• Title/Summary/Keyword: positional vertigo

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Current diagnosis and treatment of vestibular neuritis: a narrative review

  • Ba, Chang Hoon;Na, Hyung Gyun;Choi, Yoon Seok
    • Journal of Yeungnam Medical Science
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    • v.39 no.2
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    • pp.81-88
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    • 2022
  • Vertigo is the sensation of self-motion of the head or body when no self-motion is occurring or the sensation of distorted self-motion during an otherwise normal head movement. Representative peripheral vertigo disorders include benign paroxysmal positional vertigo, Ménière disease, and vestibular neuritis. Vestibular neuritis, also known as vestibular neuronitis, is the third most common peripheral vestibular disorder after benign paroxysmal positional vertigo and Ménière disease. The cause of vestibular neuritis remains unclear. However, a viral infection of the vestibular nerve or ischemia of the anterior vestibular artery is known to cause vestibular neuritis. In addition, recent studies on immune-mediated mechanisms as the cause of vestibular neuritis have been reported. The characteristic clinical features of vestibular neuritis are abrupt true-whirling vertigo lasting for more than 24 hours, and no presence of cochlear symptoms and other neurological symptoms and signs. To accurately diagnose vestibular neuritis, various diagnostic tests such as the head impulse test, bithermal caloric test, and vestibular-evoked myogenic potential test are conducted. Various treatments for vestibular neuritis have been reported, which are largely divided into symptomatic therapy, specific drug therapy, and vestibular rehabilitation therapy. Symptomatic therapies include generalized supportive care and administration of vestibular suppressants and antiemetics. Specific drug therapies include steroid therapy, antiviral therapy, and vasodilator therapy. Vestibular rehabilitation therapies include generalized vestibular and customized vestibular exercises.

Short-term Outcome of Benign Paroxysmal Positional Vertigo : Pilot Study (양성돌발성두위현훈의 단기적인 예후 : 예비연구)

  • Jeong, Sang-Wuk;Jang, Hyung Yeol;Kim, Kwang-Ki
    • Annals of Clinical Neurophysiology
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    • v.8 no.1
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    • pp.40-43
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    • 2006
  • Background: Benign paroxysmal positional vertigo (BPPV) is a relatively common disorder, and is characterized by episodic vertigo and nystagmus which was provoked by head motion. However, little is known about the short and long-term outcome and the prognostic factors for recurrence of BPPV. In this pilot study, we tried to identify the prognostic factors of BPPV for short-term outcome. Methods: We analyzed clinical features of 32 patients (men=21, mean $age=60.4^{\circ}{\pm}12.6y$) with BPPV that was diagnosed by typical nystagmus induced by positioning maneuver. The induced nystagmus was recorded using video-oculography (VOG). According to the semicircular canal involved, BPPV patients were classified into horizontal, posterior, or anterior canal type. Univariate analysis for age, sex, and history of vertigo, and Kaplan-Meier analysis for each canal type were performed. Results: Horizontal (n=21, 65.6%) semicircular canal type BPPV was more common than the posterior one (n=11, 34.4%). Median follow-up period was 113 day (from 34 to 216 days). Four patients with horizontal canal type BPPV had recurrent attacks. Age, history of vertigo, and days prior to diagnosis were not different between canal type. Overall recurrence rate of horizontal canal type BPPV by Kaplan-Meier estimation was 19% at 60 days (p=0.13). Conclusions: Horizontal canal type BPPV was more common and recurred more frequently than posterior canal type in the present study. However, we did not find prognostic factors for recurrence of BPPV.

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Pitfalls in the Diagnosis of Vertigo (현훈 진단에 있어 함정)

  • Kim, Hyun Ah;Lee, Hyung
    • Journal of the Korean neurological association
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    • v.36 no.4
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    • pp.280-288
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    • 2018
  • Vertigo/dizziness is a common complaint in patients who are seeking a primary health clinic. Vertigo is traditionally attributed to damage of the vestibular system. Many peripheral and central vestibular disorders are usually presented with vertigo. However, patients with benign paroxysmal positional vertigo (BPPV), a leading cause of vertigo, may present with postural lightheadedness, near faint, imbalance rather than true vertigo. On the contrary, patients with orthostatic hypotension may present with true spinning vertigo, not dizziness. Persistent postural perceptual dizziness, a second most common cause of dizziness (after BPPV), is mainly occurred after organic vestibular disorders such as BPPV or vestibular neuritis, and classified as a chronic functional vestibular disorder. This article describes non-vestibular disorders presenting dizziness and/or vertigos, which conditions may be misdiagnosed as structural vestibular disorders.

Benign paroxysmal positional vertigo as a complication of sinus floor elevation

  • Kim, Moon-Sun;Lee, Jae-Kwan;Chang, Beom-Seok;Um, Heung-Sik
    • Journal of Periodontal and Implant Science
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    • v.40 no.2
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    • pp.86-89
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    • 2010
  • Purpose: Osteotome sinus floor elevation (OSFE) is an often-used technique of great utility in certain implant patients with resorbed posterior maxilla. Recently benign paroxysmal positional vertigo (BPPV) has been reported as an early postoperative complication following OSFE. Although OSFE-induced BPPV commonly resolves itself within a month without treatment, this complication can be a cause of trouble between the implant surgeon and patient. This report presents a case of BPPV following OSFE. Methods: A 27-year-old man without any significant medical problems and missing his maxillary right first molar, was scheduled for OSFE and simultaneous implant placement. Results: The patient suffered dizziness accompanied by nausea immediately after implant placement using OSFE. Following referral to the ear nose throat clinic, "right posterior canal BPPV" was diagnosed. Despite anti vertigo medication and a single episode of the Epley maneuver, the condition did not improve completely. The Epley maneuver was then applied 7 and 8 days later and the symptoms of BPPV disappeared. One year later, the patient remained symptom-free. Conclusions: Before sinus elevation with an osteotome, implant surgeons should screen out patients with a history of vertigo, to diminish the possibility of BPPV. Operators should be aware of BPPV symptoms. As the symptoms may be very incapacitating, immediate referral to an otorhinolaryngologist is recommended.

Three Cases of Acute Benign Paroxysmal Positional Vertigo Improved after Korean Medicine Treatment (한방 치료 후 호전된 급성기 양성 발작성 두위성 현훈 치험 3례)

  • Choi, Yoon-Young;Byun, Jung-Ah;Kim, Su-Yeong;Hwang, Mi-Lee;An, Jae-Hyun;Jung, Hyun-A
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.4
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    • pp.134-145
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    • 2021
  • Objectives : The purpose of this study is to report three cases of Korean medical treatment for acute benign paroxysmal positional vertigo(BPPV). Methods : This study was conducted with three acute benign paroxysmal positional vertigo patients who hospit alized in Ophthalmology, Otolaryngology & Dermatology Clinic of Korean medical Hospital. Three patients were treated with Korean medical treatment including herbal medicine(Banhabaeckchulchunma-tang), acupuncture, p harmacopuncture(Hwangryunhaedok-tang). After treatment, we evaluated subjective symptoms. Results : The results of three patient showed remarkable improvements on subjective symptoms after the treatment. Conclusions : It is considered that Korean medical treatment can be applied to the treatment of BPPV.

Posttraumatic Peripheral Vertigo (외상 후 말초성현훈)

  • Yoon, Soyeon;Kim, Mi Joo;Kim, Minbum
    • Research in Vestibular Science
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    • v.17 no.4
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    • pp.125-129
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    • 2018
  • Posttraumatic vertigo can be defined as the vertiginous disorder occurred after head and neck trauma without other pre-existing vestibular disorder. Central, peripheral, and combined deficits might cause this condition. Especially, various peripheral vestibulopathies are possible causes of posttraumatic vertigo; benign paroxysmal positional vertigo, temporal bone fracture, perilymphatic fistula, labyrinthine concussion, posttraumatic hydrops, and cervical vertigo. Since the differential diagnosis of the posttraumatic vertigo is often difficult, it is essential to acquire knowledge of their pathophysiology and clinical features. In this review, peripheral vestibulopathy as the possible causes of posttraumatic vertigo were described according to the current literature.

Treatment of Benign Paroxysmal Positional Vertigo (양성돌발성 체위현훈의 치료)

  • Kim, Chul-Seung
    • Korean Journal of Clinical Laboratory Science
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    • v.40 no.2
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    • pp.135-141
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    • 2008
  • Benign paroxysmal positional vertigo (BPPV) is one of the most common clinical entities encountered in a dizziness clinic. Treatment of this disease, canalith repositioning procedures, have been reported to be successful in 44-90%. Treatment requires only one treatment visit in most patients. However, there are significant numbers of patients who require multiple treatment visits for relief. The goal of this study is to identify variables that may be associated with these difficult to treat cases. Retrospective review was performed for the patients diagnosed as BPPV at St. Carollo dizziness center. Variables for statistical analysis included age, sex, involved canal, presence of bilateral disease, presence of recent head trauma, presence of chronic otitis media, history of middle ear surgery, history of otologic surgery, unilateral vestibular loss, underlying disease such as hypertension or diabetes, change of involved canal during treatment course and number of treatment visits. Two hundred patients with BPPV who received treatment were identified from JAN. 2006 to JUN. 2007. 87% required one treatment visit, 5% required second treatment visit, and 95% were successfully treated after three treatment visits. Variables such as bilateral disease, post-traumatic BPPV, duration of symptom before treatment and change of involved canal during treatment were significantly related with number of treatments. Patient's with bilateral BPPV or with recent head trauma or longer duration of symptom are more likely to require multiple visits for canalith repositioning.

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A Clinical Study about Treatment of Vertiginous Patient (구토(嘔吐)를 동반한 두위변화(頭位變化)에 따른 현훈증(眩暈症) 치험(治驗) 1예(例))

  • Kim, Jung-Ju;Kim, Myung-Gune;Choi, Jeong-Rak;Park, Seong-Sik
    • Journal of Sasang Constitutional Medicine
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    • v.16 no.2
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    • pp.99-104
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    • 2004
  • 1. Objectives Benign Paroxysmal Positional Vertigo (BPPV) is thought to be due to debris which has collected within a part of the inner ear. It is best characterized by true vertigo and geotropic nystagmus that occur a few seconds after specific head movements. The symptoms of BPPV include dizziness or vertigo, lightheadedness, imbalance, and nausea. The vertigo usually lasts no more than a minute. This study is reported to evaluate the effect of Geopung-san(祛風散) to patient with vertigo. 2. Methods This patient was treated by Geopung-san(祛風散) and Acupuncture, who was diagnosed as Soeumin interior disease. We used Visual analogue scale(VAS) for the assessment of vertigo. 3. Results This patient's main symptom is vertigo according to head movement with nausea and vomiting. So she was treated by Geopung-san(祛風散) in "Dongyisasangsinpyun(東醫四象新編)" and showed a positive response about her problems. 4. Conclusions We suggest that Geopung-san(祛風散) is effected significantly to patient with vertigo, but then we consider that studies about the case like this are more needed.

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Five Case Report of Peripheral Vertigo Diagnosed Dam Hun with Oriental Medical Treatment - Banhabaeckchulchunma-tang gagam - (담훈으로 변증된 말초성 현훈 환자 5례에 대한 임상보고 - 반하백출천마방 가감방을 중심으로 -)

  • An, So-Hyun;Choi, Jeong-Sik;Cho, Chung-Sik;Kim, Cheol-Jung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.1
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    • pp.263-268
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    • 2009
  • Pripheral vertigo occurs if there is a problem with the part of the inner ear that controls balance or with the vestibular nerve, which connects the inner ear to the brainstem. Peripheral vertigo is caused by benign paroxysmal positional vertigo(BPPV), Menieres disease, vestibular neuronitis, or labyrinthitis. We diagnosed five patients who have severe vertigo as peripheral vertigo and Dam Hun. We treated them with Banhabaeckchulchunma-tang gagam and acupuncture. After treatment, vertigo and other symptoms -nausea, vomiting, abdominal discomfort had improved. So I report these cases, but more clinical case reports are needed.

A case report of Benign Paroxymal Positional Vertigo Patient (귀비탕가미방(歸脾湯加味方) 복용 후 호전된 양성 돌발성 체위성 현훈 환자 1례)

  • Jeong, Dal-Lim;Hong, Seung-Ug
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.21 no.2
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    • pp.198-205
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    • 2008
  • Objective : We report a case of BPPV responded to the Guibitang, Spleen Tonifying Sa-Am Acupuncture and Canalith Reposition Therapy. Methods : 1. Diagnosis and Evaulation: Bithermal Caloric test, Video Nystagmography, Dix-Hallpike test, VAS 2. Treatment: Guibitang, Acupuncture, Canalith Reposition Therapy. Results : We can observe remarkable improvement evaulated by VAS. Conclusion : It is considered that Guibitang and Acupuncture can be applied to the treatment of BPPV.

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