Central Vertigo and Dizziness

Karataş, Mehmet Baran

doi:10.1097/nrl.0b013e31817533a3

Cited by 204 publications

(74 citation statements)

References 70 publications

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“…All patients in this series had complete resolution of their vertigo. Although vertigo is commonly present with VS, it does not improve significantly after surgical or SRS intervention (11), medical management of vertigo should be attempted before intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, the presence of mild vertigo symptoms is not uncommon, with 10 to 19% of VS patients presenting with vertigo as a primary symptom. The underlying mechanism is attributed to the VS growing into the internal auditory canal and impinging on the eight nerve, cerebellum, and/or pons (11). Furthermore, the VS can cause secondary hydrocephalus and vestibular changes, which can result in vertiginous episodes.…”

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confidence: 99%

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Vertigo in Vestibular Schwannoma Patients Due to Other Pathologies

Sahyouni

Moshtaghi²,

Haidar³

et al. 2017

Otology &Amp; Neurotology

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Objective: To report findings from a cohort of vestibular schwannoma (VS) patients presenting with vertigo from a secondary comorbid vestibular disorder; and to discuss management strategies for this subset of patients presenting with both episodic vertigo and VS. Patients: All VS patients who presented with vertigo as the primary symptom from 2012 to 2015 and endorsing no other major complaints were examined. Intervention: Treatment with migraine lifestyle and prophylactic therapy, or Epley maneuver. Main Outcome Measure: Resolution of vertigo following medical treatment alone. Results: Of the nine patients studied, seven (78%) suffered from vestibular migraine, and two (22%) experienced benign positional vertigo. All patients experienced complete resolution of symptoms after treatment. As a result of symptomatic improvement, seven patients (78%) avoided surgery in favor of observation, while two patients (22%) underwent radiosurgery due to continued tumor growth and other nonvertigo symptoms. Conclusion: VS patients can sometimes present with a history of recurrent episodic vertigo. The etiology of the vertigo could be due to the tumor itself or may be due to an underlying comorbidity such as vestibular migraine or benign positional vertigo. VS patients presenting with vertigo should undergo a standard vertigo history and examination to identify other potential causes of vertigo. Most VS patients in our cohort avoided intervention and had resolution of their vertigo.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Vertigo in Vestibular Schwannoma Patients Due to Other Pathologies

Sahyouni

Moshtaghi²,

Haidar³

et al. 2017

Otology &Amp; Neurotology

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“…[1] While otological, central, somatosensorial, and visual factors may cause vertigo, central causes are responsible in one-quarter of the cases. [2] Semicircular canals, saccule, utricle, and the vestibular nerve create the peripheral vestibular system. Vestibular nucleus, cerebellum, cerebral peduncle, the spinal cord, and vestibular cortex create the central vestibular system.…”

Section: Introductionmentioning

confidence: 99%

Vertebrobasilar system computed tomographic angiography in central vertigo

Paşaoğlu

2017

Medicine

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The incidence of vertigo in the population is 20% to 30% and one-fourth of the cases are related to central causes. The aim of this study was to evaluate computed tomography angiography (CTA) findings of the vertebrobasilar system in central vertigo without stroke.CTA and magnetic resonance images of patients with vertigo were retrospectively evaluated. One hundred twenty-nine patients suspected of having central vertigo according to history, physical examination, and otological and neurological tests without signs of infarction on diffusion-weighted magnetic resonance imaging were included in the study. The control group included 120 patients with similar vascular disease risk factors but without vertigo. Vertebral and basilar artery diameters, hypoplasias, exit-site variations of vertebral artery, vertebrobasilar tortuosity, and stenosis of ≥50% detected on CTA were recorded for all patients. Independent-samples t test was used in variables with normal distribution, and Mann–Whitney U test in non-normal distribution. The difference of categorical variable distribution according to groups was analyzed with χ2 and/or Fisher exact test.Vertebral artery hypoplasia and ≥50% stenosis were seen more often in the vertigo group (P = 0.000, <0.001). Overall 78 (60.5%) vertigo patients had ≥50% stenosis, 54 (69.2%) had stenosis at V1 segment, 9 (11.5%) at V2 segment, 2 (2.5%) at V3 segment, and 13 (16.6%) at V4 segment. Both vertigo and control groups had similar basilar artery hypoplasia and ≥50% stenosis rates (P = 0.800, >0.05).CTA may be helpful to clarify the association between abnormal CTA findings of vertebral arteries and central vertigo.This article reveals the opportunity to diagnose posterior circulation abnormalities causing central vertigo with a feasible method such as CTA.

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“…Dizziness is one of the most frequent symptoms encountered in medical practice [1,2], with a prevalence of approximately 20-30% [2-4]. Dizziness is more common in women [2,5].…”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life and emotional distress in patients with dizziness: a cross-sectional approach to disentangle their relationship

Weidt

Bruehl

Straumann

et al. 2014

BMC Health Serv Res

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BackgroundDizziness is frequently encountered in medical practice, often takes a chronic course and can impair the health related quality of life (HRQoL). However results on the extent of this impairment of HRQoL are mixed. Furthermore, the relationship between dizziness and the HRQoL is only partially understood. The role of clinical symptoms of dizziness and psychosocial factors such as emotional distress on this relationship is for the most part unknown.MethodsThe cross-sectional study evaluated the HRQoL in 203 patients suffering from dizziness, using the Medical Outcomes Studies 36-Item Short-Form Health-Survey (SF-36). The results were correlated with the severity of dizziness, using the Dizziness Handicap-Inventory (DHI), with emotional distress, using the Hospital Anxiety and Depression-Scale (HADS) and with further clinical symptoms and psychosocial parameters. In a multivariate hierarchical regression analysis associated variables which explain significant variance of the mental and physical HRQoL (MCS-36, PCS-36) were identified.ResultsPatients suffering from dizziness showed a markedly reduced mental and physical HRQoL. Higher DHI and HADS scores were correlated with lower MCS-36 and PCS-36 scores. Taken together DHI and vertigo characteristics of dizziness explained 38% of the variance of PCS-36. Overall explained variance of PCS-36 was 45%. HADS and living with a significant other explained 66% of the variance of MCS-36 (overall variance explained: 69%).ConclusionBoth the physical and mental HRQoL are significantly impaired in patients with dizziness. While the impairment in PCS-36 can be explained by clinical symptoms of the dizziness, MCS-36 impairment is largely associated with psychosocial factors. To improve the patient’s overall well-being significantly and permanently doctors have to keep in mind both, the clinical symptoms and the psychosocial factors. Therefore, in addition to the physical examination doctors should integrate a basic psychological examination into the daily routine with dizziness patients.

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Central Vertigo and Dizziness

Cited by 204 publications

References 70 publications

Vertigo in Vestibular Schwannoma Patients Due to Other Pathologies

Vertigo in Vestibular Schwannoma Patients Due to Other Pathologies

Vertebrobasilar system computed tomographic angiography in central vertigo

Health-related quality of life and emotional distress in patients with dizziness: a cross-sectional approach to disentangle their relationship

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