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Vertigo
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
Rehabilitation for vertigo is often a lengthy process, but many people with this condition do improve over time. One frequently used treatment is called vestibular rehabilitation therapy which is a series of exercises that helps people experiencing vertigo to partially recover—although it is possible that the treatment will be less effective for someone with central vertigo compared to someone with peripheral vertigo (Han et al., 2011). Depending on where the damage is that caused the central vertigo, there can still be a benefit to physical therapy to retrain balance, such that the person feels more able to balance after the therapy (Brown et al., 2006).
Neurological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Blackouts are transient attacks of loss of consciousness during attacks. Dizziness can mean light-headedness, or vertigo, or a general feeling of unsteadiness. Labyrinthine disorders cause only vertigo, nausea and nystagmus.Brainstem lesions cause diplopia, dysarthria, dysphagia, blurred vision, quadriparesis or cranial nerve palsies in addition to vertigo.Cerebellar lesions may cause unsteadiness, imbalance or ‘walking as if drunk’, but not vertigo.Presyncope comprises light-headedness, faintness, sweating and pallor, which may be relieved by lying flat.Complex partial seizures may be accompanied by déjà vu, altered smell and/or taste, and vivid memories. Stereotyped movements (e.g. lip smacking), automatisms and an open-eyed trance-like state last a few minutes.Absence seizures may be accompanied by fluttering of the eyelids.
Dizziness
Published in Henry J. Woodford, Essential Geriatrics, 2022
A wide range of medications has been tried in the management of vertigo with varying success.12 Options include histamine receptor antagonists (e.g. cyclizine [H1] and betahistine [H3]). However, betahistine has not been shown to be effective for symptom control in Ménière's disease.13 These drugs may have a role in the short-term management of vertigo but prolonged use should be avoided and may actually worsen symptoms. Some also have anticholinergic effects. Reported adverse effects include sedation, confusion and dizziness. Newer antihistamine agents that are used in the management of allergies, such as loratadine, have fewer anticholinergic effects but do not cross the blood-brain barrier and so are not useful in the management of vertigo. Trialling over a period of no longer than three days is reasonable.8 Deprescribing should be considered for chronic users.
Vertigo with upbeat nystagmus shortly after exposure to a small amount of organic solvent
Published in Acta Oto-Laryngologica Case Reports, 2023
A previous epidemiological study reported that approximately 30% of vertigo cases were triggered by peripheral causes and 20% by central causes, while approximately 22% had an unknown cause [8]. This study’s findings show that the cause of vertigo is often unknown despite neuro-otological investigation. Many cases of vertigo also improve during the natural course of the disease: this may be one reason the condition has not been sufficiently investigated. Based on our experience, we believe it is important to actively question patients with unexplained vertigo about their exposure to organic solvents, including their occupational history. Although the symptoms of organic solvent poisoning, such as vertigo, may be irreversible [3], in this case, the patient showed improvement after six months of treatment, which may have been because of the low level of exposure. Therefore, patients with unexplained vertigo and a history of exposure to organic solvents should be advised to avoid such situations in the future to prevent exacerbation or recurrence of clinical symptoms and signs.
Studying subjective hearing loss in older adults measured by speech, spatial, and quality of hearing scale within the framework of the ICF core set for hearing loss
Published in Hearing, Balance and Communication, 2022
The International Society for Neuro-otology, known as the Barany Society, highlighted that dizziness is a subjective perception of disorientation or involuntary motion that occurs during head or body movement or when head or body is still. Dizziness can be further characterized as light-headedness, which is the sensation of the impending loss of consciousness associated with transient diffuse cerebral hypoperfusion, or as vertigo, which is the false sensation that the body of the environment is spinning. While the causal factors for light-headedness typically include cardiovascular disease or neurovascular disease, the causal factors for vertigo typically include otologic/neurologic diseases such as benign paroxysmal positional vertigo and Meniere’s disease [34,35]. Dizzy patients usually have motor-related activities such as imbalance and walking difficulty. Imbalance connotes disequilibrium which occurs either while walking or standing [36]. The causal factors may include muscle weakness, arthritis, and/or reduced sensory input leading to impaired postural control or instability [34–36]. Hence, dizziness, even mild, is a potentially disabling condition that has a distinct impact on physical activity, participation, psychosocial interaction, and quality of life. This impact can sustain a higher burden of neurobehavioral features of dementia, especially that related to spatial memory, other cognitive functions, and depression [34–36]. Therefore, there is certainly a need for further studies controlling dizziness since HL and vestibular (balance) loss are considered contributors to cognitive dysfunction [37].
One year on: an updated systematic review of SARS-CoV-2, COVID-19 and audio-vestibular symptoms
Published in International Journal of Audiology, 2021
Ibrahim Almufarrij, Kevin J. Munro
Vertigo was the least commonly reported audio-vestibular symptom; it was investigated in 20 (36%) studies, with an estimated prevalence of 7.2%. Similar to the previously reported symptoms, caution should be exercised when interpreting the pooled prevalence because the majority of studies relied on self-reported questionnaires and four of the cross-sectional studies combined the prevalence of vertigo with dizziness (Davis et al. 2020; Micarelli et al. 2020; Salahuddin et al. 2020; Salepci et al. 2021), and the latter is not necessarily of vestibular origin. Combining the prevalence of both of these symptoms will increase the pooled estimate because the latter is a common neurological manifestation of COVID-19 (Mao et al. 2020). There was also a concern that some researchers used the terms vertigo and dizziness interchangeably; the latter is a commonly reported symptom in COVID-19 patients. This may have inflated the pooled prevalence estimate. The final diagnosis, as reported in two case reports (Malayala and Raza 2020; Vanaparthy et al. 2020), was vestibular neuritis, an inflammation of the vestibulocochlear nerve. Anxiety and stress can also trigger vertigo attacks (Balaban and Jacob 2001; Chen et al. 2016), and these two factors, as mentioned earlier, are common among the general population during the COVID-19 pandemic (Salari et al. 2020).