scholarly journals Prevalence of Pediatric and Adolescent Balance Disorders: Analysis of a Mono-Institutional Series of 472 Patients

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1056
Author(s):  
Cristiano Balzanelli ◽  
Daniele Spataro ◽  
Luca Oscar Redaelli de Zinis
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Clinical History ◽  
Diagnostic Process ◽  
Clinical Documentation ◽  
Vestibular Loss ◽  
Balance Disorders ◽  
Positional Vertigo ◽  
Diagnostic Work ◽  
Work Up ◽  
Paroxysmal Positional Vertigo

(1) Background: To assess the prevalence and frequency distribution of balance disorders in children and adolescents to delineate the planning of a targeted clinical and instrumental diagnostic work-up; (2) Methods: Retrospective analysis of the clinical documentation of patients under 18 years suffering from balance disorders from 2010 to 2019. Detailed collection of clinical history, accurate clinical examination, including both nystagmus and vestibulospinal signs examinations, and specific instrumental testing were the basis of the diagnostic process. (3) Results: A total of 472 participants were included in the study. Vestibular loss (26.1%) was the most frequent cause of vertigo in children, followed by vestibular migraine (21.2%) and benign paroxysmal positional vertigo (10.2%). In 1.1% of patients, the cause of vertigo remained undefined; (4) Conclusions: The diagnostic process applied was effective in understanding the cause of balance disorders in most cases and prevents more complex and expensive investigations reserved for only a few selected cases.

scholarly journals Age-Associated Characteristics of Patients With Chronic Dizziness and Vertigo

2021 ◽  
pp. 089198872110361
Author(s):  
Alexander Wassermann ◽  
Sigrid Finn ◽  
Hubertus Axer
Keyword(s):  
Older Patients ◽  
Tertiary Care ◽  
Age Groups ◽  
Bilateral Vestibulopathy ◽  
Positional Vertigo ◽  
Younger Age ◽  
Chronic Dizziness ◽  
Diagnostic Work ◽  
Work Up ◽  
Paroxysmal Positional Vertigo

Objective: The incidence of dizziness and vertigo is increasing with age, and symptoms lead to significant limitations in daily living and to disability in older patients. Method: Data of 1,752 patients with chronic dizziness/vertigo subjected to a tertiary care, specialized interdisciplinary vertigo center were analyzed. Age, gender, symptoms, medical diagnosis, and Dizziness Handicap Inventory (DHI) were collected based on a questionnaire and analysis of associated patient records. The patients were assigned to 3 age groups (< 41, 41-65, and > 65 years). Results: 33.7% of the patients were older than 65 years. Frequency of symptoms and DHI score increased with age. Older patients reported less frequently about coexisting symptoms such as nausea, headache, tinnitus, ear pressure, and visual impairment. Multisensory deficit, central vertigo, bilateral vestibulopathy, and benign paroxysmal positional vertigo were diagnosed increasingly with age, while persistent postural–perceptual dizziness and vestibular migraine were diagnosed in the younger age groups. Conclusion: In the diagnostic work-up of older patients age-specific characteristics of dizziness/vertigo have to be considered. The older patient generally is more impaired by the symptoms but possibly will not report typical diagnosis-defining symptoms.

scholarly journals The Dix-Hallpike and Modified Epley Manoeuvres in the diagnosis and management of Benign Paroxysmal Positional Vertigo (BPPV)

2004 ◽  
Vol 3 (1) ◽  
pp. 36-37
Author(s):  
Matthew Clarke ◽  
◽  
Liz Stallworthy ◽  
J Dulay ◽  
◽  
...  
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Head Position ◽  
Balance Disorders ◽  
Diagnosis And Management ◽  
Positional Vertigo ◽  
Rapid Changes ◽  
Common Balance ◽  
Paroxysmal Positional Vertigo

Benign Paroxysmal Positional Vertigo (BPPV) is one of the most common balance disorders and one of the easiest to diagnose and treat. It is characterised by short lived episodes of vertigo and geotropic rotatory nystagmus, which occur a few seconds after rapid changes in head position. The vertigo usually lasts no more than a minute and the symptoms reduce in severity with repetitions of the evoking movement.

Unrecognized benign paroxysmal positional vertigo in elderly patients

2000 ◽  
Vol 122 (5) ◽  
pp. 630-634 ◽  
Author(s):  
John S. Oghalai ◽  
Spiros Manolidis ◽  
Justine L. Barth ◽  
Michael G. Stewart ◽  
Herman A. Jenkins
Keyword(s):  
Elderly Patients ◽  
Benign Paroxysmal Positional Vertigo ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Balance Disorders ◽  
Positional Vertigo ◽  
Increased Risk ◽  
Paroxysmal Positional Vertigo

Balance disorders in elderly patients are associated with an increased risk of falls but are often difficult to diagnose because of comorbid chronic medical problems. We performed a cross-sectional study to determine the prevalence of unrecognized benign paroxysmal positional vertigo (BPPV) and associated lifestyle sequelae in a public, inner-city geriatric population. Dizziness was found in 61% of patients, whereas balance disorders were found in 77% of patients. Nine percent were found to have unrecognized BPPV. Multivariate analysis demonstrated that the presence of a spinning sensation and the absence of a lightheadedness sensation predicted the presence of unrecognized BPPV. Patients with unrecognized BPPV were more likely to have reduced activities of daily living scores, to have sustained a fall in the previous 3 months, and to have depression. These data indicate that unrecognized BPPV is common within the elderly population and has associated morbidity. Further prospective studies are warranted.

scholarly journals Benign Paroxysmal Positional Vertigo (BPPV) in Adult Patients between 15-40 years of age: A study on Treatment Outcome in Teaching Hospitals

2021 ◽  
Vol 15 (6) ◽  
pp. 2115-2118
Author(s):  
Zafar Iqbal ◽  
Rehan Saleem ◽  
Muhammad Tayyab Rasheed ◽  
Mohammed Habib ◽  
Naseem ul Haq ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Medical Treatment ◽  
Benign Paroxysmal Positional Vertigo ◽  
Combined Treatment ◽  
Clinical History ◽  
Adult Patients ◽  
Teaching Hospitals ◽  
Vestibular Disorder ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Objectives: To study treatment outcome of positional vertigo in adult patients of 15-40 years of age. Place and duration of study: This study was conducted at ENT department of Chaudhary Muhammad Akram Teaching & Research Hospital, Lahore and Kuwait Teaching Hospital, Peshawar from June 2019 to June 2020. Material and Methods: 50 patients with diagnosis of benign positional vertigo were included in the study. Patients were treated and their outcomes were analyzed. Results: 50 patients of age between 15-40 years were included in the study. The analysis of treatment outcome showed that 35 patients (70%) showed maximum improvement in vertigo with medical treatment, 10 patients (20%) showed improvement in their symptoms with positional exercises and 5 patients (10%) showed improvement by combined treatment. Conclusion: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder and presents as brief, episodic, positional provoked vertigo. The diagnosis can be made through clinical history along with diagnostic maneuvers and it can have a considerable impact on the quality of life. The medical treatment with vestibular dilators and vestibular suppressant is best option, with particle repositioning maneuver (Epley maneuver) for resistant and recurrent patients. Key words: Vestibular exercises, Dizziness, Positional vertigo, Dis equilibrium

scholarly journals Diabetes and the Vestibular System

2019 ◽  
Vol 40 (04) ◽  
pp. 300-307 ◽  
Author(s):  
Erin G. Piker ◽  
Daniel J. Romero
Keyword(s):  
Diabetes Mellitus ◽  
Vestibular System ◽  
Benign Paroxysmal Positional Vertigo ◽  
Large Population ◽  
Population Based ◽  
Vestibular Disorder ◽  
Vestibular Loss ◽  
Positional Vertigo ◽  
Patients With Diabetes ◽  
Paroxysmal Positional Vertigo

AbstractFalls are among the most injurious, costly, and feared conditions affecting older adults. Patients with diabetes have a significantly greater risk for falling due to complications affecting the sensory systems required for balance: vision, proprioception, and vestibular. The effects of diabetes mellitus on the vestibular system are perhaps the least understood of these systems. The vestibular system is complex, includes multiple structures, and is difficult and expensive to thoroughly assess. There is pathophysiologic evidence suggesting a direct effect of diabetes mellitus complications on the vestibular system, but there is limited clinical evidence regarding which specific vestibular structures are most adversely affected. Nevertheless, large population-based studies show that patients with diabetes are more likely to have vestibular loss, have a high prevalence of a specific vestibular disorder called benign paroxysmal positional vertigo, and are at a greater risk for falling. Based on the available evidence, a balance screening and an evaluation of benign paroxysmal positional vertigo, a common but easy to treat pathology, in patients with diabetes is recommended as well as counseling on falls risk and home modifications.

scholarly journals Benign Paroxysmal Positional Vertigo (BPPV) in COVID-19

2021 ◽  
Vol 11 (3) ◽  
pp. 418-422
Author(s):  
Pasqualina Maria Picciotti ◽  
Giulio Cesare Passali ◽  
Bruno Sergi ◽  
Eugenio De Corso
Keyword(s):  
Benign Paroxysmal Positional Vertigo ◽  
Cytopathic Effect ◽  
Semicircular Canals ◽  
Bed Rest ◽  
Clinical History ◽  
Mild Phenotype ◽  
Direct Damage ◽  
Positional Vertigo ◽  
Epley Maneuver ◽  
Paroxysmal Positional Vertigo

Objective: The purpose of this article is to describe BPPV in COVID-19 patients by discussing the possible mechanisms underlying the onset of this vertigo. Methods: We studied eight patients (4 F, 4 M, aged between 44 and 69 years) with COVID-19 infections complaining of vertigo. Patients were evaluated at the end of infection with an accurate clinical history, and the investigation of spontaneous, positional and positioning nystagmus. Results: The vestibular findings showed benign paroxysmal positional vertigo (BPPV) in all the patients. Three patients had a mild phenotype of the COVID infection, whereas five subjects were hospitalized for the COVID infection and in three cases intensive care was required. Vestibular evaluation showed an involvement of posterior semicircular canals in five patients and horizontal in three. Three patients were treated with the Epley maneuver, two with Semont, one with Lempert and two with Gufoni maneuvers. Conclusions: We hypothesize that BPPV in COVID-19 infections can be relate to drugs, prolonged bed rest and to direct damage by viral infection on the peripheral vestibular system and in particular on the otolitic membrane due to the cytopathic effect of the virus and to the inflammatory response. Studies on large series of patients are needed to confirm our preliminary observation and to better evaluate the pathophysiological mechanisms underlying BPPV in these patients.

Vestibular Rehabilitation

2019 ◽  
Vol 4 (6) ◽  
pp. 1378-1378
Author(s):  
Neil T. Shepard
Keyword(s):  
Physical Therapy ◽  
Benign Paroxysmal Positional Vertigo ◽  
Vestibular Rehabilitation ◽  
Balance Disorders ◽  
Rehabilitation Therapy ◽  
Basic Area ◽  
Positional Vertigo ◽  
Balance Rehabilitation ◽  
Paroxysmal Positional Vertigo

Purpose In this introduction, the author introduces the reader to two articles that cover the basic area of vestibular and balance rehabilitation therapy (VBRT). The articles explain some of the uses of VBRT but not the techniques of how to establish such a program for a patient with dizziness and balance disorders. Conclusion The audiologist needs to be familiar with the various uses of VBRT and the techniques for identification and treatment of benign paroxysmal positional vertigo. However, without the audiologist undergoing further specific musculoskeletal training, the remainder of VBRT should occur in the physical therapy arena.

Characterisation and objective monitoring of balance disorders following head trauma, using videonystagmography

2011 ◽  
Vol 126 (1) ◽  
pp. 26-33 ◽  
Author(s):  
M B Naguib ◽  
Y Madian ◽  
M Refaat ◽  
O Mohsen ◽  
M El Tabakh ◽  
...  
Keyword(s):  
Head Trauma ◽  
Benign Paroxysmal Positional Vertigo ◽  
Injury Severity ◽  
Cohort Analysis ◽  
Severe Trauma ◽  
Early Recovery ◽  
Balance Disorders ◽  
Positional Vertigo ◽  
Balance Disorder ◽  
Paroxysmal Positional Vertigo

AbstractObjective:To characterise balance disorders occurring after head trauma, using videonystagmography, and to test the efficiency of videonystagmography as a diagnostic and monitoring tool.Method:Prospective, cohort analysis of 126 head trauma patients managed with vestibular evaluation, monitoring and treatment, in a tertiary referral centre. Analytical parameters included: head injury severity; balance disorder type, severity and time of onset; and patient recovery and outcome.Results:Head trauma was minor in 31.7 per cent, mild in 36.6 per cent, moderate in 19 per cent and severe in 12.7 per cent. Balance disorder symptoms included vertigo in 42.9 per cent, unsteadiness in 15.9 per cent, dizziness in 9.5 per cent and none in 31.7 per cent. Videonystagmographic balance disorder diagnosis type was peripheral vestibular in 23.8 per cent, central in 7.9 per cent, mixed in 12.7 per cent, benign paroxysmal positional vertigo in 4.8 per cent and no findings in 50.8 per cent. Balance disorder was immediate in 47.6 per cent (this included all moderate and severe trauma cases). Benign paroxysmal positional vertigo developed within the first week in two-thirds of cases. More severe trauma cases had longer recovery times. Peripheral, mixed and central balance disorders recovered within the first three months. Early rehabilitation of acute balance disorders led to early recovery regardless of diagnosis.Conclusion:Videonystagmography enables precise, simple, cost-effective monitoring of balance disorders after head trauma, and improves care and outcomes.

Unrecognized Benign Paroxysmal Positional Vertigo in Elderly Patients

2000 ◽  
Vol 122 (5) ◽  
pp. 630-634 ◽  
Author(s):  
John S. Oghalai ◽  
Spiros Manolidis ◽  
Justine L. Barth ◽  
Michael G. Stewart ◽  
Herman A. Jenkins
Keyword(s):  
Elderly Patients ◽  
Benign Paroxysmal Positional Vertigo ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Balance Disorders ◽  
Positional Vertigo ◽  
Increased Risk ◽  
Paroxysmal Positional Vertigo

Balance disorders in elderly patients are associated with an increased risk of falls but are often difficult to diagnose because of comorbid chronic medical problems. We performed a cross-sectional study to determine the prevalence of unrecognized benign paroxysmal positional vertigo (BPPV) and associated lifestyle sequelae in a public, inner-city geriatric population. Dizziness was found in 61% of patients, whereas balance disorders were found in 77% of patients. Nine percent were found to have unrecognized BPPV. Multivariate analysis demonstrated that the presence of a spinning sensation and the absence of a lightheadedness sensation predicted the presence of unrecognized BPPV. Patients with unrecognized BPPV were more likely to have reduced activities of daily living scores, to have sustained a fall in the previous 3 months, and to have depression. These data indicate that unrecognized BPPV is common within the elderly population and has associated morbidity. Further prospective studies are warranted.

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