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

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.

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Episodic vertigo related to migraine (90 cases): vestibular migraine?

Neurology Bulletin ◽

10.17816/nb78895 ◽

2000 ◽

Vol XXXII (1-2) ◽

pp. 83-83

Author(s):

M. Dieterich ◽

T. Brandt

Keyword(s):

Retrospective Study ◽

Migraine Attack ◽

Vestibular Migraine ◽

Episodic Vertigo

A retrospective study of 90 patients with episodic dizziness occurring during a migraine attack was carried out.

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Coital trauma as seen at Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20194248 ◽

2019 ◽

Vol 5 (10) ◽

pp. 279

Author(s):

Assumpta Nnenna Nweke ◽

Johnbosco Ifunanya Nwafor ◽

Bridget Nkiruka Uche-Nwidagu ◽

Wendy Chinwe Oliobi ◽

Malachy Chizoba Onyema ◽

...

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Teaching Hospital ◽

Clinical Presentation ◽

University Teaching ◽

Clinical Notes ◽

Clinical Presentations ◽

Posterior Fornix ◽

The Common ◽

Causes And Risk Factors

Background: Though pleasurable, coitus may result in morbidity and even mortality. One of such morbidities is coital trauma, a global occurrence that is grossly under reported. This study aimed to determine the causes and risk factors for coital trauma as well as its clinical presentation.Methods: This was a 4 year retrospective study of patients that presented with coital injuries at Alex Ekwueme Federal University Teaching Hospital, Abakaliki. Data were obtained from patients’ clinical notes using a specially designed proforma. Statistical analysis was performed using Epi InfoTM 7.2.1. Results: The majority of women that presented with coital trauma were adolescents (67.9%). Most of them were single (92.9%), nulliparous (89.3%) and had only primary education (57.1%). The commonest cause of coital trauma was rape (75%). The commonest risk factors were inadequate foreplay (57.1%) and coitarche (42.9%). Other risk factors were genital disproportion, pregnancy, puerperium and influence of drugs. The common clinical presentations were vaginal bruises (75%) and vaginal lacerations (64.3%) while the commonest site of injury was the hymen (42.9%) followed by the vulva (35.7%). Other less common sites of injury were the lower vagina and posterior fornix.Conclusions: Coital trauma is relatively common and young girls are mainly affected. Rape is the major cause while inadequate foreplay and coitarche are the major predisposing factors.

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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

Journal of Vestibular Research ◽

10.3233/ves-200003 ◽

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.

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Outcome of Critically Ill Patients With Influenza Infection: A Retrospective Study

Infectious Diseases Research and Treatment ◽

10.1177/1178633720904081 ◽

2020 ◽

Vol 13 ◽

pp. 117863372090408

Author(s):

Timothée Abaziou ◽

Clément Delmas ◽

Fanny Vardon Bounes ◽

Fabien Bignon ◽

Laure Crognier ◽

...

Keyword(s):

Retrospective Study ◽

Mortality Rate ◽

Influenza A ◽

Clinical Presentation ◽

Biological Data ◽

Classification And Regression Tree ◽

Influenza B ◽

Mortality Model ◽

Clinical Presentations ◽

Influenza A H1n1

Background: Influenza causes significant morbidity and mortality in adults, and numerous patients require intensive care unit (ICU) admission. Acute respiratory distress syndrome (ARDS) is clearly described in this context, but other clinical presentations exist that need to be assessed for incidence and outcome. The primary goal of this study was to describe the characteristics of patients admitted in ICU for influenza, their clinical presentation, and the 3-month mortality rate. The second objective was to search for 3-month mortality risk factors. Methods: This is a retrospective study including all patients admitted to 3 ICUs due to influenza-related disease between October 2013 and June 2016, which assesses the 3-month mortality rate. We compared clinical presentation, biological data, and outcome at 3 months between survivors and non-survivors. We created a predicting 3-month mortality model with Classification and Regression Tree analysis. Results: Sixty-nine patients were included, 50 patients (72.5%) for ARDS, 5 (7.2%) for myocarditis, and 14 (20.3%) for acute respiratory failure without ARDS criteria. Non-typed influenza A was found in 30 cases (43.5%), influenza A H1N1 in 18 (26.1%), H3N2 in 3 (4.3%), and influenza B in 18 cases (27.5%). The 3-month mortality rate was 29% ( n = 20). Extracorporeal membrane oxygenation (ECMO) was implanted in 23 patients, without any significant increase in mortality (39% vs 24% without ECMO, P = .19). A creatinine serum superior to 96 μmol/L, an aspartate aminotransferase level superior to 68 UI/L, and a Pao2/Fio2 ration below 110 were associated with 3-month mortality in our predictive mortality model. Conclusion: Influenza in ICUs may have several clinical presentations. The mortality rate is high, but ECMO may be an effective rescue therapy.

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Vestibular Migraine: Clinical Challenges and Opportunities for Multidisciplinarity

Behavioural Neurology ◽

10.1155/2016/6179805 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 2

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.

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Vestibular migraine- a dilemma no more

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20171184 ◽

2017 ◽

Vol 3 (2) ◽

pp. 312

Author(s):

Renu Rajguru ◽

Inderdeep Singh ◽

Abhishek Gupta

Keyword(s):

Vestibular System ◽

International Headache Society ◽

Clinical History ◽

Clinical Findings ◽

Vestibular Dysfunction ◽

Vestibular Migraine ◽

Vestibular Disorder ◽

Episodic Vertigo ◽

Vestibular Pathology ◽

Asymptomatic Phase

Background: Vestibular migraine (VM) is an increasingly recognized cause of episodic vertigo. However, the pathophysiology of VM is still a matter of speculation and it is not known to what extent the dysfunction is located in the central or peripheral vestibular system. Though in its earlier version International Headache Society recognized only adult onset VM in the setting of basilar migraine, but in its latest 3rd edition beta version in consensus with Barany Society (2013), VM is included in the International Headache Society classification of migraine in appendix 1. It does not figure in the main list because it is yet to be validated by scientific research. Methods: The purpose of this study is to record and describe the spectrum of clinical findings of VM patients, to study the vestibular system and find out the site of vestibular dysfunction. In this study we studied 20 patients with acute VM in the symptomatic and asymptomatic phase. Results: Abnormal findings in the vestibular work up were present in all 20 VM patients (100%). Central pathology in the vestibular system was seen in 10 patients (50%), 6 patients had peripheral vestibular pathology (30%), and in 4 patients (20%) the site of vestibular dysfunction was indeterminate as they had features of both central and peripheral dysfunction and the exact site of dysfunction could not be determined with certainty. Conclusions: Acute VM should be considered in the differential diagnosis of vertigo. It can present both as a central and a peripheral vestibular disorder. However there are no definitive signs to pin-point the diagnosis. A careful clinical history combined with clinical findings and exclusion of other causes of vertigo, is fundamental for assessing the profile of patients with vestibular migraine.

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Clinical presentation, treatment, and outcomes associated with vaginal intraepithelial neoplasia: A retrospective study of 118 patients

Journal of Obstetrics and Gynaecology Research ◽

10.1111/jog.14733 ◽

2021 ◽

Author(s):

Dake Yu ◽

Pengpeng Qu ◽

Meihua Liu

Keyword(s):

Retrospective Study ◽

Clinical Presentation ◽

Intraepithelial Neoplasia ◽

Vaginal Intraepithelial Neoplasia

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1001 Intra-Articular Distal Radius Fracture Surgical Intervention Threshold Origins and Development

British Journal of Surgery ◽

10.1093/bjs/znab134.344 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

G Esworthy ◽

N Johnson ◽

J Dias ◽

P Divall

Keyword(s):

Distal Radius ◽

Clinical Presentation ◽

Surgical Intervention ◽

Threshold Value ◽

British Society ◽

Relevant Today ◽

Clinical Presentations ◽

Post Traumatic ◽

Current Guidance ◽

Traumatic Arthritis

Abstract Background Treatment of intra-articular distal radius fractures is guided by the displacement of the articular fragments. Symptomatic post-traumatic arthritis is expected to occur if step displacement is > 2mm; this value is often used as an indication for surgery if closed reduction is not possible. Method A systematic review was performed to establish the origin and adaptations of the threshold, with papers screened and relevant citations reviewed. Orthopaedic textbooks were reviewed to ensure no earlier mention of the threshold was present. Results Knirk and Jupiter, 1986, are the first to quantify a threshold, with all their patients developing arthritis with >2mm displacement. Some papers have discussed using 1mm, although 2mm is most widely reported. Current guidance from the British Society for Surgery of the Hand supports 2mm. Although this paper is still widely cited, the authors published a re-examination of the data showing methodological flaws which is not as widely reported. They claim their conclusions are still relevant today; however, the radiological arthritis does not correlate with the clinical presentation. Conclusions Knirk and Jupiter originated the threshold value of 2mm. The lack of correlation between the radiological and clinical presentations warrants further investigation. The principle of treatment remains restoration of normal anatomical position.

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Case series on variable presentations of tuberculosis of the breast

BMJ Case Reports ◽

10.1136/bcr-2020-236019 ◽

2020 ◽

Vol 13 (12) ◽

pp. e236019

Author(s):

Tharun Ganapathy Chitrambalam ◽

Jeyakumar Sundaraj ◽

Pradeep Joshua Christopher ◽

Ramyasree Paladugu

Keyword(s):

Clinical Presentation ◽

Case Series ◽

Common Type ◽

Breast Abscess ◽

Breast Lump ◽

Clinical Presentations ◽

Malignant Lesions

Tuberculosis (TB) of the breast is extremely rare and is often mistaken for benign or malignant lesions of the breast. They are rare even in countries which are endemic for TB, like India. The most common type of clinical presentation is a vague lump in the breast, but there are even other types of presentations which are documented. In olden days, there was a lot of dilemma and challenge in diagnosing TB of the breast, but thanks to improved pathological knowledge and the advent of investigations such as QuantiFERON-TB gold and GeneXpert, TB can be diagnosed early nowadays and treated accordingly. In this study series, we report 10 cases of TB of the breast with variable clinical presentations as fibroadenosis, breast abscess, duct ectasia and breast lump on evaluation, and the challenges encountered in establishing the diagnosis.

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Brucellosis: a retrospective evaluation of 99 cases and review of brucellosis treatment

Tropical Doctor ◽

10.1258/td.2006.006266 ◽

2008 ◽

Vol 38 (1) ◽

pp. 59-62 ◽

Cited By ~ 10

Author(s):

Neşe Demirtürk ◽

Tuna Demirdal ◽

Nurettin Erben ◽

Serap Demir ◽

Zerrin Asci ◽

...

Keyword(s):

Retrospective Study ◽

Combination Therapy ◽

Clinical Sign ◽

Epidural Abscess ◽

Retrospective Evaluation ◽

University Hospitals ◽

Serological Tests ◽

Frequent Symptom ◽

Clinical Presentations

This retrospective study was performed in two university hospitals between January 2002 and 2006. Ninety-nine brucellosis patients were included in the study. These patients were classified as acute (91), chronic (4) and relapse (4) according to their clinical presentations and serological tests. Brucella bacteria were isolated in the blood of 17 (17.2%) cases. The most frequent symptom and clinical sign was fever. The osteoarticular complications were found in 17 patients (17.2%). Four of them were complicated with epidural abscess the same time. Two (2.2%) had meningitis, two (2.2%) had epididymoorchitis, three (3.3%) had skin rashes and one (1.1%) had hepatitis. Three of the acute brucellosis patients were pregnant. Rifampin and doxycycline combination therapy had been administered to most of the patients with acute and relapse brucellosis. However, complicated and chronic brucellosis cases were given different treatment combinations. This study reviews brucellosis therapy choices.

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