Expanding the Differential Diagnosis of Chronic Dizziness

Staab, Jeffrey P.; Ruckenstein, Michael J.

doi:10.1001/archotol.133.2.170

Cited by 185 publications

(158 citation statements)

References 16 publications

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“…Therefore, dizziness in elderly is not necessarily associated with vestibular disease. Special attention should be paid to proprioceptive alterations, which are mentioned as being the primary cause for imbalance in 7% of the aged population (10,22).…”

Section: Discussionmentioning

confidence: 99%

Presbivertigem como causa de tontura no idoso

Felipe

Cunha

et al. 2008

Pró-Fono R. Atual. Cient.

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INTRODUÇÃO: tontura é queixa freqüente na população geriátrica e interfere na qualidade de vida desses indivíduos. OBJETIVO: descrever as causas de tontura, correlacionar sintomas e alterações na prova calórica e verificar o impacto da presbivertigem como fator primário de tontura em população de idosos. MÉTODO: revisão do prontuário de 132 pacientes com mais de 60 anos e distúrbio do equilíbrio corporal, atendidos no ambulatório de Otoneurologia do Hospital das Clínicas da UFMG, no período de 1998 a 2007. As variáveis analisadas foram: dados epidemiológicos, história clínica, doenças associadas e resultado da prova calórica. Casos de vertigem de posição e suspeita de lesão central foram excluídos da análise. RESULTADOS: A amostra constou de 120 pacientes. A idade média foi de 70 anos, sendo 87 (71%) mulheres. Dentre os tipos de tontura, vertigem de alguns minutos de duração e freqüência diária foi mais freqüente. Em relação ao resultado da prova calórica, exame normal foi observado em 73% e, dentre os resultados alterados, hiporreflexia bilateral (presbivertigem) foi observada em 8%. Correlacionando-se com o tipo de tontura, hiporreflexia bilateral associou-se com instabilidade postural (p = 0,006; IC = 2 - 419). CONCLUSÃO: tontura no idoso tem causa multifatorial. Perda da função vestibular periférica pode estar relacionada à presbivertigem e deve ser considerada em pessoas idosas com desequilíbrio. Distúrbios metabólicos, psíquicos, disautonômicos, ortopédicos, visuais e de propriocepção podem ser causa de tontura em idosos com exame vestibular normal.

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Section: Discussionmentioning

confidence: 99%

Presbivertigem como causa de tontura no idoso

Felipe

Cunha

et al. 2008

Pró-Fono R. Atual. Cient.

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“…This clinical diagnosis was similar in many ways to PPV, but focused primarily on physical not psychological symptoms. Table 1 Features of PPV, SMD, VV, and CSD that informed the definition of PPPD PPV [13] SMD [39] VV [15] CSD [79,81] Primary Symptoms (criteria A. [76] Included in the definition of CSD were persistent nonvertiginous dizziness or unsteadiness, heightened sensitivity to motion of self or objects in the environment, and difficulty performing tasks that required precise visual focus.…”

Section: Contemporary Contextmentioning

confidence: 99%

“…The earliest reports of VV [15] also focused on situational symptoms, though recent investigations identified a link between persistent VV and chronic dizziness [22,23]. Definitions of CSD [75,79] emphasized chronic symptoms lasting throughout the day and exacerbated by motion stimuli. One study found that symptoms of CSD were absent or mildest for about an hour after patients awoke in the morning, but then increased as the day progressed [27].…”

Section: Temporal Pattern Of Symptomsmentioning

confidence: 99%

“…Smaller visual targets (e.g., books, mobile electronic devices) may be troublesome when held at a close distance. Performing tasks that require precision visual focus (e.g., using a computer, or watching television) may exacerbate symptoms even when patients are sitting still [75,79,81]. The increasing need to view information on electronic screens in the modern world is a bane for many patients with PPPD.…”

Section: Visual Stimulimentioning

confidence: 99%

“…The differential diagnosis of PPPD includes chronic sequelae of acute precipitants, recurrent attacks of episodic precipitants, ongoing manifestations of chronic precipitants, other chronic vestibular syndromes, medical or psychiatric disorders that produce persistent unsteadiness or dizziness, and adverse effects of regularly consumed prescription or non-prescription medications [13,15,24,79], as discussed in turn below.…”

Section: Differential Diagnosismentioning

confidence: 99%

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Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society

Staab

Eckhardt-Henn

Horii

et al. 2017

VES

Self Cite

582

571

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Abstract. This paper presents diagnostic criteria for persistent postural-perceptual dizziness (PPPD) to be included in the International Classification of Vestibular Disorders (ICVD). The term PPPD is new, but the disorder is not. Its diagnostic criteria were derived by expert consensus from an exhaustive review of 30 years of research on phobic postural vertigo, space-motion discomfort, visual vertigo, and chronic subjective dizziness. PPPD manifests with one or more symptoms of dizziness, unsteadiness, or non-spinning vertigo that are present on most days for three months or more and are exacerbated by upright posture, active or passive movement, and exposure to moving or complex visual stimuli. PPPD may be precipitated by conditions that disrupt balance or cause vertigo, unsteadiness, or dizziness, including peripheral or central vestibular disorders, other medical illnesses, or psychological distress. PPPD may be present alone or co-exist with other conditions. Possible subtypes await future identification and validation. The pathophysiologic processes underlying PPPD are not fully known. Emerging research suggests that it may arise from functional changes in postural control mechanisms, multi-sensory information processing, or cortical integration of spatial orientation and threat assessment. Thus, PPPD is classified as a chronic functional vestibular disorder. It is not a structural or psychiatric condition.

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2009

Selfhood, Identity and Personality Styles

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Expanding the Differential Diagnosis of Chronic Dizziness

Abstract: To improve treatment outcomes for patients with chronic dizziness by identifying clinical conditions associated with persistent symptoms and delineating key diagnostic features that differentiate its causes and direct attention to specific treatments.

Cited by 185 publications

References 16 publications

Presbivertigem como causa de tontura no idoso

Presbivertigem como causa de tontura no idoso

Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society

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