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Query: UMLS:C0004134 (ataxia)
 15,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One week after chiropractic manipulations, a 60-year-old normotensive man suffered acute onset of vertigo, ataxia, and dysarthria. CT disclosed an isodense mass of the posterior fossa. Vertebral arteriography showed that the avascular mass arose from the right cerebellar hemisphere. Hydrocephalus developed, and suboccipital craniotomy revealed a large cerebellar hematoma due to a small arteriovenous malformation. A similar episode occurred 2 months later. CT isodense cerebellar hematomas should be considered before giving anticoagulant therapy.
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PMID:Isodense cerebellar hematoma. 668 55

We studied a kindred with an acetazolamide-responsive, episodic ataxia syndrome. Affected members experienced paroxysmal attacks of ataxia that were precipitated by exertion or stress. All but one young patient had additional neurologic symptoms that included paresthesia, weakness, headache, tinnitus, vertigo, and myotonia. All symptoms were prevented by acetazolamide. Between attacks, serum pyruvate and lactate levels and urinary amino acids were normal, but electroencephalograms showed paroxysmal, high-amplitude, slow and sharp activity. Serum K+ was normal during attacks. The metabolic abnormality seems to affect the cerebellum and brainstem and may involve peripheral nerve and muscle.
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PMID:Acetazolamide-responsive episodic ataxia syndrome. 668 59

Thirteen patients with schwannomas of the jugular foramen were operated on at the Cleveland Clinic between 1974 and 1983. The authors' experience in managing these rare tumors is presented. Three major growth patterns of jugular foramen schwannoma were seen, and it is postulated that the position of the tumor depends on its point of origin from the nerves as they pass through the pars nervosa of the jugular foramen. The more distal lesions will expand inferiorly out of the base of the skull, and the more proximal lesions will enlarge into the posterior fossa. Tumors in the mid region will tend to expand primarily into bone. The schwannoma was primarily intracranial in six patients. In five patients the tumor expanded the bone at the base of the skull, with only a small intracranial component, and in two patients the tumor was primarily extracranial, with a small extension into the bone or posterior fossa. The presentation of the patients varied according to the tumor growth pattern. Deafness, vertigo, and ataxia were present in all patients with a major intracranial component, and in most of these there were only minimal deficits of the jugular foramen nerves. By contrast, lower cranial nerve involvement, including hoarseness and weakness of the trapezius and sternocleidomastoid muscles, occurred in patients in whom the tumor was primarily, within the bone or extracranial. Three of the five patients with the major component of the schwannoma within the bone also had deafness. Symptomatic history was longest in those with tumor mainly involving the bone at the base of the skull, and shortest in patients with entirely extracranial tumor. Surgical resection was accomplished with a joint neurosurgical-otological approach, usually combining a posterior fossa exploration with either a translabyrinthine transcochlear or infralabyrinthine procedure. The exact nature of the operation depended upon the presence of intracranial tumor and on the extent of bone or extracranial involvement. Total excision was performed in all cases. There was no operative mortality, and surgery resulted in loss of function of the ninth, 10th, and 11th cranial nerves in most patients. The major postoperative morbidity consisted of swallowing difficulties and sputum aspiration.
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PMID:Jugular foramen schwannomas. 671 39

We have continued to employ transmastoid labyrinthectomy since reporting our results for the first 15 patients. Further experience has confirmed our earlier findings that the vestibular system rapidly accommodates to complete unilateral surgical vestibular ablation, regardless of age and vestibular activity of the ear operated upon as measured by bithermal caloric testing. Patients are able to ambulate in one to three days and typically return home three to eight days postoperatively. Only 7 percent of sixty patients retained occasional unsteadiness and only two individuals stated that they suffered constant unsteadiness. Once compensated, there was no instance in which vertigo or unsteadiness returned during the follow-up period. In the individual with unilateral sensorineural hearing loss and incapacitating dysequilibrium, the ear with the hearing loss can be reliably implicated as the one producing the vertigo, regardless of the vestibular activity in that ear as measured by the bithermal caloric test. As we gain more experience, this has continued to be a valid assumption. No individual has lost hearing in the contralateral ear during the period of observation. Dysequililbrium with all its variants--rotary vertigo, instability, veering , ataxia, and lightheadedness--is one of man's most disabling and incapacitating afflictions and affects an individual's ability to pursue normal life and work. We continue to be impressed with the length of time many individuals have borne this incapacitation; one-third of our patients have been incapacitated for over five years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Transmastoid labyrinthectomy: surgical management of vertigo in the nonserviceable hearing ear. A five-year experience. 672 Aug 81

Hearing loss in an uncommon symptom in multiple sclerosis (MS). In nine patients with MS, seven with unilateral hearing loss and two with bilateral impairment, accompanying symptoms and signs included facial numbness, hemifacial paresis or spasms, ipsilateral limb ataxia, nystagmus, vertigo, tinnitus, and spastic-ataxic gait. Central auditory dysfunction was suggested by audiometric findings and/or by brainstem auditory evoked potentials in all nine patients. Clinical improvement in two was accompanied by return toward normal in the results of audiometric or electrophysiologic studies. Hearing impairment should be sought in patients with MS and appropriate studies pursued.
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PMID:Hearing loss in multiple sclerosis. 684 85

Head extension may cause a physiological vertigo and postural imbalance separate and distinct from basilar insufficiency. This physiological imbalance mainly is due to a vestibular sensory deficiency when the utricular otoliths are beyond their working range because of the change in head position. Since the intact visual and somatosensory control hope widely compensate for the vestibular deficiency, head-extension vertigo is of particular concern only in certain stimulus situations or diseases in which the stabilizing input from the eyes or joint receptors is reduced. Balance training on foam rubber with head extension and closed eyes improved postural-sway activity up to 50% within five days. A daily short-term training effect and a long-term training effect together form a typical exponential sawtooth curve of postural stability over time. After termination of training, learned balance skill exponentially returns to the pretraining values within weeks. The percentage of improvement through training depends on the amount of initial instability. Clinicians should treat ataxia by exposing patients to stimulus situations producing increasing body instability in order to activate sensorimotor rearrangement.
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PMID:Postural imbalance with head extension: improvement by training as a model for ataxia therapy. 697 51

A phase I study of 13-cis-retinoic acid was done in 16 patients with head and neck malignancies using a modified Fibonacci search scheme, with individual doses ranging from 20 to 120 mg/m2. Drug doses greater than 60 mg/m2 induced intense headaches, urethritis, desquamative dermatitis, vertigo, and ataxia. The severity of these side effects precludes the use of 13-cis-retinoic acid as a potential chemopreventive agent at doses greater than 60 mg/m2.
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PMID:Phase I study of 13-cis-retinoic acid toxicity. 711 51

The metabolism of an appreciable number of drugs has been shown to be influenced by age. In a study designed to assess plasma levels of clomipramine in twenty-eight patients aged between 65 and 75 years and fourteen patients over 75 years of age and compare them with the levels achieved by a control group of patients aged between 18 and 40 years, the severity of depression was assessed initially and after 7, 14, 21 and 28 days using the General Practitioner Clinical Research Group Scale. Clomipramine was administered in a single dose of 25 mg either in the morning or in the evening. In general there were similar improvements in total score and in individual items on the rating scale in all three groups of patients. More drug related drop-outs occurred in the group of elderly subjects and in extreme age the response to treatment was slower although the end result of treatment was the same as that seen in younger subjects. Some side-effects such as constipation, tremor, ataxia and vertigo were commoner in older subjects.
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PMID:Clomipramine and age: an interaction study. 720 22

An update of our experiences in the treatment of Meniere's disease with intramuscular streptomycin sulfate reveals great success in relief of episodic vertigo. Hearing losses that existed before the treatment are generally stabilized and occasionally improved. Because of the considerable morbidity caused by arduous therapy, prolonged ataxia, and occasional oscillopsia, we recommend that the treatment be reserved for the bilateral disabling form of the disease.
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PMID:Update on the use of streptomycin therapy for Meniere's disease. 721 35

A 29-year-old woman developed severe ocular manifestations of sympathetic ophthalmia on the day after enucleation of a blind, painful eye, and four weeks after a penetrating ocular injury. She was observed for one year with fundus photography, fluorescein angiography, and electrophysiologic tests. Nystagmus, a rare systemic manifestation of sympathetic ophthalmia, was noted early in the course of her disease and was accompanied by vertigo, truncal ataxia, and cerebrospinal fluid pleocytosis. Enucleation and intensive corticosteroid treatment resolved the process; however, she has experienced recurrences in the two-year follow-up period.
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PMID:Sympathetic ophthalmia. 731 33


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