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Objectives: To compare the efficacy of the home treatment program combined with office-based canalith repositioning procedure (CRP) versus office-based CRP alone for benign paroxysmal positional vertigo (BPPV). Study Design: Rando...
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Objectives: To compare the efficacy of the home treatment program combined with office-based canalith repositioning procedure (CRP) versus office-based CRP alone for benign paroxysmal positional vertigo (BPPV). Study Design: Randomized controlled trial. Method: One hundred six patients with BPPV were randomly assigned to the home treatment program combined with office-based CRP group and the office-based CRP only group. The canalith repositioning procedure was performed in all patients at an out-patient clinic. The patients in the home treatment group were additionally instructed to do the exercise tailored for their affected canal at home every day. The presence of nystagmus was recorded. The symptom of vertigo and its impact on daily life were evaluated by the Dizziness Handicap Inventory (DHI) and a visual analog scale (VAS). All outcomes were evaluated at 1, 2, and 4 weeks after the initial treatment. A cure was defined as a patient having no nystagmus on the appointment date. Results: The success rate of the home treatment program combined with office-based CRP group and the office-based CRP only group were 100 and 91.67%, respectively (p = 0.043). The nystagmus duration, latency, DHI, and VAS scores decreased significantly from baseline at 1, 2, and 4 weeks for both groups (p < 0.001). No significant side effects were noted in either of the groups. Conclusion: The office-based CRP plus home treatment program was more effective than the CRP only group for BPPV. Both groups were effective in reducing the symptom of vertigo and its impact on daily life.
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Museum material and literature data on Vertigo-species from France and the Iberian Peninsula have been revised and critically evaluated. Distribution maps based on all available data for four, in this area rare and poorly known, s...
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Museum material and literature data on Vertigo-species from France and the Iberian Peninsula have been revised and critically evaluated. Distribution maps based on all available data for four, in this area rare and poorly known, species: Vertigo substriata, V. modesta arctica, V. lilljeborgi and V. alpestris are presented. The distribution and ecology of the species in the area are discussed. Two species are restricted to higher altitudes in the Pyrenees: V. modesta arctica (3 localities) and V. lilljeborgi (2 localities - first record for Spain). V. substriata and V. alpestris both have a wider distribution, but are very rare and their occurrences scattered. V. alpestris is restricted to the northern and eastern parts of France, V. substriata occurs also in the Pyrenees and northern Spain and has ail isolated occurrence in the south (Sierra Nevada). The total distribution of both species is discussed and North and Middle European is considered a good characterisation of both. Vertigo Baudoni Massot, 1872 is a synonym of V. substriata. Vertigo acheila Servain, 1880 is a synonym of V. pygmaea and not of V. alpestris or V. moulinsiana as previously supposed.
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Objective: Epidemiologic studies have shown Vestibular migraine (VM) to be the most common cause of vertigo in children, but little is known about the typical presentation and response to treatment of this disorder in the pediatri...
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Objective: Epidemiologic studies have shown Vestibular migraine (VM) to be the most common cause of vertigo in children, but little is known about the typical presentation and response to treatment of this disorder in the pediatric population. The aim of this study was to evaluate the diagnostic features and response to therapy of VM in children managed at a pediatric vestibular clinic.
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The recurrent nature of the 3 most common vestibulopathies suggests a recurrent cause. Histopathology in temporal bones from patients with these syndromes - vestibular neuronitis (VN, n = 7), Ménière's disease (MD, n = 8) and be...
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The recurrent nature of the 3 most common vestibulopathies suggests a recurrent cause. Histopathology in temporal bones from patients with these syndromes - vestibular neuronitis (VN, n = 7), Ménière's disease (MD, n = 8) and benign paroxysmal positional vertigo (BPPV, n = 5) - shows focal degeneration of vestibular nerve axons and degenerated nearby facial nerve meatal ganglion cells. Transmission electron microscopic confirmation of intracytoplasmic viral particles in surgically excised vestibular nerves from patients with VN and MD support a viral etiology in these vestibulopathies. Antiviral treatment of these syndromes in a series of 211 patients with a 3- to 8-year follow-up resulted in complete control of vertigo in VN (88%), MD (90%) and BPPV (60%).
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Objective. This plain language summary serves as an overview in explaining benign paroxysmal positional vertigo, abbreviated BPPV. This summary applies to patients >= 18 years old with a suspected or potential diagnosis of BPPV an...
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Objective. This plain language summary serves as an overview in explaining benign paroxysmal positional vertigo, abbreviated BPPV. This summary applies to patients >= 18 years old with a suspected or potential diagnosis of BPPV and is based on the 2017 "Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update)." The evidence-based guideline includes research to support more effective diagnosis and treatment of BPPV. The guideline was developed as a quality improvement opportunity for managing BPPV by creating clear recommendations to use in medical practice.
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Vertigo is a common symptom in everyday clinical practice. The treatment depends on the specific etiology. Vertigo may be secondary to inner ear pathology, or any existing brainstem or cerebellar lesion but may also be psychogenic...
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Vertigo is a common symptom in everyday clinical practice. The treatment depends on the specific etiology. Vertigo may be secondary to inner ear pathology, or any existing brainstem or cerebellar lesion but may also be psychogenic. Central vertigo is a consequence of a central nervous system lesion. It is often associated with a focal neurological deficit. Peripheral vertigo is secondary to dysfunction of the peripheral vestibular system and is usually characterized by an acute vertigo with loss of balance, sensation of spinning in the space or around self, and is exaggerated with changes of the head and body position; no other neurological deficit is present. Some medications may also cause vertigo. Depending on the cause of the vertigo, drugs with different mechanisms of action, physical therapy, psychotherapy, as well as surgery may be used to combat this disabling malady. Symptomatic treatment has a particularly important role, regardless of the etiology of vertigo. We reviewed the current medications recommended for patients with vertigo, their mechanisms of action and their most frequent side effects.
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The aim of the study was to ascertain the validity of a personal protocol used for the diagnostic classification of a group of 20 patients suffering from migraine without aura and with recurrent vertigo and postural disorders. A s...
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The aim of the study was to ascertain the validity of a personal protocol used for the diagnostic classification of a group of 20 patients suffering from migraine without aura and with recurrent vertigo and postural disorders. A series of ten factors (anamnestic and constitutional) considered predictive of migrainous vertigo and four types of response to sensory provocation made it possible to identify two types of patients: type A, simultaneous presence of at least 5 (≥50%) of the 10 factors considered and at least 2 (≥50%) of the four established responses; type B, presence of fewer than five factors (≤50%), or of more than five (≥50%) but fewer than two (≤50%) of the responses envisaged by the protocol. All patients underwent migraine prophylaxis for 4 months. Vertigo and postural status were evaluated using a questionnaire, i.e. the Dizziness Handicap Inventory (DHI), and a posturographic test before and after prophylaxis. The treatment was considered effective by 30% of the total group of 20 patients and by 75% of type A patients. No improvement was recorded in type B patients. Furthermore, the latter group did not show significant changes in the DHI or posturographic tests. Instead, type A patients demonstrated a statistically significant reduction in sway area and DHI score at the end of prophylaxis (P = 0.001). Research into a particular constitutional functional habitus, thus, proved useful for the diagnostic definition of migraine-associated vertigo.
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Bislang liegen nur wenige valide epidemiologische Untersuchungen zum Leitsymptom Schwindel vor. Nach einer Analyse von 4214 Patienten einer überregionalen Spezialambulanz für Schwindel zwischen 1989 und 2002 stellen der benigne ...
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Bislang liegen nur wenige valide epidemiologische Untersuchungen zum Leitsymptom Schwindel vor. Nach einer Analyse von 4214 Patienten einer überregionalen Spezialambulanz für Schwindel zwischen 1989 und 2002 stellen der benigne periphere paroxysmale Lagerungsschwindel (BPPV) und der phobische Schwankschwindel (PPV) die beiden häufigsten Schwindelsyndrome dar. In der vorliegenden Untersuchung wurde die relative Alters- und Geschlechtsverteilung dieser beiden Erkrankungen analysiert. Im Alter zwischen 20 und 50 Jahren stellt der PPV mit einem Anteil von 22–26% die relativ häufigste Schwindelform dar. Da der PPV einerseits unbehandelt meist chronifiziert und zu deutlichen (auch beruflichen) Beeinträchtigungen führt, andererseits bei richtiger Diagnosestellung in mehr als 70% erfolgreich therapiert werden kann, kommt dieser Erkrankung eine erhebliche medizinische und sozioökonomische Bedeutung zu. Der PPV sollte deshalb zum diagnostischen Repertoire jeden Arztes gehören.Up to now, there have been only a few valid epidemiological investigations of dizziness or vertigo as key symptoms. According to an analysis of 4,214 patients examined between 1989 and 2002 in an outpatient dizziness unit, benign peripheral paroxysmal positional vertigo (BPPV) and phobic postural vertigo (PPV) constitute the two most frequent syndromes. In this study, the relative age and sex distribution of both disorders was analysed. In the age group from 20 to 50 years, PPV was comparatively the most frequent form of dizziness, with a share of 22% to 26%. When left untreated, PPV becomes chronic in most cases and leads to considerable impairments, also at work. However, when diagnosed correctly, it can be treated successfully in more than 70% of cases. Thus, it takes on considerable medical and socioeconomic significance and should be part of the diagnostic repertoire of every doctor.Schlüsselwörter Schwindel - Epidemiologie - Phobischer Schwankschwindel - Benigner peripherer paroxysmaler LagerungsschwindelKeywords Vertigo - Epidemiology - Dizziness - Phobic postural vertigo - Benign paroxysmal positioning vertigo
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