness are common in community-dwelling people and can be treated in specialized multidisciplinary settings. To develop tailored interventions, however, we have to explore risk factors for favorable and unfavorable outcomes.

Methods: We prospectively investigated patients with chronic vertigo and dizziness subjected to our 5-day multimodal and interdisciplinary day care treatment in the Center for Vertigo and Dizziness of Jena University Hospital, Germany. Read More

Acta Otorrinolaringol Esp (Engl Ed) 2022 Mar-Apr;73(2):89-95

Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.

Introduction And Objectives: Family members play a major role in the assessment and final result of the treatments of patients. The goal of the present study was to evaluate how much the perception of patients' family members could be trusted regarding the vertigo and imbalance which they experienced.

Materials And Methods: A cross-sectional study was conducted on 110 patients and their family members who were referred to the Central Vestibular Clinic in Mashhad from April 2018 to September 2019. Read More

J Neurol 2022 Apr 9. Epub 2022 Apr 9.

Department of Neurology, Dizziness Center, Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, South Korea.

Fixation nystagmus refers to the nystagmus that appears or markedly increases with fixation. While relatively common in infantile (congenital) nystagmus, acquired fixation nystagmus is unusual and has been ascribed to lesions involving the cerebellar nuclei or the fibers projecting from the cerebellum to the brainstem. We aimed to report the clinical features of patients with acquired fixation nystagmus and discuss possible mechanisms using a model simulation and diagnostic significance. Read More

Zh Nevrol Psikhiatr Im S S Korsakova 2022 ;122(3):22-26

Kazan Medical University, Kazan, Russia.

Older age is characterized by a high prevalence of dizziness/vertigo, including various variants - central and peripheral vestibular disorders, feelings of instability, balance disorders. High frequency of dizziness and chronic cerebral ischemia in the elderly age category supports traditional ideas about relationship of these pathologies. However, there is a known overestimation of Chronic cerebral ischemia as a cause dizziness of and unclear mechanisms of this process. Read More

J Neurol 2022 Apr 8. Epub 2022 Apr 8.

Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Research Institute for Convergence of Biomedical Science and Technology, Kumo-ro 20, Beomo-ri, Mulgum-eup, Yangsan, Gyeongnam, 50612, South Korea.

This study aimed to determine the incidence, pattern, and etiology of dissociated vestibulo-ocular reflex (VOR) function according to the stimulus frequency in dizzy patients. We retrospectively evaluated the results of bithermal caloric tests and video-head impulse tests (vHITs) in 1022 patients with dizziness or vertigo between July 2016 and April 2021. Patients were classified into concordant group (normal or abnormal results on both tests) and discordant group (dissociated results between two tests). Read More

JMIR Res Protoc 2022 Apr 7;11(4):e34297. Epub 2022 Apr 7.

Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.

Background: Some children with central nervous system (CNS) and solid tumors are at risk to develop ototoxicity during treatment. Up to now, several risk factors have been identified that may contribute to ototoxicity, such as platinum derivates, cranial irradiation, and brain surgery. Comedication, like antibiotics and diuretics, is known to enhance ototoxicity, but their independent influence has not been investigated in childhood cancer patients. Read More

Med Pr 2022 Apr 6;73(2):143-150. Epub 2022 Apr 6.

Instytut Medycyny Pracy im. Jerzego Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Audiologii i Foniatrii / Audiology and Phonistrics Clinic).

Background: The posturography test allows assessment of the entire function of balance system and quantitative, device-based verification of the clinical Romberg test. Therefore, the aim of this study is assessment of usefulness of posturography as primary test for balance disorders in occupational medicine.

Material And Methods: The study is cross-sectional, analyzing anonymous results of 1030 patients reporting dizziness and balance disorders. Read More

OTO Open 2022 Jan-Mar;6(1):2473974X221089847. Epub 2022 Mar 29.

Department of Neurology, Medical University of Vienna, Vienna, Austria.

Benign paroxysmal positional vertigo of the horizontal semicircular canal may present a differential diagnostic challenge. In addition to the classical positional nystagmus, a persistent nystagmus in a seated position occasionally occurs, so-called pseudo-spontaneous nystagmus (PSN), which can be mistaken for a central or peripheral spontaneous nystagmus. We report a case with cupulolithiasis of the horizontal semicircular canal presenting with horizontal PSN in a sitting position, with implications for a new pathomechanism of PSN. Read More

Front Neurol 2022 17;13:804777. Epub 2022 Mar 17.

Department of Otorhinolaryngology, St. Marianna University School of Medicine, Kanagawa, Japan.

Objective: The pathogenesis of Ménière's disease is still largely unknown; however, it is known to be strongly associated with stress. Excessive stress can cause hyperactivity of the sympathetic autonomic nervous system. With the aim of understanding changes in sympathetic hyperactivity before and after Ménière's disease, we compared autonomic nervous function in patients in a stable phase of Ménière's disease and that in healthy adults. Read More

J Vestib Res 2022 ;32(3):205-222

Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig Maximilians University, Munich, Germany.

This paper presents diagnostic criteria for vascular vertigo and dizziness as formulated by the Committee for the Classification of Vestibular Disorders of the Bárány Society. The classification includes vertigo/dizziness due to stroke or transient ischemic attack as well as isolated labyrinthine infarction/hemorrhage, and vertebral artery compression syndrome. Vertigo and dizziness are among the most common symptoms of posterior circulation strokes. Read More

J Family Med Prim Care 2022 Feb 16;11(2):784-786. Epub 2022 Feb 16.

Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India.

Vertigo is not an uncommon presenting symptom in patients presenting to the emergency department (ED) and primary physician's clinic, and around one-tenth of these patients have a central cause, i.e., posterior circulation stroke. Read More

Ann Indian Acad Neurol 2022 Jan-Feb;25(1):148-151. Epub 2021 Oct 11.

Department of Internal Medicine, Daswani Dental College, Kota, Rajasthan, India.

Auris Nasus Larynx 2022 Mar 23. Epub 2022 Mar 23.

Department of Otorhinolaryngology & Head and Neck Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea. Electronic address:

Objective: To evaluate how often the positive sign of HINTS (Head-Impulse, Gaze Evoked Nystagmus, Test of Skew) appears in patients with acute peripheral vestibular lesion, HINTS findings were quantitatively measured and analyzed in patients with peripheral vestibulopathy accompanying spontaneous nystagmus.

Methods: HINTS was evaluated in 14 vertigo patients with spontaneous nystagmus. Horizontal vestibulo-ocular reflex (VOR) gain was measured using the video head impulse test (vHIT). Read More