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At least 19 recordsLinked to original sources
PubMed2000

[Vertigo drug therapy--merely drug vertigo? Vertigo from the pharmacologic viewpoint].

Vertigo drug therapy is indicated only in few types of vertigo. A causal therapy is possible for infections of the inner ear by antibiotics or antiviral drugs. A symptomatic therapy of severe attacks of vertigo consists in the administration of sedative drugs like antihistaminics, benzodiazepines or neuroleptics. These drugs, however have to be used no longer than one week to avoid an inhibition of beneficial compensatory processes in the central nervous system. Furthermore, the use of non specifically acting blood flow increasing drugs like pentoxifylline in combination with prednisolone can be recommended. For the prophylaxis of Menière's disease, betahistine is the drug of choice because of its two modes of action (beneficial effect on the blood flow in the inner ear, inhibitory effect in vestibular nuclei). For prevention of vomiting as a consequence of vertigo, scopolamine is unsurpassed. In cases of psycogenicly caused vertigo, antivertiginosa from plant origin and homoeopathic drugs can be recommended, especially in the elderly patient, despite the fact that the effect of these drugs can not be fully explained as jet. Beside vertigo drug therapy, vertigo as a side effect of many drugs has to be taken into consideration in clinical routine. The variety of drugs responsible for vertigo consists in relatively harmless substances like aspirin up to substances used in vertigo drug therapy!

Humans↗
PubMed2000

[Special forms of vertigo. Which therapy for which type of vertigo?].

Paroxysmal vertigo, permanent vertigo, positional and postural vertigo, and transient vertigo are special forms, which are differentiated by their temporal course. Paroxysmal vertigo, together with hearing impairment and noises in the ear, is typical of Menière's disease. Persistent vertigo often occurs after the loss of a peripheral vestibular end organ (e.g. after trauma of infection). In the case of positional and postural vertigo, a differentiation must be made between benign paroxysmal positional vertigo due to "wandering" otoliths, and orthostatic vertigo, which occurs on changing rapidly from a lying to a sitting position. The diagnosis is verified by Epley or Semont positional maneuvers. Confirmation of a cervical vertigo is provided by the de Kleijn and Nieuwenhuyse test. Brief episodes of vertigo (transient vertigo) occur after transient ischemia, for example when craning to look at a high building. In the acute stage, treatment of vestibular vertigo consists in the damping of the threshold for vestibular stimuli with antiemetics. For long-term treatment, antihistaminics and histamine-like substances have proven of value.

Diagnosis, Differential↗
PubMed2001

The interrelations of migraine, vertigo, and migrainous vertigo.

OBJECTIVE: To assess the prevalence of migrainous vertigo in patients with migraine and in patients with vertigo according to explicit diagnostic criteria that are presented for discussion. METHODS: The authors prospectively evaluated 200 consecutive patients from a dizziness clinic and 200 patients from a migraine clinic for migrainous vertigo based on the following criteria: 1) recurrent vestibular symptoms (rotatory/positional vertigo, other illusory self or object motion, head motion intolerance); 2) migraine according to the criteria of the International Headache Society (IHS); 3) at least one of the following migrainous symptoms during at least two vertiginous attacks: migrainous headache, photophobia, phonophobia, visual or other auras; and 4) other causes ruled out by appropriate investigations. In addition, the authors compared the prevalence of migraine according to the IHS criteria in the dizziness clinic group with a sex- and age-matched control group of 200 orthopedic patients. RESULTS: The prevalence of migraine according to the IHS criteria was higher in the dizziness clinic group (38%) compared with the age- and sex-matched control group (24%, p < 0.01). The prevalence of migrainous vertigo was 7% in the dizziness clinic group, and 9% in the migraine clinic group. In 15 of 33 patients with migrainous vertigo, vertigo was regularly associated with migrainous headache. In 16 patients, vertigo occurred both with and without headache, and in two patients headache and vertigo never occurred together. The duration of attacks varied from minutes to days. CONCLUSION: These results substantiate the epidemiologic association between migraine and vertigo and indicate that migrainous vertigo affects a significant proportion of patients both in dizziness and headache clinics.

Adult↗
PubMed1996

Vertigo of cerebrovascular origin proven by CT scan or MRI: pitfalls in clinical differentiation from vertigo of aural origin.

To get a better insight into the clinical differentiation between vertigo of cerebrovascular origin and of aural origin, we investigated radiologically proven stroke patients who presented with vertigo as an initial clinical manifestation. Of 154 stroke patients, 30 patients with vertigo (20%) had the relevant lesion, demonstrated with the initial computerized tomographic scan (13 patients) or the follow-up magnetic resonance imaging (MRI) study (17 patients) of the brain. Every lesion was in the vertebrobasilar arterial territory; 19 in the cerebellum, 8 in the pons, and 3 in the medulla oblongata. Although 12 of the 30 patients (40%) presented with vertigo in isolation at the onset of stroke, eight patients (27%) developed additional neurologic abnormalities from four hours to seven days later. Patients with isolated vertigo (13%) had the small lesion exclusively in the cerebellum of the PICA medial branch territory. The most frequent accompanying neurological sign was swaying in the cerebellar and medullary lesion, and dysarthria in the pontine lesion. The direction of nystagmus or swaying did not match the lesion side in some patients. Our findings suggest that cerebellar stroke may commonly manifest isolated vertigo or vertigo with swaying mimicking labyrinthine disorder, particularly at the onset of the disease. MRI study and tests for truncal ataxia and lateropulsion may be crucial for the detection of vertigo of cerebrovascular origin.

Adult↗
PubMed2000

Vertigo in patients with benign paroxysmal positional vertigo.

We retrieved information on 59 patients, 19 men and 40 women, with benign paroxysmal positional vertigo (BPPV) from the database of the otoneurologic expert system (ONE). The original number of patients was greater, but we excluded all those with hearing loss of any origin. The patients filled in a questionnaire concerning their symptoms, earlier diseases, accidents and tobacco and alcohol use. This information was then integrated with results of audiometric, otoneurologic and imaging studies. The mean age at onset of symptoms was 44 years. Most patients had had vertiginous spells for < 1 year. None of the patients had hearing loss. Tinnitus was experienced by 32% of patients, and these patients experienced more anxiety than the others [r(53) = 0.40, p < 0.01]. The mean duration of the vertigo attacks ranged from a few seconds to 5 min, and they were fairly mild (26%) or moderate (41%) in intensity. The attacks were perceived as more intense if vertigo was rotational [r(54) = 0.60, p < 0.01] or if it was accompanied by nausea [r(58) = 0.42, p < 0.01]. Patients with headache had more intense attacks [r(58) = 0.36, p < 0.01]. The vertigo attacks occurred in spells; patients had several attacks a week (23%) or during the course of 1 day (52%). The vertigo was rotational in 80% of patients, and 47% experienced a floating sensation. The floating vertigo was most often provoked by pressure changes [r(54) = 0.41, p < 0.01] or changes in visual surroundings [r(54) = 0.52, p < 0.01].

Adult↗
PubMed1997

["Phobic postural vertigo". A further differentiation of psychogenic vertigo conditions seems necessary].

Due to the results of an interdisciplinary study on patients with vertigo as the chief symptom and on the background of psychodynamic theories concerning anxiety disorders the term of phobic postural vertigo (Brandt & Dieterich 1986) is discussed. It becomes obvious that phobic postural vertigo is a generalizing term which encompasses different forms of psychogenic vertigo. The authors plead for a more differentiated diagnosis and subgroup oriented classification of vertigo caused by psychiatric disorders.

Adolescent↗
PubMed2002

The test and treatment methods of benign paroxysmal positional vertigo and an addition to the management of vertigo due to the superior vestibular canal (BPPV-SC).

A review of the tests and treatment manoeuvres for benign paroxysmal positional vertigo of the posterior, horizontal and superior vestibular canals is presented. Additionally, a new way to test and treat positional vertigo of the superior vestibular canal is presented. In a prospective study, 57 out of 305 patients' visits are reported. They had residual symptoms and dizziness after the test and the treatment of benign paroxysmal positional vertigo of the horizontal canal (BPPV-HC) and posterior canal (PC). They were tested with a new test and treated with a new manoeuvre for superior canal benign paroxysmal positional vertigo (BPPV-SC). Results for vertigo in 53 patients were good; motion sickness and acrophobia disappeared. Reactive neck tension to BPPV was relieved. Older people were numerous among patients and their quality of life (QOL) improved.

Adult↗
PubMed2000

Psychological findings in benign paroxysmal positional vertigo and psychogenic vertigo.

OBJECTIVE: A prospective study conducted at the Post Graduate Institute of Medical Education and Research, Chandigarh, India, to study the psychological factors in cases of benign paroxysmal positional vertigo (BPPV) and to compare them with patients with psychogenic vertigo. METHODS: In the present study, 75 subjects each (25-45 years) with BPPV and psychogenic vertigo were compared with an equal number of age- and sex-matched normal controls using the psychological and audiovestibular test batteries. RESULTS: The psychological variables tested, namely, loneliness, depression, anxiety components, introversion, and social desirability, were found to be statistically significant (p < .01) for the three groups (i.e., BPPV, psychogenic, and control). There was no significant difference among the three groups on the audiovestibular measures. CONCLUSION: Psychological factors play an important role in patients with BPPV. The provoking activities result in precipitation of an acute attack and the patients experience heightened emotionality because of the incapacitating feeling of severe vertigo.

Acute Disease↗
PubMed1980

The efficacy of piracetam in vertigo. A double-blind study in patients with vertigo of central origin.

In a double-blind trial according to a switchback design with 4 periods of one week each a comparison was made between the effects of piracetam and a placebo. In 22 patients with vertigo of central origin (posttraumatic, psychogenic, ecileptogenic and hypertensive vertigo were excluded) piracetam was found to significantly reduce symptoms. On anamnestic examination the patients noted the effect of both substances on vertigo, motility disturbances, vitality and sleep. Piracetam was found to have a significant effect on the first three. The effect of piracetam is explained by an enhanced control of the cerebral cortex on the subordinated vestibular centers, in agreement with findings in the literature on animal and human pharmacology.

Adult↗
PubMed1999

Relationship between physical and psychosocial dysfunction in Mexican patients with vertigo: a cross-cultural validation of the vertigo symptom scale.

The Vertigo Symptom Scale (VSS) was designed to assess and differentiate symptoms of: (a) balance disorder; and (b) somatic anxiety and autonomic arousal in patients complaining of dizziness and vertigo. Although it has been translated for use in countries other than the UK, where it was originally developed, its validity in different languages and cultures has not previously been evaluated. This study examined the structure, reliability, and discriminative power of a Spanish translation of the VSS administered to a Mexican sample of 172 dizzy patients and 40 healthy controls. Scores on the two subscales of the VSS not only discriminated between patients and controls, but were also sensitive to differences between patient groups classified on the basis of diagnosis, test results, and occupational disability. The pattern of intercorrelations between symptoms, anxiety, depression, and handicap in the Mexican sample was almost identical to that observed in the original UK sample.

Adult↗
PubMed1981

Vertigo originating from inflammation of the paranasal sinuses (the so-called sinugenic vertigo).

A routine X-ray examination of the sinuses of a patient complaining of regular bouts of dizziness may provide diagnostic information about a so-called sinugenic vertigo. In addition to the pathological X-ray findings in the maxillary sinuses, the patients presented either a positioning nystagmus or a head-shaking nystagmus, with disturbed vestibular spinal reaction as a pathological vestibular condition. Out of 15 patients in whom a sinusitis-induced (sinugenic) dizziness was diagnosed and who appeared regularly for the control checks, 14 patients said that they were relieved of the dizziness as a result of sinus therapy, often immediately afterwards. Interrelationships possibly exist between pathological trigeminus reflexes via the sphenopalatine ganglion brought about by maxillary sinusitis and a reflectory labyrinthine irritation, triggering the vertigo.

Humans↗
PubMed1997

["Zurich Vertigo Meeting"--phobic postural vertigo].

Phobic postural vertigo has been described as a syndrome that is distinguishable from agoraphobia, acrophobia, and "space phobia". Closely related to locomotion, it is characterized by a combination of nonrotational vertigo with subjective postural and gait instability mainly in patients with an obsessive-compulsive personality. The monosymptomatic disturbance of balance manifests with superimposed attacks that occur with and without recognizable provoking factors in the same patient and are experienced with and without accompanying excess anxiety, misleading both patient and physician to a false diagnosis of organic disease.

Diagnosis, Differential↗
PubMed1996

Postural vertigo. Quick relief from the postural vertigo component of vestibular diseases.

Patients who had disorders of the vestibular system with a component of benign postural vertigo as a symptom were studied, using an examination table suitable for the canalith (otolith) repositioning maneuver as described by Epply, followed by lack of recumbency for 48 hours. The patients regularly had resolution or decreased intensity of symptoms, as did those described by Epply. A repeated positioning maneuver may be needed in some of the patients. The application of a vibrator, as previously described has not been found to be essential.

Humans↗
PubMed2000

[Psychogenic vertigo incapacitates patients longer. What psychiatric illnesses might manifest as vertigo].

Dizziness is a common symptom that, despite extensive medical evaluation, often remains unexplained. Psychiatric or psychosomatic disorders underlie the condition in 30-55% of the cases. The most common disturbances are phobic and anxiety disorders, followed by dissociative, depressive and somatoform disorders. The assessment of psychiatric and psychosomatic symptoms should always be included in the neuro-otological examination of dizziness. Early interdisciplinary treatment should be initiated with the aim of preventing chronification of psycho-genetic vertigo.

Diagnosis, Differential↗
PubMed1998

[Benign paroxysmal vertigo or benign postural vertigo].

This paper defines the benign paroxysmal vertigo (BPV). It recalls the etiopathogenicity of this syndrome and describes the different types of BPV and their treatment by "liberatory maneuvers". The paper also discusses the need for an otoneurological examination to reach an exact diagnosis.

Adult↗