Acupuncture, Ear ; adverse effects ; Female ; Humans ; Middle Aged ; Vertigo ; etiology

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: To analyze the occurrence and probable etiological factors of benign paroxysmal positional vertigo (BPPV). METHOD: one hundred and twenty four BPPV cases were inquired histories, classified into different groups and analyzed relevant diseases. All patients were taken Caloric tests before Canal repositioning procedure, and compared the differences of unilateral weakness (UW) and semicircular canal involved between BPPV patients with and without relevant diseases. RESULT: There were 97 (78.2%) patients with relevant diseases while 27 (21.8%) without. Ninety-two (74.2%) patients with abnormal UW. To compare the normal and abnormal UW, posterior canal and lateral canal with abnormal UW values, unilateral or bilateral of abnormal UW values, consistency of abnormal UW side and BPPV side between BPPV patients with and without relevant diseases, there were no significant differences (Chi-square values were 0.000, 0.000, 0.306, 0.027, P>0.05). CONCLUSION BPPV patients with relevant diseases are common, which mainly occurs in middle-aged or aged people and female. Otolith ecclesiis and dysfunction of semicircular canal may have the same etiological factors. Caloric tests may do help to analyze the BPPV etiological factors.
Adolescent ; Adult ; Aged ; Benign Paroxysmal Positional Vertigo ; Caloric Tests ; Female ; Humans ; Male ; Middle Aged ; Vertigo ; diagnosis ; etiology ; pathology ; Young Adult

OBJECTIVE: To investigate the risk factor,type and characteristic nystagmus of the otolith abnormal migration during diagnosis and treatment for posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV). The therapy and prevention is also discussed. METHOD: Four hundred and seventy-nine patients with PSC-BPPV were treated by Epley's canalith repositioning procedures(CRP) from March 2009 to March 2012. We observed otolith abnormal migration complicating during diagnosis and treatment. According the type of otolith abnormal migration, the additional repositioning maneuver was performed. RESULT: The rate of complication was 8. 1%(39/479), with canal conversion in 5.4%(26/479) and primarily canal reentry in 2.7%(13/479). The rate of incidence of conversion to horizontal canal conversion and anterior canal were 4. 8%(23/479)and 0. 6%(3/479) respectively. All the patient was cured in follow up. The risk factors were unappropriated head movement during or after CRP, including another Dix-Hallpike were performed immediately. CONCLUSION To prevent the complications,the pathognostic positioning sequence and angle of head rotation are commenced during CRP. Appropriate short time postural restrictions post-treatment is necessary. Careful observation of nystagrnus variation is crucial to determine the otolith abnormal migration.
Benign Paroxysmal Positional Vertigo ; therapy ; Head ; Humans ; Incidence ; Nystagmus, Pathologic ; etiology ; Otolithic Membrane ; Patient Positioning ; adverse effects ; Semicircular Canals ; Vertigo

Humans ; Meniere Disease ; diagnosis ; etiology ; Vascular Diseases ; complications ; Vertigo ; diagnosis ; etiology

Female ; Humans ; Laser Therapy ; methods ; Middle Aged ; Semicircular Canals ; surgery ; Vertigo ; etiology ; surgery

BACKGROUNDAnatomic and electrophysiological studies have revealed that the neurons located in the media vestibular nuclei (MVN) receive most of the sensory vestibular input coming from the ipsilateral labyrinth and the responses of MVN neurons to caloric stimulation directly reflect changes in primary vestibular afferent activity. The aim of this study was to clarify the intrinsic characteristics of serotonin (5-hydroxytryptamine, 5-HT) release in the MVN during the period of vertigo induced by caloric stimulation.

METHODSWe used an in vivo microdialysis technique to examine the effects of caloric stimulation on the serotoninergic system in MVN. Twenty four guinea pigs were randomly divided into the groups of irrigation of the ear canal with hot water (n = 6), ice water (n = 6) and 37 degrees C water (n = 4), and the groups of irrigation of the auricle with hot water (n = 4) and ice water (n = 4), according to different caloric vestibular stimulation. We examined the animal's caloric nystagmus with a two-channel electronystagmographic recorder (ENG), and meanwhile examine serotonin (5-hydroxytryptamine, 5-HT) level in the MVN with microdialysis technique after caloric stimulation.

RESULTSIn the caloric test the hot water (44 degrees C) irrigation of the right external auditory canal induced horizontal nystagmus towards the right side lasting about 60 seconds and the ice water irrigation of the right external auditory canal induced it towards the left side lasting for about 90 seconds. No nystagmus was induced by 37 degrees C water irrigation of the external ear canal. Therefore, it was used as a negative control stimulation to the middle ear. The MVN 5-HT levels significantly increased in the first 5-minute collecting interval and increased to 254% and 189% of the control group in the second collecting interval in response to caloric vestibular stimulation with ice water and hot water respectively. The serotonin release was not distinctly changed by the irrigation of the auricle with ice water or hot water.

CONCLUSIONSNeither somato-sensory stimulation of the middle ear nor nonspecific cold or hot stress affects the serotonin release. The rise of 5-HT in MVN may be involved in the mechanism of vertigo induced by caloric stimulation.

Animals ; Caloric Tests ; Guinea Pigs ; Microdialysis ; Serotonin ; secretion ; Vertigo ; etiology ; Vestibular Nuclei ; pathology

Brain ; Brain Abscess ; Humans ; Meniere Disease ; Vertigo/etiology* ; Vestibular Function Tests

OBJECTIVETo investigate the incidence of benign paroxysmal positional vertigo(BPPV) and to further understand the possible mechanism of BPPV.

METHODSTo observe the incidence of BPPV among vestibular neuritis, sudden deafness, Meniere's disease and Bell's palsy at vertigo clinic from January at 2004 to November at 2006 and to compare the therapeutic results with that of the primary BPPV.

RESULTSThere are 4 types of inner ear disorders involved in the concomitant BPPV, ie, vestibular neuritis, sudden deafness, Meniere's disease and Bell's palsy and the incidence are 9.5% (5/53), 38.9% (35/90) and 0.3% (1/381) respectively; and there was 1 case of BPPV concomitant to Bell's palsy. Among the 42 concomitant BPPV, 5 cases were horizontal canal BPPV, 37 cases were posterior canal BPPV, and 1 cases had complicated anterior BPPV during repositioning maneuver. 39 cases of concomitant BPPV were canalithiasis and 3 cases were cupuliothiathitis, of which 75% (27/36) of concomitant BPPV emerged within 1/2 years after the onset of primary inner ear disorders. The therapeutic efficacy of the concomitant BPPV with canalith repositioning was similar to that of the primary type of BPPV.

CONCLUSIONSFollowing some inner ear disorder, BPPV could emerge, such as sudden deafness, vestibular neuritis and Meniere's disease. The most common type of BPPV was canalithiasis of posterior canal, and the cupulolithiasis of horizontal canal was uncommon. The anterior canal therapeutic efficacy of the concomitant BPPV with canalith repositioning was similar to that of the primary type of BPPV. The therapeutic efficacy of the concomitant BPPV with canalith repositioning was similar to that of the primary type of BPPV.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Benign Paroxysmal Positional Vertigo ; Ear Diseases ; complications ; therapy ; Ear, Inner ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Vertigo ; etiology ; therapy ; Young Adult

OBJECTIVE: To retrospectively analyze the clinical characteristics of the benign paroxysmal positional vertigo (BPPV) secondary to the sudden deafness (SD) and to explore pathogenetic mechanism. METHOD: One hundred and seventy-eight cases of the SD in our department were retrospectively analyzed. They were all treated under the guidance of clinical guidelines. RESULT: (1) In all these patient's with SD, there were 31 cases with BPPV secondary to the SD. There were 26 cases of BPPV of posterior semicircular canal and 5 cases of BPPV of lateral BPPV semicircular canal. All patients with BPPV were diagnosed as the same ears as the SD, including 16 cases on left sides and 15 on right sides. (2) The interval between the onset of SD and BPPV was less than one week in 27 cases, between one week and one month in 3 cases, and between one and three months in 1 case. (3) All patients with BPPV secondary to the SD were cured with Epley maneuver or Barbecue roll maneuver. CONCLUSION The occurrence of BPPV may follow SD, and the major of BPPV secondary to the SD occurs in the posterior semicircular canal. The canalith repositioning is an effective therapy to the secondary BPPV.
Adult ; Aged ; Benign Paroxysmal Positional Vertigo ; Female ; Hearing Loss, Sudden ; complications ; diagnosis ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Vertigo ; diagnosis ; etiology ; Young Adult