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PubMed1979

[Vestibular results before and after neurectomy of the vestibular nerve in cases of vertigo resistant to medical treatment (author's transl)].

25 patients suffering from vertigo due to peripheral-vestibular disorders resistant to medical treatment underwent neurectomy of the vestibular nerve. Präoperatively 24 showed a pathological result in the neurotological examination. In 83% of the cases an abnormal caloric reaction could be seen in the frequency-calorigram, which graphically represents the caloric test. The postoperative objective vestibular results always correlated with the subjective feeling of vertigo. We could see a decrease and finally a disappearance of the horizontal unidirectional spontaneous nystagmus. It is of value to examine the gaze nystagmus in none directions of gaze. In the positiogram, a quantitative scheme of the positional test, one could recongize a decrease of the nystagmus intensity in the follow-up examination. The same was found by testing the vestibulo-spinal reactions. Although the neurectomy of the vestibular nerve involves a serious operation it is nevertheless the first choice of treatment. 96% of the cases are free from vertigo. Postoperative there is a very low complication quota.

Adult↗

PubMed1976

Benign paroxysmal vertigo of childhood.

Thirty-three cases of benign paroxysmal vertigo in childhood have been seen at our institution since the disorder was recognized ten years ago. Progression from paroxysmal torticollis of infancy to paroxysmal vertigo of childhood is documented. Ear infections and allergy appeared causative in a few, but not most, of the cases. The most important consideration for the pediatrician is to rule out epilepsy and brain tumor. Parents should be reassured that the condition is benign, and that the attacks will cease in a few months or years.

Caloric Tests↗

PubMed1975

A practical approach to the patient with vertigo: an outline of diagnosis and management for the nonspecialist.

A careful history is the most important part of a medical examination for vertigo, especially to establish whether it is acute, chronic or recurrent. If the patient spontaneously volunteers ear complaints, such as fullness, tinnitus, or hearing loss, the cause is probably otologic and deserves immediate referral. If no otologic complaints are volunteered, the whole body becomes a source of investigation. All nonvital drugs should be withheld while the vertigo study is progressing. A complete physical examination and blood profile should be carried out. Roentgenograms of the skull and chest should be obtained. Accurate diagnosis and proper management are possible only with prolonged follow-up. Unnecessary expense, inconvenience, and discomfort for the patient can be avoided by a screening audiogram to identify unilateral hearing loss. All unilateral hearing loss should be investigated thoroughly in order to diagnose serious retrocochlear disease early.

Acute Disease↗

PubMed1977

Psychogenic vertigo within an anxiety frame of reference: an experimental study.

The theoretical point of departure here was the assumption that a psychogenic vertigo patient displaces affect, or experience of anxiety to one of dizziness, the dizziness serving as an anxiety equivalent. This is seen to imply a change in the locus of experience from the me to the not-me sphere. "Percept-genetic" techniques and a spiral after-effect measurement were used to compare 23 patients with presumed psychogenic vertigo with a control group matched in sex, age, education and occupation. Results of the percept-genetic techniques showed the patients to display stronger signs of affect anxiety than subjects in the control group. Also two main subgroups of patients were differentiated with the help of the descriptive instruments, one group with signs of a primitive-hysteroid mode of functioning, the other with signs of an obsessive-compulsive mode. For both subgroups the suggested displacement mechanism seemed to be functioning. Its apparent effect differed, however, for the two subgroups: in the "primitive-hysteroid" group the displacement mechanism was more effective. The "obsessive-compulsive" group showed stronger signs of affect anxiety, dizziness here being better characterized as a concomitant than as an equivalent of anxiety. Results of a follow-up two years after the investigation also showed a poorer development of symptoms within the "obsessive-compulsive" group.

Adult↗

PubMed1979

Benign recurrent vertigo.

Patients with recurrent vertigo in the absence of cochlear signs remain a diagnostic problem. The absence of a standard system of nomenclature further hampers the understanding of these disorders. The term benign recurrent vertigo is suggested as a useful term to characterise many of these patients. The disorder shares some of the features of migraine, and seems likely to have a similar vasospastic aetiology.

Adult↗

PubMedDate not supplied

Benign paroxysmal positonal vertigo: A clinical study.

Summary--Ru-Vert, a combination product, containing in each tablet, 25 mg of pentylenetetrazol, 12.5 mg of pheniramine maleate, and 50 mg of nictonic acid, was evaluated in the treatment of seventeen patients with benign paroxysmal positional vertigo. The study was double-blind with crossover. Ru-Vert at a dosage of two tablets t.i.d. was found to reduce significantly the nystagmus and the vertigo induced by Hallpike maneuvers in these patients.

Adult↗

PubMedDate not supplied

Caloric-eye tracking pattern test: I. Visual suppression and the possibility of simplified differential diagnosis between peripheral and central vertigo.

During the examination of patients who complain of vertigo or who have equilibrium disorders, it is often difficult to determine the etiology of the disorders, that is, to determine whether it is dependent on a peripheral or central vestibular disorder. To attempt to guess the etiology in these cases, we devised a new method: the caloric eye-tracking pattern test. In normal subjects and in patients with peripheral disorders, as is well known, caloric nystagmus has little influence on the eye-tracking pattern. In contrast, in patients with central vestibular disorders, caloric nystagmus evoked abnormalities on the eye-tracking pattern, either superimposed or saccades, in spite of the fact that the eye-tracking pattern before the caloric stimulation is normal. These findings result from the visual suppression mechanism to the vestibular nystagmus. We can say that the visual suppression to the vestibular nystagmus is evoked more strongly bu pursuing a moving visual stimulus than by gazing at a stationary target. These results are interesting, not only form the physiological view point, but also from the clinical view point. There is a possibility of the differential diagnosis between peripheral and central vertigo.

Adult↗

PubMedDate not supplied

Vertigo as reflected by the nystagmogram. A clinical analysis.

Efforts to evaluate findings in the nystagmogram were made in a material of 338 vertiginous and dizzy patients. A spontaneous nystagmus, a positional nystagmus as well as a difference in caloric reactivity are as solitary findings of lettle value for revealing peripheral disorders. On the other hand, central disturbances are frequently revealed by inability to track a moving optic target, resulting in an irregular or a saccadic pattern, by persistence of vestibular nystagmus in light, by persistence of such nystagmus at eye-closure, by an increase in spontaneous nystgmus on eye-closure or by dysrhythmic nystagmus in caloric tests. Cases of functional vertigo seem to differ from cases of vertigo from other sources by their increase of spontaneous nystagmus (when present) or by persistence of caloric nystagmus on eye-closure.

Caloric Tests↗

PubMed1976

[Simple method of differential diagnosis of peripheral and central vertigo--development of diagnostic method and studies of 178 cases].

In patients who complain of vertigo or who have equilibrium disorders, it is often difficult to determine the etiology of the disorder, that is to determine whether it is dependent on a peripheral or central vestibular disorder. To attempt to determine the etiology in these cases, we divised a new method, the caloric eye tracking pattern test (CETP-Test). Seventeen normal subjects and 161 patients were tested. The latter group included 33 with peripheral disorders such as Meniere's disease, benign paroxysmal positional nystagmus, and others, and 128 with central disorders such as vertebral basilar artery insufficiency, cervical vertigo, and others, were tested. The cases of central disorders were limited to those patients whose eye tracking pattern before the caloric stimulation was normal. In normal subjects and in patients with peripheral disorders, it is well known that caloric nystagmus has little influence on the eye tracking pattern. In contrast, in patients with central vestibular disorders, caloric nystagmus evokes abnormalities on the eye tracking pattern, either superimposed or saccades, despite the fact that the eye tracking pattern before the caloric stimulation is normal. First we administer the eye tracking stimulation test using a target which moves horizontally at 0.3 cycle per second. Next, we perform the caloric test on the right ear, using 20 c.c. of ice water for 10 seconds. During the evoked caloric nystagmus we administer the eye tracking test once again. The eye tracking pattern is recorded for 20 seconds beginning 50 seconds after the start of the ice water injection. The procedure repeated on the left ear. The results on each case are presented as three patterns of ENG-recording. We may stat that in normal subjects and in patients with peripheral vestibular disorders, visual suppression of caloric nystagmus remains functional. Caloric induced nystagmus does not affect the CETP. In patients with central vestibular disorders, visual suppression of caloric nystagmus does not function properly because of defects in the visual suppression mechanism. Therefore, caloric nystagmus greatly influences the CETP. Consequently, the CETP may not be smooth when CETP test is administered to patients with central vestibular disorders. We may say also that the visual suppression to the vestibular nystagmus is evoked more strongly by pursuing a moving visual stimulus than by gazing a stational target. These results allow for a differential diagnosis between peripheral and central disorders.

Adult↗

PubMed1975

[The acute cervical vertigo under otologic and osteopathic view (author's transl)].

The acute cervical vertigo with the single symptome of rotary vertigo is most probably caused by a functional disturbance in the upper third of the cervical spine. Distinct patho-anatomical changes could not be observed. The findings on the cervical spine are based on an osteopathic examination. The therapy of choice is a manipulation. Three cases are reported.

Adult↗

PubMed1978

Vertigo after head injury--a five year follow-up.

Three hundred and twenty-one head injury patients investigated at the Workmen's Compensation Board Hospital and Rehabilitation Centre were studied. The patients were classified into two groups, minor and moderate according to the duration of post-traumatic amnesia. Post-traumatic vertigo was a significant symptom in 34 per cent and 50 per cent of the minor and moderate groups respectively. Based on the findings of full otoneurologic and vestibular examination, objective vestibular disorder was noted in 40 per cent and 65 per cent of the two vertiginous groups respectively. An approach to the interpretation of vestibular and oculomotor abnormalities is outlined in order to assign a peripheral (end organ or nerve), central (brainstem or cerebellar) or undertermined localization. Hearing loss occurred in 20 per cent of the minor and 72 per cent of th e moderate head injury patients tested. A five-year post head injury follow-up was available with respect to recovery of vertigo and work rehabilitation. The results of this follow-up are discussed.

Adolescent↗

PubMed1977

Vertigo.

Vertigo reflects dysfunction in the vestibular system. Any disease state which changes the firing frequency of a vestibular end-organ and which produces unequal neural input to the brainstem causes vertigo. Caloric stimulation mimics acute end-organ dysfunction and helps establish the diagnosis.

Caloric Tests↗

PubMed1977

Clinical evaluation of vertigo.

In attempting to outline the clinical evaluation of these patients with vertigo we have discussed examples which range in order from benign self-limited disease to those requiring emergency surgery or extensive diagnostic evaluation. We sought also to illustrate how the logic of hypothesis testing is generally employed by clinicians in approaching this or other diagnostic problems. The examples were chosen to illustrate the indications for, as well as the limitations of, the various diagnostic modalities--caloric testing, electronystagmography, audiometric testing, roentgenographic and nuclear medicine procedures--which may be employed by the clinician. Most of the skills discussed in our paper, though traditionally accorded to the fields of neurology and otolaryngology, would seem to be fundamental for any general physician, while the problem of vertigo is an example of how common ambulatory problems may require knowledgeable approach to sort self-limited from more serious illnesses as well as to utilize procedures with purpose and efficiency.

Adult↗

PubMed1977

Vertigo in children: differential diagnosis and treatment.

A study of vertigo in 50 children showed that a careful neurological examination should be performed for all patients. A detailed family and personal history to find possible episodes of loss of consciousness or seizures should be obtained; 13 children with vertiginous seizures had a positive family history for seizures and 5 had febrile seizures in infancy. Electroencephalograms should be obtained in all instances of vertigo occurrence.

Adolescent↗

PubMed1976

Vertigo.

Vertigo, with or without nystagmus, may accompany many diseases. Most causes are transient and benign. A systematic approach saves valuable time. Nonrotational dizziness must be distinguished from true vertigo in which a sensation of motion is involved. Careful evaluation of nystagmus is essential, as is a complete cardiovascular examination. Meniere's syndrome, while common, is overdiagnosed.

Brain Diseases↗

PubMed2026

DNA Extraction Optimisation for Minute Land Snails of Vertigo Müller, 1773 (Gastropoda: Vertiginidae): A Comparative Evaluation of Six Methods, Including a Non-Destructive Shell-Preserving Protocol.

No systematic comparison of DNA extraction strategies exists for minute Vertiginidae (shell height < 3 mm), a group posing a dual analytical challenge: extremely low tissue input and co-purified PCR-inhibitory mucus. For legally protected species, an additional requirement to preserve the shell voucher further constrains available protocols. Using Vertigo antivertigo as the model species, we compared six approaches applied to specimens preserved in 96% ethanol (n = 10 per method): two HotSHOT alkaline-lysis protocols (destructive and non-destructive shell-preserving variants), a modified CTAB protocol supplemented with PVP-40 and DTT, and three commercial silica-column kits (GeneJET Genomic, DNeasy Blood & Tissue, QIAamp DNA Micro). DNA yields were quantified by QuantiFluor fluorometry, and PCR performance was subsequently assessed across four loci (COI barcode, COI mini-barcode, ITS1, ITS2). DNeasy Blood & Tissue produced the highest fluorometric concentrations; QIAamp DNA Micro and CTAB + PVP-40 gave intermediate values. The shell-preserving HotSHOT variant yielded lower concentrations but improved A260/230 ratios. BSA and trehalose supplementation increased PCR success in inhibition-prone HotSHOT extracts from 70% to 100%. ITS1 Sanger sequencing of three Vertigo species listed in Annex II of the EU Habitats Directive, all extracted with the shell-preserving protocol, confirmed species-level identification (99.8%-100% BLASTn identity; mean Phred Q > 51). The shell-preserving non-destructive HotSHOT protocol yields sequenceable DNA from protected Vertiginidae while retaining the morphological voucher, making it the preferred option for conservation-genetic monitoring. The practical decision framework documented here-integrating voucher preservation, amplification robustness and per-sample cost-has broad applicability to other minute terrestrial gastropods processed in large-scale biodiversity surveys.

Habitats Directive↗

PubMedDate not supplied

Vertigo of delayed onset after sudden deafness.

An entity of episodic true vertigo of delayed onset following sudden and profound sensorineural hearing loss is described. Data on 12 patients and three case reports are presented. The latency between sudden deafness and the onset of the vertigo varied from 1 to 68 years. The vestibular symptoms are identical to the vestibular symptoms of Ménière's disease, and there is some evidence that endolymphatic hydrops in the previously deafened ear represents at least part of the labyrinthine pathology. Labyrinthectomy in the deaf ear was curative. Tentatively, this entity is best considered a variant of Ménière's disease.

Adult↗

PubMed1979

Vertigo and drop attacks caused by acute transient monocular disequilibrium (Halpern's syndrome).

Among the causes of acute vertigo the syndrome of sensorimotor induction in unilateral disequilibrium (Halpern's syndrome) should be considered. This syndrome was found in a patient and described in detail. The major features of this syndrome are the displacement of vertical and horizontal axes induced by looking with the "affected" eye only, which are further aggravated by applying red filters to the eyes only, which are further aggravated by applying red filters to the eyes and corrected by blue filters. The symptomatology is described and discussed in detail. Theories causing this syndrome are discussed.

Acute Disease↗