scholarly journals Vestibular Migraine: Clinical Challenges and Opportunities for Multidisciplinarity

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Isabel Luzeiro ◽  
Leonel Luís ◽  
Freire Gonçalves ◽  
Isabel Pavão Martins
Keyword(s):  
Multidisciplinary Approach ◽  
Clinical Presentation ◽  
Imaging Techniques ◽  
Vestibular Migraine ◽  
Therapeutic Approaches ◽  
Actual Knowledge ◽  
New Concepts ◽  
Challenges And Opportunities ◽  
Vestibular Symptoms

Migraine and vertigo are two very prevalent conditions in general population. The coexistence of both in the same subject is a significant clinical challenge, since it is not always possible to understand whether they are causally related or associated by chance, requiring different diagnostic and therapeutic approaches. In this review we analyze and summarize the actual knowledge about vestibular migraine (VM), focusing on the new concepts proposed by the International Classification of Headache Disorders 3-beta and by the Bárány Society and also addressing the former concepts, which are still present in clinical practice. We conclude that clinical studies using a multidisciplinary approach are crucial in this field, since different specialists observe the same pathology with different eyes. Clinical presentation of VM is variable in what concerns vestibular symptoms temporal relation with migraine headache, as well as in their accompanying manifestations. Biomarkers, either genomics or functional, and molecular imaging techniques will be helpful to clarify many aspects of the complexity of this entity, helping to define to what extent can VM be considered a separate and independent clinical entity.

Migraine and vertigo

2020 ◽  
pp. 128-137
Author(s):  
Yoon-Hee Cha
Keyword(s):  
Migraine Headache ◽  
Clinical Characteristics ◽  
Vestibular Migraine ◽  
Headache Disorders ◽  
Temporal Profile ◽  
Growing Body ◽  
Vestibular Symptoms ◽  
The Common ◽  
Treatment Responses

The phenomena of migraine headache and vertigo share many epidemiological, anatomical, and clinical characteristics. The historically parallel development of the neuroscience of each field has formally intersected in the development of consensus criteria for vestibular migraine and the inclusion of vestibular migraine in the International Classification of Headache Disorders. Differences exist in the temporal profile of head pain and vertigo as manifestations of migraine, which can obscure the association. However, the growing body of evidence on the common demographic, neurochemical signature, and treatment responses of pain and vestibular symptoms indicate that they exist as symptoms of a common syndrome, one which can only be fully understood by recognizing the significance of each kind of manifestation.

Vestibular migraine of childhood and recurrent vertigo of childhood: Diagnostic criteria consensus document of the committee for the classification of vestibular disorders of the bárány society and the international headache society

2020 ◽  
pp. 1-9
Author(s):  
Raymond van de Berg ◽  
Josine Widdershoven ◽  
Alexandre Bisdorff ◽  
Stefan Evers ◽  
Sylvette Wiener-Vacher ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Past History ◽  
International Headache Society ◽  
Vestibular Migraine ◽  
Future Research ◽  
Vestibular Disorders ◽  
Consensus Document ◽  
Severe Intensity ◽  
Vestibular Symptoms

This paper describes the diagnostic criteria for “Vestibular Migraine of Childhood”, “probable Vestibular Migraine of Childhood” and “Recurrent Vertigo of Childhood” as put forth by the Committee for the Classification of Vestibular Disorders of the Bárány Society (ICVD) and the Migraine Classification subgroup of the International Headache Society. Migraine plays an important role in some subgroups of children with recurrent vertigo. In this classification paper a spectrum of three disorders is described in which the migraine component varies from definite to possibly absent. These three disorders are: Vestibular Migraine of Childhood, probable Vestibular Migraine of Childhood and Recurrent Vertigo of Childhood. The criteria for Vestibular Migraine of Childhood (VMC) include (A) at least five episodes with vestibular symptoms of moderate or severe intensity, lasting between five minutes and 72 hours, (B) a current or past history of migraine with or without aura, and (C) at least half of episodes are associated with at least one migraine feature. Probable Vestibular Migraine of Childhood (probable VMC) is considered when at least three episodes with vestibular symptoms of moderate or severe intensity, lasting between five minutes and 72 hours, are accompanied by at least criterion B or C from the VMC criteria. Recurrent Vertigo of Childhood (RVC) is diagnosed in case of at least three episodes with vestibular symptoms of moderate or severe intensity, lasting between 1 minute and 72 hours, and none of the criteria B and C for VMC are applicable. For all disorders, the age of the individual needs to be below 18 years old. It is recommended that future research should particularly focus on RVC, in order to investigate and identify possible subtypes and its links or its absence thereof with migraine.

scholarly journals Imaging Inflammation – From Whole Body Imaging to Cellular Resolution

2021 ◽  
Vol 12 ◽  
Author(s):  
Tuula Peñate Medina ◽  
Jan Philip Kolb ◽  
Gereon Hüttmann ◽  
Robert Huber ◽  
Oula Peñate Medina ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Imaging Techniques ◽  
Point Of View ◽  
Imaging Modalities ◽  
Whole Body ◽  
Whole Body Imaging ◽  
New Concepts ◽  
Current Usage ◽  
Inflammation Imaging ◽  
Challenges And Opportunities

Imaging techniques have evolved impressively lately, allowing whole new concepts like multimodal imaging, personal medicine, theranostic therapies, and molecular imaging to increase general awareness of possiblities of imaging to medicine field. Here, we have collected the selected (3D) imaging modalities and evaluated the recent findings on preclinical and clinical inflammation imaging. The focus has been on the feasibility of imaging to aid in inflammation precision medicine, and the key challenges and opportunities of the imaging modalities are presented. Some examples of the current usage in clinics/close to clinics have been brought out as an example. This review evaluates the future prospects of the imaging technologies for clinical applications in precision medicine from the pre-clinical development point of view.

scholarly journals Circadian variations in occurrence and the clinical presentation of Vestibular Migraine: A retrospective study

2020 ◽  
Author(s):  
Wei Liu ◽  
Le Yang ◽  
Hongli Dong ◽  
Huifeng Qian ◽  
Hongru Zhao ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Presentation ◽  
International Headache Society ◽  
Onset Time ◽  
Vestibular Migraine ◽  
Circadian Variations ◽  
Episodic Vertigo ◽  
Clinical Presentations ◽  
Lack Of Sleep ◽  
Vestibular Symptoms

Abstract Background: As a new clinical disease entity, vestibular migraine (VM) is considered to be the commonest cause of spontaneous episodic vertigo. This study is trying to explore the circadian variations in occurrence and the clinical presentation of VM.Methods: We conducted a retrospective study and identified female patients who fulfilled the 2012 International Headache Society-Bárány Society Criteria for VM. Population’s clinical data were collected, including onset time and descriptions of sensations experienced by our patients during VM attacks.Results: A total of 189 female VM patients were included in our study. 74.0% of attacks in VM were presented in morning hours before 12 o’clock and the peak of occurrence was at about 7 o'clock. The attack frequency reached the baseline during 12:00-23:59 while there were two abnormal upward fluctuations at about 14:00 and 20:00. The biological circadian cycles may have greater impact of VM than lack of sleep. In addition, clinical presentations of vestibular symptoms including orthostatic vertigo, visually induced vertigo and dizziness showed variations among four 6-hour quadrants per day. Conclusions: Occurrence as well as clinical presentations of vestibular symptoms exhibited circadian variations among VM patients. These data suggested that chronobiological mechanisms may play a role in vestibular migraine pathophysiology.

scholarly journals Unraveling the Etiology of Pediatric Vertigo and Dizziness: A Tertiary Pediatric Center Experience

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 475
Author(s):  
Nina Božanić Urbančič ◽  
Domen Vozel ◽  
Jure Urbančič ◽  
Saba Battelino
Keyword(s):  
Multidisciplinary Approach ◽  
Clinical Presentation ◽  
Case Series ◽  
Vestibular Migraine ◽  
The Self ◽  
Retrospective Case ◽  
Common Cause ◽  
Migrainous Vertigo ◽  
Retrospective Case Series ◽  
Pediatric Center

Background and Objectives: Numerous authors have reported that the commonest type of vertigo in children is migraine-associated vertigo (vestibular migraine and benign paroxysmal vertigo of childhood—BPV). We aimed to provide the possible etiological background of vertigo and dizziness in Slovenian children. Materials and Methods: A retrospective case series of pediatric vertigo and dizziness children referred to the tertiary pediatric otorhinolaryngology center from 2015 to 2020. Children received a complete audiological and vestibular workup and were referred to pediatric specialists depending on the clinical presentation. Results: Of 257 children (42% male, 58% female) aged 1–17 years (M = 10.9, SD = 4.3 years) in 19.1% vertigo and dizziness were classified as central, in 12.4% as a peripheral vestibular, in 10.9% as a hemodynamic, in 5.8% as a psychological and none as visual by pediatric neurologists, otorhinolaryngologists, cardiologists, psychologists or ophthalmologists, respectively. 40.8% (20) children with central vertigo had BPV (7.8% of all children) and 8.2% (4) migrainous vertigo. In 43.6% (112 children), the etiology remained unclassified. Conclusions: After a thorough multidisciplinary workup, the etiology of vertigo and dizziness was unraveled in the majority of children referred to our tertiary otorhinolaryngology center. The most common cause was central; however, in a considerable number, the etiology remained unclassified. The latter could be attributed to the self-limiting nature of vertigo spells. Hence, a child presenting with dizziness and vertigo requires a multidisciplinary approach, in which referral to a neurologist is, in most cases, essential.

Vestibular migraine in multicenter neurology clinics according to the appendix criteria in the third beta edition of the International Classification of Headache Disorders

Cephalalgia ◽  
2015 ◽  
Vol 36 (5) ◽  
pp. 454-462 ◽  
Author(s):  
Soo-Jin Cho ◽  
Byung-Kun Kim ◽  
Byung-Su Kim ◽  
Jae-Moon Kim ◽  
Soo-Kyoung Kim ◽  
...  
Keyword(s):  
Headache Disorder ◽  
International Classification ◽  
Vestibular Migraine ◽  
Headache Disorders ◽  
The Third ◽  
Common Term ◽  
Vestibular Symptoms ◽  
The Common ◽  
Probable Migraine

Background Vestibular migraine (VM), the common term for recurrent vestibular symptoms with migraine features, has been recognized in the appendix criteria of the third beta edition of the International Classification of Headache Disorders (ICHD-3β). We applied the criteria for VM in a prospective, multicenter headache registry study. Methods Nine neurologists enrolled consecutive patients visiting outpatient clinics for headache. The presenting headache disorder and additional VM diagnoses were classified according to the ICHD-3β. The rates of patients diagnosed with VM and probable VM using consensus criteria were assessed. Results A total of 1414 patients were enrolled. Of 631 migraineurs, 65 were classified with VM (10.3%) and 16 with probable VM (2.5%). Accompanying migraine subtypes in VM were migraine without aura (66.2%), chronic migraine (29.2%), and migraine with aura (4.6%). Probable migraine (75%) was common in those with probable VM. The most common vestibular symptom was head motion-induced dizziness with nausea in VM and spontaneous vertigo in probable VM. The clinical characteristics of VM did not differ from those of migraine without VM. Conclusion We diagnosed VM in 10.3% of first-visit migraineurs in neurology clinics using the ICHD-3β. Applying the diagnosis of probable VM can increase the identification of VM.

Alteraciones sistémicas y metabólicas producidas por lesión medular

2019 ◽  
Vol 1 (1) ◽  
pp. 59-75
Author(s):  
Gabriel Guízar Sahagún
Keyword(s):  
Spinal Cord ◽  
Daily Living ◽  
Autonomic Function ◽  
Clinical Presentation ◽  
Scientific Literature ◽  
International Standards ◽  
Therapeutic Approaches ◽  
Cord Injury ◽  
Life Threatening ◽  
The Impact

Besides the well-known loss of motor and sensory capabilities, people with spinal cord injury (SCI) experience a broad range of systemic and metabolic abnormalities including, among others, dysfunction of cardiovascular, respiratory, gastrointestinal, urinary, and endocrine systems. These alterations are a significant challenge for patients with SCI because such disorders severely interfere with their daily living and can be potentially life-threatening. Most of these disorders are associated with impairment of regulation of the autonomic nervous system, arising from disruption of connections between higher brain centers and the spinal cord caudal to the injured zone. Thus, the higher and more complete the lesion, the greater the autonomic dysfunction and the severity of complications.This article summarizes the medical scientific literature on key systemic and metabolic alterations derived of SCI. It provides information primarily focused on the pathophysiology and clinical presentation of these disorders, as well as some guides to prevent and alleviate such complications. Due to the impact of these alterations, this topic must be a priority and diffuse to those involved with the care of people with SCI, including the patient himself/herself. We consider that any collaborative effort should be supported, like the development of international standards, to evaluate autonomic function after SCI, as well as the development of novel therapeutic approaches.

Clinical Epidemiology of Coronavirus Disease 2019:Defined on Current Research

2020 ◽  
pp. 54-72 ◽  
Author(s):  
Fengyu Zhang ◽  
Claude Hughes
Keyword(s):  
Clinical Presentation ◽  
Population Distribution ◽  
Clinical Epidemiology ◽  
Case Fatality ◽  
Immunological Response ◽  
Prevention Strategies ◽  
Clinical Type ◽  
Global Pandemic ◽  
Potential Therapeutics

Coronavirus disease 2019 (COVID-19) is a new infectious respiratory disease that has caused the ongoing global pandemic. The primary purpose of this article is to describe evolving clinical epidemiology of COVID-19, including 1) infection and testing, 2) clinical spectrum including classification of clinical type, asymptomatic cases, severe cases and comorbidity, and clinical and immunological response, 3) regional variation in clinical presentation, 4) population distribution by age, sex, and occupation, and finally, 5) case-fatality. This content may provide important information on detailed clinical type and presentation of the disease, in which appropriate clinical outcomes can be derived for developing prevention strategies and clinical studies or trials that aim to test potential therapeutics or products for different patient populations.

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