Dizziness or vertigo is a common clinical symptom, and its underlying etiology is complex. Many clinicians are confused about its diagnosis and treatment. This article presents a case about chronic vestibular syndrome. And case appreciation and academic discussion are conducted by well-known domestic neurologists and otologists, so as to provide a good thinking model and basic ideas for the diagnosis and treatment of dizziness or vertigo, hoping to further improve the diagnosis and treatment level among clinicians.
Humans ; Dizziness/therapy* ; Vertigo/etiology* ; Vestibular Diseases/complications* ; Otolaryngologists

OBJECTIVE: This retrospective study compared clinical manifestations of idiopathic sudden hearing loss between children and the elderly. METHOD: 44 pediatric patients and 76 elderly patients diagnosed with idiopathic sudden deafness in our clinic from December 2009 to September 2014 were enrolled. Different clinical parameters were compared. RESULT: The incidence of initially profound hearing loss was highest and mild hearing loss was lowest in both groups (P < 0.05). There were no differences in the proportion with initially mild, moderate, severe, and profound hearing loss between both groups (P > 0.05). The number of patients was the most in initially profound type of audiogram pattern and the fewest in ascending type in both groups (P < 0.05). Hearing recovery rates in children (27/44, 61.4%) was higher than that in elderly patients (32/76, 42.1%) (P < 0.05). There were no differences in hearing recovery rates of the patients with initially level of hearing loss in both groups (P > 0.05). The highest recovery rate in children was in those with descending type and the lowest was in those with profound type (P < 0.05). There were no differences in hearing recovery rates in elderly patients with initially different types of audiogram pattern (P > 0.05). Hearing recovery rates of descending type in children were higher than that in elderly patients. Presence of tinnitus in pediatric patients was not relavent to the outcome (P > 0.05). Presence of tinnitus in elderly patients was associated with favorable outcomes. (P < 0.05). Presence of dizziness in pediatric patients was not relavent to the outcome (P > 0.05). Presence of dizziness in elderly patients was associated with poor outcomes (P < 0.05). Presence of initially different degrees of opposite side hearing loss in elderly patients was not relavent to the outcome (P > 0.05). Presence of chronic diseases in elderly patients was not associated with the outcome (P > 0.05). CONCLUSION The clinical manifestion of idiopathic sudden deafness is respective in Children and in elderly patients.
Aged ; Child ; Dizziness ; complications ; Hearing Loss, Sudden ; physiopathology ; Hearing Tests ; Humans ; Incidence ; Retrospective Studies ; Tinnitus ; complications ; Vertigo ; complications

The common etiologies of pneumocephalus, presence of air in the intracranial cavity, are trauma and cranial surgery. Pneumocephalus after spinal surgery is an unusual postoperative complication. We report the case of a male 59-year-old man who developed a pneumacephalus after posterior lumbar surgery for spinal stenosis. Intraoperatively, a cerebrospinal fluid leak following a dural tear was noted and immediately repaired. The next day, the patient complained of headache and dizziness. Head and lumbar computed tomography scans revealed significant air in the frontal region, several cisterns, intraventricle, and extra-dural area in the spine canal. Symptoms were spontaneously resolved within 2 weeks with conservative management.
Cerebrospinal Fluid Rhinorrhea ; Dizziness ; Head ; Headache ; Humans ; Male ; Middle Aged ; Pneumocephalus ; Postoperative Complications ; Spinal Stenosis ; Spine

BPPV is the most common cause of dizziness in adults, and the symptoms, causes, behavior of adult patients are clearly defined. Pregnant woman may also suffer from BPPV. To our knowledge, there are few reports on BPPV in pregnant women. In this paper, the clinical characteristics and results of 3 pregnant women with BPPV are reported.
Adult ; Benign Paroxysmal Positional Vertigo ; diagnosis ; Dizziness ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; diagnosis

OBJECTIVETo investigate the clinical characteristics and the effect of drug treatment for sudden hearing loss with vertigo or dizziness.

METHODSIn a prospective, randomized, single blinded randomized multicenter clinical study, patients with sudden deafness, ranging in age from 18 to 65 years old, with a duration less than 2 weeks, and with no any medical treatments were collected. In accordance with the hearing curve, those patients were divided into four types, i.e., low and intermediate frequency descent type; high frequency descent type; fall flat type; and total deafness type. Each type was treated by four different treatment options, according to the unified design of the random table, and randomly selected one of the options for treatment. The efficacy of the patients with sudden deafness with vertigo and dizziness was analyzed statistically after the follow-up for 4 weeks. SPSS 13.0 software was used to analyze the data.

RESULTSIn August 2007 to October 2011, 33 hospitals in the country included 1 024 patients with sudden deafness in line with the inclusion criteria, of whom 296 (28.91%) were accompanied by vertigo/dizziness symptoms, 126 were males and 170 were females, with an average age of (41.2 ± 13.5) years old. types of the different audiometric curves of sudden deafness, the occurrence of complete deafness with vertigo/dizziness was the highest (44.93%), followed by flat down type (25.87%), high frequency descent type (21.28%) and low intermediate frequency descent type (18.54%). After the standard treatment, the vertigo and dizziness symptoms of the sudden deafness patients could disappear, and the hearing in each group was obviously improved. The hearing curative effect on patients accompanied by vertigo/dizziness of low frequency and intermediate frequency descent type was the best, and the total efficiency can reach up to 94.74%, with the cure rate of 68.42%; followed by flat type, in which the total effective rate was 80.76%, with the recovery rate of 22.12%; and the effects on patients in high frequency descent type and total deafness type effect were relatively poor, in which the total effective rates were 70.00% (recovery rate of 10.00%) and 65.32% (recovery rate of 5.65%), respectively. The total effective rate of patients with sudden deafness associated with halo had no statistical significance (P > 0.05), in comparison to that of patients without halo; but, the cure rate of patients with no vertigo/dizziness of total deafness and the high frequency decreased patients with sudden deafness was significantly higher than that of vertigo/dizziness patients, with a statistical difference (P < 0.05).

CONCLUSIONSThe patients with sudden deafness in each type have a certain proportion of vertigo/dizziness, especially the deaf type. The possibility of hearing complete recovery in patients with vertigo/dizziness was significantly lower than that without vertigo/dizziness.

Adult ; Audiometry ; Dizziness ; complications ; therapy ; Female ; Hearing Loss, Sudden ; complications ; therapy ; Hearing Tests ; Humans ; Male ; Middle Aged ; Prospective Studies ; Single-Blind Method ; Software ; Vertigo ; complications ; therapy

We describe a case involving a 69-year-old woman who developed anaphylatic shock caused by a clinical dose of sugammadex (2 mg/kg, 100 mg intravenously) 5 minutes after its administration. She developed redness and welts all over her body, and complained of an oropharyngeal itching sensation with dyspnea and dizziness. Her vital signs were closely monitored. She also experienced a sudden onset of hypotension (from 110/70 to 49/40 mmHg) and tachycardia (from 75 to 120 bpm). We diagnosed anaphylactic shock on the basis of these clinical manifestations. After 20 min of traditional treatment (hydration, ephedrine, cortisol, and phenylephrine), her vital signs returned to normal. No postoperative complications were evident, and the patient was discharged from the hospital. Although the prevalence of anaphylactic reactions to sugammadex is rare, physicians using sugammadex should be aware of the possibility of sugammadex-induced anaphylaxis.
Aged ; Anaphylaxis* ; Dizziness ; Dyspnea ; Ephedrine ; Female ; Humans ; Hydrocortisone ; Hypersensitivity ; Hypotension ; Postoperative Complications ; Prevalence ; Pruritus ; Sensation ; Shock ; Tachycardia ; Vital Signs

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.
Adult ; Dizziness ; Ear ; Floors and Floorcoverings ; Humans ; Maxilla ; Maxillary Sinus ; Molar ; Nausea ; Nose ; Outpatients ; Pharynx ; Postoperative Complications ; Referral and Consultation ; Vertigo

BACKGROUND AND OBJECTIVES: Common complications after the operation of chronic otitis media are dizziness, postoperative nausea, and postoperative pain. Authors aimed to investigate whether the intravenous injection of dexamethasone during the operation of chronic otitis media can reduce these complications. SUBJECTS AND METHOD: With the approval of the institute's ethics committee, a total of 68 patients who had been diagnosed with chronic otitis media were included in the study. The patients in the dexamethasene group received 5mg of intravenous dexamethasone during canal wall-up mastoidectomy, and the patients in the placebo group received no additional injection except for Hartman solution. All patients requested to fill up the questionnaires about dizziness, postoperative pain, and postoperative nausea according to VAS (Visual analogue system) score at 3 hours, 6 hours and 24 hours after operation. RESULTS: No postoperative complications were found in both groups. There was significant improvement in dizziness and postoperative nausea 24 hours postoperatively in the dexamethasone group. But dexamethasone group failed to show significant difference regarding postoperative pain when compared with the placebo group. CONCLUSION: Intravenous dexamethasone injection during canal wall-up mastoidectomy appeared to have significant effects on reducing postoperative dizziness and postoperative nausea.
Dexamethasone* ; Dizziness* ; Ethics Committees ; Humans ; Injections, Intravenous ; Nausea* ; Otitis Media ; Pain, Postoperative ; Postoperative Complications ; Postoperative Nausea and Vomiting ; Surveys and Questionnaires

OBJECTIVETo analyze the clinical characteristics, prognosis and therapeutic effects of sudden sensorineural hearing loss (SSHL) patients associated with vertigo, and to investigate the strategy of diagnosis and treatment.

METHODSWe retrospectively analyzed the clinical characteristics of 240 patients diagnosed as SSHL with vertigo, who were treated in the Chinese PLA General Hospital from July 2008 to August 2012. Various factors affecting the therapeutic effects were analyzed, such as audiological features, vestibular function tests, genders, audiograms, lasting before seeing a doctor, courses of vertigo and vascular factors.

RESULTAmong the contemporaneous SSHL patients (873 cases), the cases with vertigo accounted for 27.49% (240/873). Among the 240 patients with vertigo, the cases with different hearing impaired degree of mild, moderate, severe and profound were 30, 13, 28 and 34, respectively, primarily by the profound cases. Detailed vestibular function tests were performed in 97 patients, with 54 cases having unilateral vestibular disfunction and 43 patients having normal vestibular function, among which 23 cases were diagnosed as benign paroxymal positional vertigo (BBPV). The relationship between vestibular function and different hearing impaired degrees or various audiogram types had no statistically significant difference. 219 cases had detailed records of the onset time of cochlear and vestibular symptoms, including 122 patients with cochlear symptoms and dizziness occurring simultaneously. After standardized drug treatment, the total effective rate was 46.67%, with recovery in 17 cases, excellent in 34 cases, better in 61 cases and poor in 128 cases, respectively. Statistical analysis showed that different genders, audiogram types, vertigo courses of time, the results of vestibular function and neck vascular ultrasounds were not related to the curative effects, while, the treatment time after onset was significantly associated with treatment effects.

CONCLUSIONSSSHL with vertigo has a high incidence, primarily single side affected, with relatively severe hearing impairment, and total deafness and downslope hearing curve mainly. Vestibular function can be normal or low in SSHL patients with vertigo, with a higher incidence of BPPV. Vestibular and cochlear symptoms occur simultaneously in more than half of the patients. The detection rate of vestibular dysfunction gradually increased, as the degree of hearing loss increased, without statistical significance although. The therapeutic effects of sudden hearing loss with vertigo cases have no relationship with dizziness duration or vestibular function, while the disease course plays an important role in treatment.

Benign Paroxysmal Positional Vertigo ; complications ; Cochlea ; physiopathology ; Deafness ; Dizziness ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; complications ; Hearing Tests ; Humans ; Prognosis ; Retrospective Studies ; Vestibular Function Tests ; Vestibule, Labyrinth ; physiopathology

OBJECTIVE: Evaluation and analyze the characteristics of balance function in patients with type 2 diabetes, and to find out the importance of proprioception, vision and vestibular in postural control. METHOD: All subjects were divided into two groups, 37 normal individuals, 33 patients with type 2 diabetes mellitus. All were assessed by computerized posturography under six upright stance.conditions: including standing on the firm surface and foam with eyes open and closed. RESULT: (1) On anteroposterior,the scores of proprioception, vision and vestibular were 93.96 ± 7.95, 80.22 ± 16.24, 70.87 ± 20.99, the normal were 98.00 ± 2.18, 91.44 ± 6.01, 80.44 ± 7.81. There were significances between diabetes mellitus group and normal control group (P < 0.05) respectively. (2) On lateral, the scores of vision and vestibular were 80.39 ± 12.60, 73.96 ± 16.04, and the normal were 92.11 ± 4.50, 83.18 ± 9.45. There were significances with P < 0.05 between diabetes mellitus group and normal control group. However, there was no obvious difference in proprioception scores between the two groups. (3) The limit of stability of normal group were (176.47 ± 44.13) mm²; diabetic group was (143.13 ± 62.30) mm². There was statistical significance between the group with P < 0.05. (In diabetic patients, there was no significant difference between the no dizziness group and the dizziness group of the scores of proprioceptive, visual, vestibular as well as stable limits, P > 0.05. CONCLUSION The balance function of patients with type 2 diabetes decreased. It is the main characteristic that the vision and vestibular decreased more significantly in the postural control.
Case-Control Studies ; Diabetes Mellitus, Type 2 ; physiopathology ; Dizziness ; complications ; Humans ; Postural Balance ; Proprioception ; Vertigo ; complications ; Vestibule, Labyrinth ; physiopathology ; Vision, Ocular