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At least 19 recordsLinked to original sources
PubMed1976

[Differential diagnosis of dizziness (author's transl)].

The common denominator of the different meanings of dizziness is a disturbance of spatio-postural orientation, which indicates an imminent danger of fall. Höhenschwindel (fear of hights) with grasping and holding in the primate is instinctive behavior caused by a visual cliff or sudden dizziness. Because of the many possible meanings of dizziness, the case history is important for differential diagnosis. Vertiginous and non-vertiginous dizziness, black out and unsteady gait without vertigo should be distinguished. In addition, the duration and time course of the attack, releasing mechanisms and accompanying symptoms of dizziness should be explored. In recurrent dizziness without hearing loss, vestibular, vascular, cardial and epileptic disorders should be considered as well as intoxication, cerebral tumor, cerebellar hemangioblastoma, multiple sclerosis, neurosis and psychosis. Epileptic dizziness occurs not only in the prodromal stage of grand mal attacks and in temporal lobe epilepsy, but also in petit mal absences of short duration (less than 5 s) in which the blurring of consciousness is not apparent; absences of short duration are easily overlooked in childhood. Besides the objective history obtained from the patient's relatives, EEG-recording when falling asleep in the morning after one night of sleep deprivation are the best means for the diagnosis of epilepsia. Spontaneous nystagmus after complete exclusion of visual fixation is a physiological phenomenon. For differential diagnosis between physiological and pathological spontaneous nystagmus, Frenzel's spectacles in the dark room are indispensable. The distinction of spontaneous nystagmus in the narrower sense, gaze nystagmus and fixation nystagmus is discussed. The diagnostic importance of the direction of nystagmus is mentioned. Jerking nystagmus may be congenital. Pendular nystagmus may be acquired. Therefore, additional criteria for the differential diagnosis between congenital and acquired nystagmus are necessary.

Alcoholism↗
PubMed1977

Dizziness, epilepsy and the EEG.

EEGs were done on 97 patients with the complaint of dizziness and were compared to a normal control group. In patients with dizziness of a syncopal-like type there was a small but significant increase in the incidence of bitemporal sharp wave discharges. Another group, consisting of 48 patients with seizures was evaluated; 71% had noted dizziness, significantly more than a control group. Most seizure patients experienced dizziness as a syncopal-like sensation with an abrupt onset just before their clinical seizures. The majority also experienced identical episodes of dizziness unassociated with their seizures, possibly as an abortive epileptic phenomenon. Dizziness described as rotational (vertigo) was uncommon in these epileptics.

Adolescent↗
PubMed1975

Evaluation and management of the dizzy patient.

Evaluation and management of the dizzy patient remains frustrating to both the patient and physician. Numerous disorders may induce dizziness; these include not only inner ear disoders but also various central nervous system, ocular, and general systemic disturbances. Since dizziness has many variations, the subtle nuances the symptom may manifest must be explored throughly. Similarly, a consistent approach to the patient's physical and larboratory examination must be taken to understand the pathophysiology of the dizziness. This includes comprehensive auditory and vestibular evaluation, complete neurologic and ophthalmologic examination, and laboratory evaluation for latent or manifest systemic disease. The management of dizziness and vertigo is largely symptomatic. Certain exceptions exist where specific medical and surgical approaches may be beneficial, but the limitations of such treatment must be appreciated.

Anti-Bacterial Agents↗
PubMed1975

[Vestibular dizziness. Differential diagnosis and therapy].

Dizziness includes a wide variety of subjective sensations which are not conclusive as to their localization or pathogenesis. Even in the absence of other symptoms an analysis of dizziness, including consideration not only of its occurrence but also of its quality and course, can suggest several possibilities for differential diagnosis. We differentiate between positional vertigo, permanent vertigo and attacks of dizziness, which may be of long or only short (seconds to few minutes) duration. Based on this classification the differential diagnosis of vestibularly-induced dizziness, which ranges from distinct entities of peripheral disease (acute vestibulopathy, Ménière's disease) to symptomatic forms of peripheral or central pathogenesis, is discussed. The symptomatic medical treatment of vestibular dizziness is based on sedation of the central vestibular system. Translabyrinthine vestibular neurectomy is the treatment of choice for drug resistant Ménière's disease with a high frequency of attacks.

Acute Disease↗
PubMed1978

Dizziness: surgical treatment.

The purpose of ths paper is to discuss the various surgical procedures which are available for the treatment of dizziness and vertigo. Special emphasis will be placed on the indications for these operations and the advantages of each. Dizziness is a common complaint of patients seen by general medical physicians and otolaryngologists. At the Otologic Medical Group in Los Angeles about one third of our new patients seek assistance because of dizziness. The etiologies of these various types of dizziness are multiple. It is not the intent of this paper to discuss the differential diagnosis or methods of evaluation. However, it is important to understand the various types of etiological factors as they are important in successful treatment.

Cerebrospinal Fluid Shunts↗
PubMed1975

Electron microscopic observations of the utricle and ampullae in a case of dizziness of suspected saccular origin.

Electron microscopic observation was reported on the utricle and ampullae of a case, a 36-year-old male, with dizziness attack due to suspected saccular origin. After the removal of the utricle and ampullae, the dizziness recurred, and finally the saccular nerve section relieved the dizziness attack of this case. So the actual lesion was localized in the saccule and was not in the specimens obtained at the first surgery. Though most of hair cells appeared normal, there were a few with many vacuoles or shrinkage of the cytoplasm distributing sparsely throughout the sensory epithelia. The distribution of the pathological hair cells in the utricle was more general than in the ampullae. The sensory hair cells without pathology and the presynaptic structures were similar to those found in the experimental animals. Nerve and nerve endings showed normal structures. The findings may be physiological at this age group or an extension of the pathology of the dizziness-causing lesion.

Adult↗
PubMed1978

[Diagnostic problems in dizziness or vertigo (author's transl)].

Different causes of dizziness or vertigo can only be recognized by thorough anamnestic explorations. Following a classification in vestibular and nonvestibular causes for vertigo, a further differentiation is possible by defining different characteristic qualities of the symptoms involved. In addition to the classical vestibular forms of vertigo seen, dizziness currently results from drug overdosages, hypertension, polyneuropathy and--less commonly, but equally important--brief epileptic seizures. Psychosomatic and neurotic symptoms may also lead to unsteady gait, dizziness or vertigo, all of which are distinguished only with difficulty by the patient.

Altitude↗
PubMed1979

Holter monitoring in dizziness and syncope.

Holter monitoring was used to detect the underlying mechanism among 53 patients referred for dizziness, fainting and/or syncope. The complaints were unexplained on clinical grounds in 38, suggestive of SSS in 11, and of pacemaker dysfunction in 4 patients who underwent pacemaker implantation for symptomatic A-V block. Occult dysrhythmias were revealed in 24 of 38 (61%) of the first group; the clinical impression of SSS was confirmed in 8 of 11 (72%) in the second, and ineffective pacing confirmed in 2 of 4 in the third group. Thus, the diagnosis was clarified in 34 of 53 (64%) of patients. It is concluded that Holter monitoring is most useful for detecting the underlying mechanism in the above mentioned conditions, especially in elderly subjects whose syncopal attacks remained unexplained despite routine cardiological and neurological examination. Holter monitoring should be carried out for at least 36 hours before ruling out dysrhythmias as a cause of dizziness and/or syncopal attacks.

Adams-Stokes Syndrome↗
PubMed1977

The importance of rotatory proofs in the evaluation of a dizzy patient.

In order to obtain an adequate functional evaluation of the vestibular system, we have to take into account the results of as well the caloric as the rotary tests. The discordance obtained in some cases, where a complete bilateral caloric areflexia is present whereas a conserved reactivity is confirmed by the rotationstimulus, argues against the merely application of the caloric stimulus. The opposite data obtained by both tests provide us information necessary to a good understanding of the functional state of our dizzy patient. Those cases where an unilateral hypo- or areflexia is detected by the calorics, may prove to be either "compensated" or not at the rotary stimulus. This functional datum is very important, as it informs us about the "Regulations-funktion", the central vestibular processing. Even in some cases only the rotary proof may indicate a dysequillibrium, which constitutes an objectivation of the dizzy state of our patient. The caloric DP, though it is a similar dysequilibrium, cannot substitute the rotary DP, this imbalance being of the same nature but not identical. We confirm and illustrate these argumentations by the statements in a series of 513 patients examined by a complex rotatory stimulationscheme.

Eye Movements↗
PubMed1979

The dizzy, the giddy and the vertiginous.

For optimal examination of the giddy patient the case history is the best basis. The description of what the patient feels is not as important as has been stated rather often. The words dizzy, giddy and vertiginous from a patient do not really mean different things - they only mean: I feel unbalanced or disequilibrated. In the anamnesis it is much more important to find out firstly whether the disturbances are: (1) paroxysmal; (2) one acute attack; (3) chronic, (4) positional (positioning), and secondly whether the giddy feeling is accompanied by other disturbances (deafness, headache, pains, palsies, etc.). Some tables are presented that give a survey of the combination of some of these data and that facilitate the further examination towards the goal of the right diagnosis.

Diagnosis, Differential↗