1,997 results match your criteria Central Vertigo


Posttraumatic Dizziness: Navigating the Maze Towards Accurate Vestibular Diagnosis and Treatment.

Otol Neurotol 2021 Jun;42(5):e573-e578

Division of Otology/Neurotology-Skull Base Surgery, Department of Otolaryngology/Head and Neck Surgery, Michigan Medicine, The University of Michigan, Ann Arbor, Michigan.

Objective: Highlight the importance of establishing a differential diagnosis to identify and treat multiple origins of dizziness in a patient following traumatic brain injury (TBI).

Patient: 73-year-old man with TBI and temporal bone fracture developed posttraumatic bilateral multiple canal benign paroxysmal positional vertigo (BPPV).

Intervention: Multi-disciplinary diagnostic evaluation and vestibular rehabilitation (VR) treatment focused on canalith repositioning maneuvers (CRMs) and central adaptation. Read More

View Article and Full-Text PDF

Cerebellar liponeurocytoma, a rare tumor: Case report and review of the literature.

Int J Surg Case Rep 2021 Apr 30;82:105937. Epub 2021 Apr 30.

Makassed Islamic Charitable Society, Jerusalem, Palestine.

Introduction: Cerebellar liponeurocytoma is a rare tumor of the central nervous system occurring mainly in the posterior fossa, which shows neuronal and variable astrocytic differentiation, along with foci of lipomatous differentiation.

Case Presentation: Herein, we describe a 50-year-old female patient who presented to the hospital complaining of headache, tinnitus, and vertigo with positive cerebellar signs. MRI revealed a left cerebellar tumor. Read More

View Article and Full-Text PDF

Vestibular disorders in children: A retrospective analysis of vestibular function test findings.

Int J Pediatr Otorhinolaryngol 2021 Apr 29;146:110751. Epub 2021 Apr 29.

Acibadem Maslak Hospital ENT Department, Istanbul, Turkey.

Objective: This study was designed to describe the most common vestibular disorders in children and their associated findings on vestibular function testing.

Method: Data from 203 children with a mean age of 11.16 ± 3. Read More

View Article and Full-Text PDF

Efficacy and Pharmacological Appropriateness of Cinnarizine and Dimenhydrinate in the Treatment of Vertigo and Related Symptoms.

Int J Environ Res Public Health 2021 Apr 30;18(9). Epub 2021 Apr 30.

Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata (BiND), Sezione di Audiologia, Università Degli Studi di Palermo, Via del Vespro 129, 90127 Palermo, Italy.

Vertigo is not itself a disease, but rather a symptom of various syndromes and disorders that jeopardize balance function, which is essential for daily activities. It is an abnormal sensation of motion that usually occurs in the absence of motion, or when a motion is sensed inaccurately. Due to the complexity of the etiopathogenesis of vertigo, many pharmacological treatments have been tested for efficacy on vertigo. Read More

View Article and Full-Text PDF

Clinical Diagnosis of Central Vertigo in Patients With Dizziness in Emergency Practice.

Neurologist 2021 May 5;26(3):75-79. Epub 2021 May 5.

Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama.

Background: Life-threatening diseases should be promptly identified to provide appropriate medical care for emergency outpatients experiencing dizziness. However, dizziness is associated with various medical conditions; thus, a definitive diagnosis is challenging. To accurately diagnose vertigo in an emergency outpatient, we conducted a survey on the need to identify vertigo patients in the current outpatient departments. Read More

View Article and Full-Text PDF

Clinical, oculographic, and vestibular test characteristics of vestibular migraine.

Cephalalgia 2021 May 2:3331024211006042. Epub 2021 May 2.

Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.

Background: We characterise the history, vestibular tests, ictal and interictal nystagmus in vestibular migraine.

Method: We present our observations on 101 adult-patients presenting to an outpatient facility with recurrent spontaneous and/or positional vertigo whose final diagnosis was vestibular migraine (n = 27) or probable vestibular migraine (n = 74). Ictal and interictal video-oculography, caloric and video head impulse tests, vestibular-evoked myogenic potentials and audiometry were performed. Read More

View Article and Full-Text PDF

[Betahistine in vestibular disorders: current concepts and perspectives].

Vestn Otorinolaringol 2021 ;86(2):73-81

Federal Siberian Research Clinical Centre under the Federal Medical Biological Agency, Krasnoyarsk, Russia.

The goal of this paper is to review the pharmacological profile of betahistine and evidence for using it in the treatment of common vestibular disorders. Betahistine is a weak agonist for histamine H1 receptors and strong antagonist for histamine H3 receptors. It demonstrates the maximum benefit in different types of peripheral vertigo, especially in Meniere's disease. Read More

View Article and Full-Text PDF

Clinical Characteristics of Patients With Dizziness/Vertigo Accompanied by Posterior Semicircular Canal Hypofunction.

Front Med (Lausanne) 2021 13;8:589969. Epub 2021 Apr 13.

Department of Neurology, Aerospace Center Hospital, Peking University Aerospace School of Clinical Medicine, Beijing, China.

To investigate the clinical characteristics of patients with dizziness/vertigo accompanied by loss of the posterior canal(s) (LPC). Clinical data of 23 patients with LPC were collected. We determined video-head-impulse test (vHIT) gains of all six semicircular canals and correlated vHIT findings with other vestibulo-cochlear tests, including caloric test, ocular and cervical vestibular-evoked myogenic potentials (oVEMP, cVEMP), pure tone audiometry (PTA), and analyzed the differences in clinical manifestations of patients with LPC with different etiologies. Read More

View Article and Full-Text PDF

Acute Dizziness, Vertigo, and Unsteadiness.

Neurol Clin 2021 05 30;39(2):373-389. Epub 2021 Mar 30.

Department of Neurology, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 1805, USA; Tufts University School of Medicine, Burlington, MA, USA.

Vestibular symptoms, including dizziness, vertigo, and unsteadiness, are common presentations in the emergency department. Most cases have benign causes, such as vestibular apparatus dysfunction or orthostatic hypotension. However, dizziness can signal a more sinister condition, such as an acute cerebrovascular event or high-risk cardiac arrhythmia. Read More

View Article and Full-Text PDF

[Vertigo and dizziness].

Authors:
Ken Johkura

Rinsho Shinkeigaku 2021 Apr 17. Epub 2021 Apr 17.

Department of Neurology, Yokohama Brain and Spine Center.

Pathophysiology of vertigo/dizziness can be understood by eye deviation (nystagmus). In benign paroxysmal positional vertigo, eye deviation of causative semicircular canal stimulation is directly observed. In other peripheral vestibular disorders, eye deviation results from the sum of unilateral all semicircular canal disorders. Read More

View Article and Full-Text PDF

Melatonin Exerts Anti-Inflammatory, Antioxidant, and Neuromodulatory Effects That Could Potentially Be Useful in the Treatment of Vertigo.

Int J Otolaryngol 2021 23;2021:6641055. Epub 2021 Mar 23.

Scientific Direction, Foltra Medical Center, Teo 15886, Spain.

The acute phase of vertigo involves multiple neurotransmitters, inflammatory mediators, and products of oxidative stress. The vestibular pathway has multiple melatonin receptors distributed along its path, both centrally and peripherally. In addition, melatonin has been shown to be a powerful antioxidant and anti-inflammatory agent against factors related to vertigo, such as Bax/caspases, interleukins, and chemokines. Read More

View Article and Full-Text PDF

Value of copeptin and S100B protein in the differential diagnosis of central vertigo and peripheral vertigo.

J Laryngol Otol 2021 Apr 8;135(4):336-340. Epub 2021 Apr 8.

Department of Emergency Medicine, Cerrahpasa Medical Faculty, Istanbul University - Cerrahpasa, Turkey.

Objective: To investigate the usefulness of copeptin and S100B levels in the differentiation of central and peripheral vertigo.

Methods: Ninety patients were included in the study. Copeptin and S100B levels were measured using the enzyme-linked immunosorbent assay method. Read More

View Article and Full-Text PDF

The cingulate oculomotor cortex.

Cortex 2021 May 4;138:341-355. Epub 2021 Mar 4.

German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University Munich, Munich, Germany; Institute for Neuroradiology, Ludwig-Maximilians-University Munich, Munich, Germany.

Knowledge about the relevance and extent of human eye movement control in the cingulate cortex to date is very limited. Experiments in non-human primates brought about evidence for a potentially central role of the dorsal bank of the cingulate sulcus in saccadic eye movements. In humans, a putative cingulate eye field (CEF) in the same region has been proposed; however, its function and location still remain controversial. Read More

View Article and Full-Text PDF

[Bilateral vestibular hypofunction: a literature review and a case report].

Med Pr 2021 Apr 31;72(2):185-192. Epub 2020 Dec 31.

Śląski Uniwersytet Medyczny w Katowicach / Medical University of Silesia in Katowice, Katowice, Poland (Wydział Nauk o Zdrowiu w Katowicach, Zakład Anatomii / School of Health Sciences in Katowice, Department of Anatomy).

Bilateral vestibular hypofunction (BVH) is a rare disorder of the peripheral part of the balance organ, which may cause chronic vertigo and oscillopsia accompanying body movements. The chronic and severe nature of the symptoms and difficulties in maintaining balance and performing precise movements may cause the patient's withdrawal from professional activity. A frequently long period from the onset of the symptoms to the diagnosis of BVH, which should be based on the objective examination of the peripheral part of the vestibular organ, drastically reduces the chances of improving the patient's precise movement motility and significantly deteriorates the quality of life. Read More

View Article and Full-Text PDF

From Genotype to Phenotype: Expanding the Clinical Spectrum of Variants in the Era of Next Generation Sequencing.

Front Neurol 2021 2;12:639994. Epub 2021 Mar 2.

Center for Rare Movement Disorders Innsbruck, Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.

Ion channel dysfunction is a key pathological substrate of episodic neurological disorders. A classical gene associated to paroxysmal movement disorders is , which codes for the pore-forming subunit of the neuronal calcium channel P/Q. Non-polyglutamine variants underlie familial hemiplegic ataxia type 1 (FHM1) and episodic ataxia type 2 (EA2). Read More

View Article and Full-Text PDF

Epley manoeuvre for posterior semicircular canal benign paroxysmal positional vertigo in people with multiple sclerosis: protocol of a randomised controlled trial.

BMJ Open 2021 03 18;11(3):e046510. Epub 2021 Mar 18.

Department of Physiotherapy, University of Seville, Sevilla, Spain.

Introduction: Vestibular disorders in multiple sclerosis (MS) could have central or peripheral origin. Although the central aetiology is the most expected in MS, peripheral damage is also significant in this disease. The most prevalent effect of vestibular peripheral damage is benign paroxysmal positional vertigo (BPPV). Read More

View Article and Full-Text PDF

[Effects of vestibular spontaneous nystagmus on visual smooth pursuit function].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Mar;56(3):280-284

Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital, Institute of Otolaryngology of Tianjin, Tianjin Key Laboratory of Auditory Speech and Balance Medicine, Key Clinical Discipline of Tianjin (Otolaryngology), Otorhinolaryngology Clinical Quality Control Centre of Tianjin, Tianjin 300192, China.

The aim of the study is to analyze the effects of vestibular spontaneous nystagmus(SN) on the smooth pursuit function of visual ocularmotor system. A total of 46 patients with acute unilateral peripheral vestibular syndrome with SN (26 cases of vestibular neuritis, 6 cases of Ramsay Hunt Syndrome (RHS) with vertigo, 14 cases of sudden deafness with vertigo) were included in this work. In the study group, the results of SPT and SN test with videonystagmography(VNG) were also reviewed. Read More

View Article and Full-Text PDF

[Positional vertigo variant].

Zh Nevrol Psikhiatr Im S S Korsakova 2021 ;121(2):88-91

Central Research Institute for Dentistry and Maxillofacial Surgery, Moscow, Russia.

The article describes case history and multiphase treatment of the patient with attacks of vertigo, initially regarded as the onset of Meniere's disease, but later qualified as secondary positional attacks with combined musculoskeletal pathology of the craniovertebral region and temporomandibular joint. Medicinal, local and surgical treatment led to the perfect result. Thus, the team work of neurologist, otolaryngologist, maxillofacial surgeon and orthodontist led to the successful elimination of vertigo attacks. Read More

View Article and Full-Text PDF

Successful Management of Natalizumab-Associated Primary Central Nervous System Lymphoma through Autologous Stem Cell Transplant.

Curr Oncol 2020 12 30;28(1):203-208. Epub 2020 Dec 30.

CHUM Research Center, CHUM, Montréal, QC H2X 3E4, Canada.

Natalizumab is used as a second-line treatment for multiple sclerosis (MS). Some reports have linked natalizumab to primary central nervous system lymphoma (PCNSL), although few have described its management. A 45-year-old woman with Balo's Concentric Sclerosis presented dizziness, vertigo accompanied by dysarthria, weakness on the left side and blurred vision to the right eye after the fourth dose of natalizumab. Read More

View Article and Full-Text PDF
December 2020

Clinical Implication of Corrective Saccades in the Video Head Impulse Test for the Diagnosis of Posterior Inferior Cerebellar Artery Infarction.

Front Neurol 2021 18;12:605040. Epub 2021 Feb 18.

Research Institute of Clinical Medicine, Jeonbuk National University Hospital-Biomedical Research Institute, Jeonbuk National University, Jeonju, South Korea.

In the present study, we characterized the vestibulo-ocular reflex (VOR) gain and properties of corrective saccades (CS) in patients with posterior inferior cerebellar artery (PICA) stroke and determined the best parameter to differentiate PICA stroke from benign peripheral vestibular neuritis (VN). In particular, we studied CS amplitude and asymmetry in video head impulse tests (vHITs) to discriminate these two less-studied disease conditions. The vHITs were performed within 1 week from symptom onset in patients with PICA stroke ( = 17), patients with VN ( = 17), and healthy subjects (HS, = 17). Read More

View Article and Full-Text PDF
February 2021

The use and misuse of the Dix-Hallpike test in the emergency department.

CJEM 2021 Mar 6. Epub 2021 Mar 6.

The Department of Emergency Medicine, Health Science North Research Institute, Northern Ontario School of Medicine, 41 Ramsey Lake Rd, Sudbury, ON, P3E 5J1, Canada.

Objectives: A simple bedside test, the Dix-Hallpike test (DHT), can reliably diagnose benign paroxysmal positional vertigo (BPPV) in patients with acute onset dizziness or vertigo. We evaluated patterns of DHT use by emergency physicians in patients presenting with dizziness and vertigo. Our objective was to assess the frequency and clinically appropriate use of the DHT in an emergency department. Read More

View Article and Full-Text PDF

Agreement Between Physical Therapists in Diagnosing Benign Paroxysmal Positional Vertigo.

J Neurol Phys Ther 2021 04;45(2):79-86

Physical Therapy Department, University of the Sciences, Philadelphia, Pennsylvania (A.K.G.); Excel Physical Therapy, Blue Bell, Pennsylvania (A.T.); Willow Grove Physical Therapy, Willow Grove, Pennsylvania (M.F.); and WWS Physical Therapy and Vestibular Rehabilitation, Doylestown, Pennsylvania (W.W.S).

Background And Purpose: Individuals with benign paroxysmal positional vertigo (BPPV) are frequently referred to physical therapy for management, but little is known on how reliable therapists are at diagnosing BPPV. The purpose of the study was to examine the agreement between physical therapists in identifying nystagmus and diagnosing BPPV.

Methods: Thirty-eight individuals with complaints of positional vertigo, 19 from each of 2 clinics (clinics 1 and 2) that specialize in vestibular rehabilitation, had eye movements recorded using video goggles during positioning tests including supine-to-sit, supine roll, and Dix-Hallpike tests. Read More

View Article and Full-Text PDF

Dizziness Handicap Inventory in Clinical Evaluation of Dizzy Patients.

Int J Environ Res Public Health 2021 02 24;18(5). Epub 2021 Feb 24.

Balance Disorders Unit, Department of Otolaryngology, Medical University of Lodz, 90-237 Lodz, Poland.

(1) Objectives: The evaluation of dizzy patients is difficult due to nonspecific symptoms that require a multi-specialist approach. The Dizziness Handicap Inventory (DHI) is widely used in the assessment of dizziness-related disability, but its clinical efficacy needs further expansion. The aim of this study was to identify the subscales of DHI that may correlate with some vestibular or nonvestibular dysfunctions. Read More

View Article and Full-Text PDF
February 2021

MCQ-Balance: a method to monitor patients with balance disorders and improve clinical interpretation of posturography.

PeerJ 2021 23;9:e10916. Epub 2021 Feb 23.

IDERGO (Research and Development in Ergonomics) Research Group, I3A (Aragon Institute of Engineering Research), Zaragoza, Spain.

Background: An estimated 20% to 30% of the global population has suffered a vertiginous episode. Among them, 20% do not receive a clear diagnosis. Improved methods, indicators and metrics are necessary to assess the sensory systems related to balance, especially when patients are undergoing treatment for vertiginous episodes. Read More

View Article and Full-Text PDF
February 2021

Ozone-induced encephalopathy: A novel iatrogenic entity.

Eur J Neurol 2021 Mar 3. Epub 2021 Mar 3.

Neurology Department, San Camillo Forlanini Hospital, Rome, Italy.

Background And Purpose: Ozone-based treatments can be associated with central nervous system toxicity, which we have termed ozone-induced encephalopathy (OIE). A detailed description of its phenotype is lacking.

Methods: Three cases with findings suggestive of OIE are presented, and the literature is reviewed. Read More

View Article and Full-Text PDF

Head-Shaking Nystagmus in Posterior Canal Benign Paroxysmal Positional Vertigo with Canalolithiasis.

J Clin Med 2021 Feb 26;10(5). Epub 2021 Feb 26.

Department of Neurology, School of Medicine, Keimyung University, Daegu 42601, Korea.

Background: There have been several studies about head-shaking nystagmus (HSN) in posterior canal benign paroxysmal positional vertigo (PC-BPPV). The purpose of the study was to determine the characteristics of HSN and its relationship with head-bending nystagmus (HBN) and lying-down nystagmus (LDN) in PC-BPPV and to suggest a possible pathomechanism of HSN based on these findings.

Methods: During the study period, 992 patients with BPPV were initially enrolled. Read More

View Article and Full-Text PDF
February 2021

Neurologists' Diagnostic Accuracy and Interspecialties' Diagnostic Concordance of Acute Vertigo: Observational Study at the Emergency Department in a Tertiary Center.

Neurologist 2021 Mar 4;26(2):36-40. Epub 2021 Mar 4.

Department of Neurology, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.

Background: Acute vertigo (AV) is often a challenging condition. Because of its multiple causes, patients are frequently observed by neurologists and physicians from other areas of specialites, particularly Ear, Nose, and Throat (ENT). We aimed to assess the diagnostic accuracy of AV in patients observed by Neurology and other medical specialties. Read More

View Article and Full-Text PDF

Gait in Benign Paroxysmal Positional Vertigo.

Front Neurol 2021 12;12:633393. Epub 2021 Feb 12.

Department of Neurology, School of Medicine, Ewha Womans University Mokdong Hospital, Seoul, South Korea.

Patients with benign paroxysmal positional vertigo (BPPV) experience gait unsteadiness not only during the attacks but also between the spells. This study aimed to measure gait changes in BPPV and determine whether these changes are associated with the involved canal or lesion side. We recruited 33 patients with a diagnosis of unilateral BPPV. Read More

View Article and Full-Text PDF
February 2021

Diagnosing Stroke in Acute Vertigo: Sensitivity and Specificity of HINTS Battery in Indian Population.

Neurol India 2021 Jan-Feb;69(1):97-101

Department of Neurology, Poona Hospital and Research Centre, Pune, Maharashtra, India.

Introduction: Most patients presenting with acute vertigo are believed to suffer from acute, self-limited, presumed viral or post-viral vestibular neuritis (VN). But 25% of such cases can be "Pseudo VN", and are due to central causes, most often stroke. The aim of the present research was to study the sensitivity and specificity of Head Impulse, Nystagmus, Skew deviation (HINTS) battery for diagnosis of stroke in patients with acute-onset first episode of spontaneous vertigo. Read More

View Article and Full-Text PDF

Primary Lymphoma of Internal Acoustic Meatus Mimicking Vestibular Schwannoma-A Rare Diagnostic Dilemma.

J Neurol Surg Rep 2021 Jan 23;82(1):e1-e5. Epub 2021 Feb 23.

Department of Radiology, Dr. Balabhai Nanavati Hospital, Mumbai, Maharashtra, India.

 A subject presenting with a unilateral sensorineural hearing loss and with vertigo/imbalance and a lesion of internal acoustic meatus (IAM) most often represents a vestibular schwannoma. Several alternative pathologies involving the region, with clinical and neuroradiological similarities, could lead to an error in judgement and management. Rare tumors of the IAM pose unique diagnostic difficulty. Read More

View Article and Full-Text PDF
January 2021