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H Neuhauser

Publications and source records attributed to H Neuhauser.

At least 19 recordsLinked to original sources
PubMed2006

Epidemiology of benign paroxysmal positional vertigo: a population based study.

OBJECTIVES: To examine the prevalence and incidence, clinical presentation, societal impact and comorbid conditions of benign paroxysmal positional vertigo (BPPV) in the general population. METHODS: Cross-sectional, nationally representative neurotological survey of the general adult population in Germany with a two stage sampling design: screening of 4869 participants from the German National Telephone Health Interview Survey 2003 (response rate 52%) for moderate or severe dizziness or vertigo, followed by validated neurotological interviews (n = 1003; response rate 87%). Diagnostic criteria for BPPV were at least five attacks of vestibular vertigo lasting <1 min without concomitant neurological symptoms and invariably provoked by typical changes in head position. In a concurrent validation study (n = 61) conducted in two specialised dizziness clinics, BPPV was detected by our telephone interview with a specificity of 92% and a sensitivity of 88% (positive predictive value 88%, negative predictive value 92%). RESULTS: BPPV accounted for 8% of individuals with moderate or severe dizziness/vertigo. The lifetime prevalence of BPPV was 2.4%, the 1 year prevalence was 1.6% and the 1 year incidence was 0.6%. The median duration of an episode was 2 weeks. In 86% of affected individuals, BPPV led to medical consultation, interruption of daily activities or sick leave. In total, only 8% of affected participants received effective treatment. On multivariate analysis, age, migraine, hypertension, hyperlipidaemia and stroke were independently associated with BPPV. CONCLUSION: BPPV is a common vestibular disorder leading to significant morbidity, psychosocial impact and medical costs.

Adult↗
PubMed2006

Short-term efficacy of Epley's manoeuvre: a double-blind randomised trial.

BACKGROUND: Benign paroxysmal positional vertigo of the posterior canal (PC-BPPV) is a common vestibular disorder and can be easily treated with Epley's manoeuvre. Thus far, the short-term efficacy of Epley's manoeuvre for treatment of PC-BPPV is unknown. OBJECTIVES: To evaluate the efficacy of Epley's manoeuvre for treatment of PC-BPPV 24 h after applying the manoeuvre. METHODS: The short-term efficacy of Epley's manoeuvre was compared with a sham procedure in 66 patients with PC-BPPV by using a double-blind randomised study design. RESULTS: 24 h after treatment, 28 of 35 (80%) patients in the Epley's manoeuvre group had neither vertigo nor nystagmus on positional testing compared with 3 of 31 (10%) patients in the sham group (p<0.001). CONCLUSION: Epley's manoeuvre is shown to resolve PC-BPPV both effectively and rapidly.

Adult↗
PubMed2006

[A basic set of indicators for mapping migrant status. Recommendations for epidemiological practice].

Data on the health status of migrants are still scarce. One of the reasons for this is that migration status has not been well recorded in official statistics and epidemiological studies. In order to obtain an adequate and standardised operationalisation of migrant status, we first need an exact definition of the terms "migrant" and "migration background". We discuss approaches to the definition of terms and the surveying of ethnic minorities and migrants, and then develop a basic set of migration status indicators for use in epidemiological research. This set of indicators includes country of birth of the father and mother, year of immigration, mother tongue, German language skills and status of residence. The key indicator for the identification of migrants is the country of birth of the parents and not the nationality as was previously often the case. Thus, the classification based on the judicial category of nationality is replaced by a classification based on the biographical event "migration". Migration brings with it specific life conditions and challenges that can impact health across several generations. An instrument for surveying migrant status must be further developed both to reflect the special conditions of the life situation resulting from the migration experience and to take as full account as possible of all aspects of a migrant's history.

Algorithms↗
PubMed2005

[Methodological standards for migrant-sensitive epidemiological research].

Migrant-sensitive epidemiological research often encounters methodological problems: differences among studies with regard to the definition of the term "migrant", difficulties in identifying migrants among the study participants and low participation rates of migrants in epidemiological studies. Therefore, a project has been initiated at the Robert Koch Institute with the aim of developing standards which ensure migrant-sensitive epidemiological research, provide a uniform framework for data collection and analysis, and make different data sources comparable. Ideally, the following standards should be followed: a comprehensive definition of the study population which includes migrants, standardisation of the term "migrant" and of its operationalization, adequate participation rates of migrants in the study, inclusion of migrant-specific topics and questions, and migrant-specific non-responder analysis, data analysis, reporting of results and quality assurance. We give an overview of the status quo of the implementation of the these standards in ongoing studies of the Robert Koch Institute and propose minimum standards, which do not require considerable additional financial resources.

Adolescent↗
PubMed2005

[The German Telephone Health Survey 2003: an instrument of federal health reporting].

The Robert Koch Institute has carried out health surveys at irregular intervals since the 1980s . Internationally telephone surveys have been used to supplement examination surveys for some time. Health interview surveys by telephone provide a timely and inexpensive possibility to build up a time series on health while being flexible enough to cover new health aspects. Health telephone surveys will also serve as a module of a coming health-monitoring system in Germany, which is currently under discussion. From September 2002 to March 2003, 8,313 German-speaking people randomly selected from the resident population aged 18 years and over were asked about topics such as chronic diseases, health behaviour and the extent to which they make use of health care services and others.

Adolescent↗
PubMed2005

[Participation of migrants in health surveys conducted by telephone: potential and limits].

Migrants living in Germany are a both large and vulnerable population subgroup. They are not easily induced to participate in health surveys, Hence, achieving high participation rates of migrants in health surveys and avoiding selection bias is a difficult task. In this study, we report on the participation of migrants in the German National Health Telephone Survey 2003 (GSTel03), the first comprehensive national health survey conducted by telephone in Germany. Three migrant groups were identified: individuals with non-German citizenship (foreigners), naturalized migrants, and ethnic German immigrants (Spätaussiedler). The aim of this study is to evaluate the degree to which the GSTel03 subsample of foreigners is representative for foreigners living in Germany. We compare the prevalence of sociodemographic characteristics and selected health indicators of foreigners in the GNTel03 subsample with prevalences from national statistics and from a large national household survey ("Mikrozensus 2003"). The proportion of participants with non-German nationality in the overall GSTel03 sample was significantly lower than the proportion of foreigners in the residential population in Germany (3.7 % vs. 8.9 %). While there was no evidence of selection bias with regard to age and sex distribution, we found significant differences with regard to other factors, including nationality, length of stay in Germany, unemployment rate and education. The comparison of health indicators showed only moderate differences between GSTel03 sample and "Mikrozensus" results. However, these differences did not consistently point to a better or worse health status in the GSTel03 sample of foreigners and should therefore not be generalised in respect of other health indicators. Our study emphasises the importance of a continuous effort to improve migrant participation in health studies and of a thorough analysis of selection bias when interpreting results.

Adolescent↗
PubMed2005

[Chronic back pain in the general population in Germany 2002/2003: prevalence and highly affected population groups].

Back pain is one of the most common complaints in the general population and chronic back pain is a major Public Health burden. However, the prevalence of chronic back pain in Germany is not known. The aim of our study was to determine the prevalence of chronic back pain in the general adult population in Germany and to identify highly affected population groups. A nation-wide computer-assisted telephone interview (CATI) survey was conducted with 8,318 men and women aged 18 years and older residing in German households. Participants were selected using the Gabler-Häder telephone sampling method and the next-birthday method. The one-year prevalence of chronic back pain defined as daily or almost daily back pain over a period of three months was 16 % in men and 22 % in women, the lifetime prevalence 24 % in men and 30 % in women. The 12-months prevalence of any back pain was 66 % in women and 58 % in men. Back pain on the day preceding the interview was reported by 18 % of men and 27 % of women and had a median intensity on a 1 - 10 point scale of 5 in women and 4 in men. Factors independently associated with chronic back pain in the past 12 months were age, female sex, a history of arthritis, self-reported depression, lower educational level, current unemployment, overweight or obesity, no sports, smoking and living with a partner. In conclusion, chronic back pain is a highly prevalent complaint in the general population in Germany. The association not only with bone and joint diseases but also with depression, a lower level of education and with certain lifestyle behaviours emphasises that back pain should not be viewed only in the context of the spine.

Adolescent↗
PubMed2004

Self-treatment of benign paroxysmal positional vertigo: Semont maneuver vs Epley procedure.

The authors compared the efficacy of a self-applied modified Semont maneuver (MSM) with self-treatment with a modified Epley procedure (MEP) in 70 patients with posterior canal benign paroxysmal positional vertigo. The response rate after 1 week, defined as absence of positional vertigo and torsional/upbeating nystagmus on positional testing, was 95% in the MEP group (n = 37) vs 58% in the MSM group (n = 33; p < 0.001). Treatment failure was related to incorrect performance of the maneuver in the MSM group, whereas treatment-related side effects did not differ significantly between the groups.

Adult↗
PubMed2004

Vertigo and dizziness related to migraine: a diagnostic challenge.

Vertigo and dizziness can be related to migraine in various ways: causally, statistically or, quite frequently, just by chance. Migrainous vertigo (MV) is a vestibular syndrome caused by migraine and presents with attacks of spontaneous or positional vertigo lasting seconds to days and migrainous symptoms during the attack. MV is the most common cause of spontaneous recurrent vertigo and is presently not included in the International Headache Society classification of migraine. Benign paroxysmal positional vertigo (BPPV) and Ménière's disease (MD) are statistically related to migraine, but the possible pathogenetic links have not been established. Moreover, migraineurs suffer from motion sickness more often than controls. Persistent cerebellar symptoms may develop in the course of familial hemiplegic migraine. Dizziness may also be due to orthostatic hypotension, anxiety disorders or major depression which all have an increased prevalence in patients with migraine.

Diagnosis, Differential↗
PubMed2004

Benign paroxysmal positional vertigo predominantly affects the right labyrinth.

Benign paroxysmal positional vertigo (BPPV) occurs when there are freely moving particles in a semicircular canal and the head is turned in the plane of the affected canal. The aim of the present study was to clarify whether BPPV manifests equally in both labyrinths or whether there is a preponderance for one side. We conducted a PubMed literature search of BPPV case series which specified the affected side and a retrospective chart review of 80 consecutive patients with BPPV of the posterior canal who had presented at our dizziness clinic. Eighteen studies with a total of 3426 patients were identified. In our own series the right side was affected in 54 of 80 patients (right/left ratio 2.08). Altogether, in 3506 patients the right labyrinth was involved 1.41 times more often than the left (95% CI 1.37 to 1.45). We think that the reason for the predominant involvement of the right ear in BPPV is the habit-of most patients-of sleeping on the right side.

Ear, Inner↗
PubMed2002

Migraine and Ménière's disease: is there a link?

BACKGROUND: A possible link between Ménière's disease (MD) and migraine was originally suggested by Prosper Ménière. Subsequent studies of the prevalence of migraine in MD produced conflicting results. OBJECTIVE: To determine the lifetime prevalence of migraine in patients with MD compared to sex- and age-matched controls. METHODS: The authors studied 78 patients (40 women, 38 men; age range 29 to 81 years) with idiopathic unilateral or bilateral MD according to the criteria of the American Academy of Otolaryngology. Diagnosis of migraine with and without aura was made via telephone interviews according to the criteria of the International Headache Society. Additional information was obtained concerning the concurrence of vertigo and migrainous symptoms during Ménière attacks. The authors interviewed sex- and age-matched orthopedic patients (n = 78) as controls. RESULTS: The lifetime prevalence of migraine with and without aura was higher in the MD group (56%) compared to controls (25%; p < 0.001). Forty-five percent of the patients with MD always experienced at least one migrainous symptom (migrainous headache, photophobia, aura symptoms) with Ménière attacks. CONCLUSIONS: The lifetime prevalence of migraine is increased in patients with MD when strict diagnostic criteria for both conditions are applied. The frequent occurrence of migrainous symptoms during Ménière attacks suggests a pathophysiologic link between the two diseases. Alternatively, because migraine itself is a frequent cause of audio-vestibular symptoms, current diagnostic criteria may not differentiate between MD and migrainous vertigo.

Adult↗
PubMed2002

[Questionnaire and interview on physical health within the scope of The Child and Adolescent Health Survey].

Physical health is an important dimension within even the broadest concept of health. However, comprehensive and representative data on the physical health of children and adolescents in Germany are so far lacking. In the Health Survey for Children and Adolescents information will be collected on various aspects of physical health: pregnancy, birth, child development, self-rated health, physical well-being, acute and chronic disorders, congenital malformations, injuries, symptoms and complaints, disability and pain. It will be possible to analyse various determinants and consequences of physical health of children in Germany since data will also be collected on health risks, nutrition, physical activity, preventive behavior, quality of life, mental health, environmental aspects, socioeconomic and demographic characteristics and use of health services. This paper summarises the items on physical health assessed in the questionnaires and the medical interview, outlines the theoretical background for some methodological issues and reports conclusions from the survey pretest.

Adolescent↗
PubMed2001

[Vertigo as a symptom of migraine].

EPIDEMIOLOGY: Since both migraine and vertigo are common complaints in clinical practice they may coincide in an individual patient just by chance. There are, however, numerous patients with vestibular symptoms caused by migraine, accounting for 6-8% of diagnoses in specialized dizziness clinics. CLINICAL MANIFESTATION: Migraine-associated vertigo is a vestibular disorder which manifests itself with spontaneous or positional rotational vertigo or dizziness induced by head motion. The vertigo may occur without accompanying headache and may last from seconds to several weeks. DIAGNOSIS: Migraine-associated vertigo can be diagnosed according to the following criteria: 1. recurrent vestibular symptoms, 2. migraine according to the criteria of the International Headache Society, 3. migrainous symptoms during the vertigo such as headache, photophobia, phonophobia, scintillating scotoma or other auras, 4. exclusion of other causes. PATHOPHYSIOLOGY: The mechanism of migraine-associated vertigo is still obscure. Several hypotheses relating to the pathophysiology of migraine have been proposed: cortical spreading depression, regional changes in brain perfusion, release of neurotransmitters and paroxysmal dysfunction of ion channels. Clinical findings suggest both central and peripheral vestibular involvement. THERAPY: Treatment is based on the repertoire of acute and prophylactic medications that are used for migrainous headaches. Controlled studies on the treatment of migraine-associated vertigo are still lacking.

Age Factors↗
PubMed2001

The interrelations of migraine, vertigo, and migrainous vertigo.

OBJECTIVE: To assess the prevalence of migrainous vertigo in patients with migraine and in patients with vertigo according to explicit diagnostic criteria that are presented for discussion. METHODS: The authors prospectively evaluated 200 consecutive patients from a dizziness clinic and 200 patients from a migraine clinic for migrainous vertigo based on the following criteria: 1) recurrent vestibular symptoms (rotatory/positional vertigo, other illusory self or object motion, head motion intolerance); 2) migraine according to the criteria of the International Headache Society (IHS); 3) at least one of the following migrainous symptoms during at least two vertiginous attacks: migrainous headache, photophobia, phonophobia, visual or other auras; and 4) other causes ruled out by appropriate investigations. In addition, the authors compared the prevalence of migraine according to the IHS criteria in the dizziness clinic group with a sex- and age-matched control group of 200 orthopedic patients. RESULTS: The prevalence of migraine according to the IHS criteria was higher in the dizziness clinic group (38%) compared with the age- and sex-matched control group (24%, p < 0.01). The prevalence of migrainous vertigo was 7% in the dizziness clinic group, and 9% in the migraine clinic group. In 15 of 33 patients with migrainous vertigo, vertigo was regularly associated with migrainous headache. In 16 patients, vertigo occurred both with and without headache, and in two patients headache and vertigo never occurred together. The duration of attacks varied from minutes to days. CONCLUSION: These results substantiate the epidemiologic association between migraine and vertigo and indicate that migrainous vertigo affects a significant proportion of patients both in dizziness and headache clinics.

Adult↗
PubMed1999

A modified Epley's procedure for self-treatment of benign paroxysmal positional vertigo.

We compared the efficacy of a modified Epley's procedure (MEP) and Brandt-Daroff exercises (BDE) for self-treatment of benign paroxysmal positional vertigo of the posterior semicircular canal (PC-BPPV) in 54 patients. PC-BPPV resolved within 1 week in 18 of 28 patients (64%) using the MEP and in 6 of 26 patients (23%) performing BDE (p<0.01). Type and adequate performance of the maneuver predicted treatment outcome in the multivariate analysis. The frequency of side effects was not significantly different between the two groups. The MEP is more suitable for self-treatment of PC-BPPV than conventional BDE.

Humans↗
PubMed1998

[Hemodynamically-induced transitory ischemic attacks. A differential focal motor seizures diagnosis?].

This case report intends to focus attention on hemodynamic TIAs as cause of repetitive involuntary movements (RIMs) as differential diagnosis of simple partial motor seizures. We report two patients with episodic unilateral limb shaking lasting up to several minutes and which could be triggered by orthostasis, heat or physical exertion. Repeated EEG recordings revealed no epileptic discharges. In both patients, duplex ultrasonography revealed an occlusion of the internal carotid artery (ICA) contralateral to the side of the RIMs. Blood flow velocities in the middle cerebral artery ipsilateral to ICA occlusion were reduced and vasomotor reactivity to hypercapnia was absent. After elevation of blood pressure both patients became asymptomatic. We suggest that in patients with episodes of RIMs, Doppler sonography and tests of cerebral vascular reserve capacity should be performed to search for a hemodynamic origin of these symptoms.

Aged↗