Diagnosis and Management of Dizziness and Vertigo

Chawla, Nancy; Olshaker, Jonathan S.

doi:10.1016/j.mcna.2005.11.003

Cited by 61 publications

(45 citation statements)

References 21 publications

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“…1,2 Specific treatment, such as diuretics along with dietary salt restriction, is used to prevent the expansion of endolymphatic volume in Ménière disease. 1,2 Antibiotics have a role in the treatment of bacterial labyrinthitis and otitis media-induced vertigo. 2 Glucocorticoid therapy has been employed in inflammation-induced vestibular dysfunction, vestibular neuritis, and Ménière disease.…”

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confidence: 99%

“…1,2 Antibiotics have a role in the treatment of bacterial labyrinthitis and otitis media-induced vertigo. 2 Glucocorticoid therapy has been employed in inflammation-induced vestibular dysfunction, vestibular neuritis, and Ménière disease.…”

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confidence: 99%

“…SECTION 2 The differential diagnoses of vertigo can encompass several etiologies (table e-1 at Neurology.org). [1][2][3] The priority in the neurologist's evaluation of vertigo is to distinguish peripheral from central causes.…”

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confidence: 99%

“…2,4,5 In addition, spontaneous nystagmus from central lesions is often persistent, with lack of suppression on fixation, and may continue for weeks to months. 5 Alternate eye cover testing can uncover ocular vertical misalignment, or skew deviation, which has been linked to lateral medulla and pontine ischemic strokes.…”

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Clinical Reasoning: Labyrinthine hemorrhage

Parikh¹,

Frank

2017

Neurology

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A 65-year-old man presented with a 2-week history of worsening vertigo. The sensation of vertigo was constant and exacerbated by turning in bed, sitting, and standing. Exacerbations lasted 5-10 minutes and were intense enough to cause gait impairment. Two days prior to presentation, the vertigo had worsened in severity and was associated with one episode of nausea and vomiting. Review of systems was positive for a 3-month history of a whistling noise in the patient's left ear, a 2-week history of acute-on-chronic left-sided hearing impairment, and a recent upper respiratory infection.The patient's medical history was notable for a left radical mastoidectomy performed 14 years prior to presentation for treatment of complications of chronic otitis media, which resulted in chronic leftsided hearing impairment. Medical history also included hepatitis C and remote alcohol and heroin abuse.Questions for consideration:

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Clinical Reasoning: Labyrinthine hemorrhage

Parikh¹,

Frank

2017

Neurology

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“…In Benign Paroxysmal Positional Vertigo, there is usually a latent phase and the vertigo only last for a few seconds (5-10secs), in the migraine type, it usually can last from some minutes to a few hours. Whereas in Meniere's disease, it may last for hours and in vestibular neuronitis it usually lasts for days [4]. The prevalence of vertigo ranges from 20-30% in the USA [5], 4.9-21% in UK [6], 5% in Germany [7], 18.6% and 24.6% in two separate studies involving elderly patients in South Western Nigeria [8,9].…”

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confidence: 99%

Aetiology of Vertigo as Seen at the Federal Medical Center Lokoja, North Central Nigeria

Ogah¹

2017

SJMS

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Background: Human beings are able to maintain their balance from a combination of proprioceptive, graviceptive, visual and the vestibular inputs integrated by the central nervous system. Hence, symptoms of imbalance can arise whenever there is a defect either in these peripheral sensors or the modulating central nervous system. The prevalence of vertigo is 20-30% and it is a major health issue all over the world. Objectives: To determine the prevalence and causes of vertigo in Federal Medical Center Lokoja, North Central Nigeria. Materials and Methods: This is a 3-year retrospective hospital based study undertaken in the ENT Unit of the Department of Surgery Federal Medical Centre, Lokoja. From the hospital Medical Records, patients' files were retrieved. Data about their age, sex, occupation, presentation, treatment modality and outcome were extracted, studied and analyzed. Results: Three thousand two hundred and fourteen patients were seen and 65 of them had vertigo with a prevalence of 2.0%. Fifteen files had incomplete information and were not include in the study. The remaining 50 patients' files that were reviewed, consisted of 32 males (64%) and 18 females (36%). Male to female ratio was 1.8:1 and a mean age of 24.8 years. Bengin Paroxysmal Positional Vertigo (BPPV) 22(44%) was the commonest aetiology found followed by Meniere's disease 8(16%), trauma 7(14%) and Vestibular Neuronitis 5(10%) respectively.

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