Vestibular dysfunction in adult patients with osteogenesis imperfecta (original) (raw)
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Acta Otorrinolaringologica (English Edition), 2008
There are many different vertigo classifications and different denominations are frequently used for the same clinical processes. The Otoneurology Committee of the Spanish Society for Otorhinolaryngology and Head and Neck Pathology proposes an eminently practical classification of peripheral vertigo to facilitate a common terminology that can be easily used by general ENT practitioners. The methodology used has been by consensus within our society and especially among the most outstanding work groups in the area of otoneurology in Spain. Initially vertigo is divided into single-episode vertigo and recurring attacks of vertigo, and these are then sub-divided into 2 groups, depending on whether or not hearing loss is present. Acute vertigo without hearing loss corresponds to vestibular neuritis and if it is associated with hearing loss, it is due to labyrinthitis of different aetiologies and cochleovestibular neuritis. Recurrent vertigos without hearing loss are classified as induced, either by posture (BPPV) or pressure (perilymphatic fistula), or as spontaneous, including migraine-associated vertigo, metabolic vertigo, childhood paroxysmal vertigo, and vertigo of vascular causes (TIAs, vertebrobasilar insufficiency). Finally, recurrent vertigo with hearing loss includes Ménière's disease and others such as vertigomigraine (with hearing loss), autoimmune pathology of the inner ear, syphilitic infection, and perilymphatic fistula (with hearing loss).
International Journal of Audiology, 2012
Objectives: Vertigo can be a manifestation of underlying vertebrobasilar stroke in older adults. The study objectives were to investigate the correlation, sensitivity, and specifi city of the auditory brainstem response (ABR), electronystagmorgraphy (ENG), and transcranial Doppler (TCD) collectively to distinguish between vertigo due to vertebrobasilar insuffi ciency (VBI) and vertigo due to non-VBI. Design: Prospective experimental study comparing ENG, ABR, and TCD battery fi ndings between two groups of patients with vertigo and a control group. Study sample: Participants included 14 patients with vertigo of VBI origin, 14 patients with vertigo of non-VBI, and 11 matched controls. Results: Participants with VBI had more abnormal fi ndings in the ENG (86%), TCD (72%), and ABR (64%) compared to the non-VBI group (64%, 21%, and 7%, respectively) and the control group. The combined battery revealed positive correlations, 64% sensitivity, and 84% positive predictive value (PPV) in the VBI group, and 100% specifi city with lack of correlations in the non-VBI group. Conclusions: The modest sensitivity and PPV helps with early detection of VBI, thus preventing risk of vertebrobasilar stroke in 84% to 64% of patients. The 100% specifi city in the non-VBI group rules out VBI, thus reducing the referral rate for unnecessary, diagnostic evaluations and ineffective treatment. Key Words: Vertigo; vertebrobasilar insuffi ciency (VBI); electronystagmography (ENG); transcranial Doppler (TCD); auditory brainstem response (ABR); pulsatility index (PI); mean fl ow velocity (MFV); posterior inferior cerebellar artery (PICA) Correspondence: Wafaa A. Kaf,
Cureus
Introduction: Vertigo/dizziness is defined as disturbed postural awareness and could range from a feeling of sensation of spinning of self or surrounding. Dizziness or disturbed postural awareness is a common presentation in varying age groups. Vertigo has varied clinical presentations. Classically, there are four vertigo syndromes: vertigo, imbalance/disequilibrium, presyncope/lightheadedness, and psychogenic dizziness. The present study was conducted to examine the various etiologies involved in these syndromes and to help unmask the overlaps between them. This study also aimed to further classify the etiologies underlying these vertigo syndromes and overlaps into peripheral or vestibular, central, and non-vestibular. This would help develop a comprehensive management protocol for vertigo of any origin. Methods: A prospective observational cross-sectional study was undertaken in a rural hospital in Central India. We studied patients with giddiness and categorized them into vertigo syndromes according to the site of origin of vertigo. We also compared overlaps in the presentation of vertigo. Results: Out of the 80 patients that were studied, vertigo with disequilibrium was observed in 72.50% of the patients. Non-vestibular vertigo of cervicogenic origin was the common cause of vertigo seen in 36.25% of the patients occurring alone or in association with vestibular vertigo. Among patients with overlaps, vestibular vertigo with non-vestibular vertigo was the most common etiology observed in 89.65% of the patients with overlaps. Conclusion: The syndrome of "vertigo with disequilibrium" was the commonest presentation in the patients studied, followed by "vertigo syndrome" as an isolated symptom, not associated with "disequilibrium." Ours is probably the first study to report this observation of overlaps of two syndromes, with diagnostic implications.
Neuro-otological profile of Episodic Vertigo
1994
Episodic Vertigo Comprises a large group of patients seen in any neurootology unit. A total of 118 subjects were reviewed who attended the neurootology unit. Vertigo of shorter duration was noted in 78 and of longer duration in 40 cases. 51 cases showed bilateral neurosensory deafness, 15 cases had bilateral and another one case had unilateral conductive loss. Spinovestibular tests were abnormal in all cases of vertigo of short duration but only 29 cases showed abnormal reflex in patients with a long duration of illness. Thermal vestibulometry revealed hyporeflexia in 33 cases, directional preponderance in 30 cases and 4 cases showed hyperreflexia 28 cases had peripheral lesions while 81 cases had central lesions. The acute cases showed significant improvement on follow up except cases with abnormality in thermal vestibulometry . The cases with positional nystagmus showed improvement with head and body balance exercises expect in those who received treatment with vestibulosedative and vestibular suppersive drugs. Hearing loss remained the same except in patients with middle ear disorders.
Osteopenia and osteoporosis in idiopathic benign positional vertigo
Neurology, 2009
Objective: Causes of benign positional vertigo (BPV) are mostly unknown. The aim of this study was to elucidate an association of osteoporosis with idiopathic BPV. Methods: Two hundred nine consecutive patients with a confirmed diagnosis of idiopathic BPV underwent bone mineral densitometry of anterior-posterior lumbar spine and femur. The T scores were compared with those of 202 controls without a history of dizziness. Recurrence was defined when the patients reported two or more previous episodes of positional vertigo similar to those experienced at the time of diagnosis. Results: In both women and men, the lowest T scores were decreased in patients with BPV compared with those in controls. Furthermore, the prevalences of osteopenia (Ϫ2.5 Ͻ T score Ͻ Ϫ1.0) and osteoporosis (T score ՅϪ2.5) were higher in both women and men with BPV than in controls. Multiple logistic regression analyses adjusted for age, sex, alcohol, smoking, and hyperphosphatemia showed that only the existence of osteopenia/osteoporosis was associated with an increased risk of BPV (adjusted odds ratio of osteopenia ϭ 2.0, 95% confidence interval 1.2-3.4, p ϭ 0.011; adjusted odds ratio of osteoporosis ϭ 3.1, 95% confidence interval 1.4-7.2, p ϭ 0.007). In women aged Ն45 years, the lowest T scores were also decreased in the recurrent group, compared with those in the de novo group. Conclusion: Osteopenia/osteoporosis may be associated with idiopathic benign positional vertigo (BPV). The effectiveness of measuring bone mineral densitometry and restoring normal calcium metabolism for preventing recurrences of BPV requires further validation. Neurology ® 2009;72: 1069-1076 GLOSSARY BMD ϭ bone mineral density; BPV ϭ benign positional vertigo; BPV-AC ϭ BPV involving the anterior canal; BPV-HC ϭ BPV involving the horizontal canal; BPV-PC ϭ BPV involving the posterior canal.
Vertigo. A neurobiological review
2004
Dizziness is one of the most common presenting symptoms in clinical practice. Yet, the meaning of this symptom is patient-dependent and can span from true vertigo due to vestibular dysfunction to syncope or vertebro-basilar stroke. This review addresses the neurobiological background of vertigo and the most common syndrome of benign paroxysmal positional vertigo, with an outline of the approach towards localization and management of the acute vertiginous patient.
Malaysian Journal of Medicine and Health Sciences
Introduction: Vertigo is estimated to occur in 3% of adults every year. In contrast to dizziness, vertigo is associated with symptoms of peripheral or central balance disorders, while dizziness is associated with cardiovascular, neuropathic, neuromuscular, or psychosomatic diseases. Methods: Data for 123 patients at Hospital were taken retrospectively. The variables studied were demographic data, vestibular examination, audiometry, and vertigo diagnosis. Results: There were 123 vertigo patients consisting of 42 men and 81 women. The average age of the patients was 48.46 years. Most patients were diagnosed with other peripheral vertigo 37.40%, then unspecified disorder of vestibular function 15.45%, BPPV 14.63%, Meniere’s disease 8.94%, dizziness 8.94%, central vertigo 8.13%, and vestibular neuritis 6.50%. The types of hearing loss were Conductive Hearing loss (CHL) 6.10%, Sensorineural Hearing Loss (SNHL) 21.54%, and Mixed Hearing Loss (MHL) 11.38%. Location of hearing loss was unil...